Understanding the causes of health problems in women and working towards preventing them
Dr. Shoiba Saldana a practicing gynecologist who also is well-versed with sexuality and reproductive health issues conducted the session. She also physically examined and went through reports of women who had suffered different kinds of problems. The key take home messages of her session were:
- To eat well: A lot of the health problems women face including the severe anemia in Raichur can be prevented by eating well and eating the right kind of food. However, women had gotten used to visiting doctors and seeking injection and consuming tablets which only increase their health problems. As an illustration she showed the medicines brought in by one of the women from a local doctor for ‘gas’ problem. She said that the doctor had given her two tablets and one tonic for ‘gas’ where only one tablet was adequate. And the fourth tablet was for body ache which actually increased ‘gas’. This helped the women to understand their own preference for ‘cures’ as against preventive measures. She listed the kinds of foods that will help to fight infections, support well-being
- She also brought in gender norms, preferential treatment for sons and early marriage for women’s poor nutritional status.
- Importance of menstrual hygiene in preventing infections.
- Sanitation: She explained the connection between anemia, malnutrition and open defecation. She explained how worms from feces get into the stomach and eat away all the nutrition. So sanitation and toilets with water facility was very important to ensure women and children’s well-being.
- She also emphasized the importance of not hankering after hysterectomy as a way of ‘getting rid of problems’ and explained the role and importance of a uterus in a woman’s life beyond having children.
The session was greatly appreciated as women could get their personal health issues sorted and clarified particularly from a woman doctor. They felt convinced particularly about eating right, not visiting the doctor repeatedly and about getting toilets constructed.
Community Health Workers
Our health in our hands – An Initiative in primary health care
Existing in extreme economic depravation Dalit women carry the burden to domestic responsibilities, production within the unorganized sector and reproduction in the domestic sphere. Their social and economic status necessitates a condition of premature and repeated reproduction and production, which result in life long conditions compromised health status. Caste and patriarchal relations and unequal distribution to resources dominate the lives of women agricultural labourers and labour relations. The onset of malnutrition, anemia, and exposure to toxic pollutants within their living environments set the stage for decreased immunity and repeated infections throughout the course of their lives while their economic vulnerability and responsibility of caring for their children demands that they work outside the home in highly unfavorable conditions with regard to their health status. Women agricultural labourers inhabit the lowest rung in the socioeconomic ladder and vulnerability to economic crisis and acute poverty due to the seasonal and low paying nature of their occupation. With neither favorable living nor working condition we have found increased morbidity, joint pains, weakness, high anemia. Malnutrition, decreased overall sense of well being stress, health problems related to pesticides used in the fields etc. Due to the State’s withdrawal from the social sector the constitutionally defined responsibility of the state to provide basic and necesary health care has been sidelined and the impact of faltering and nonexistent basic health care facilities falls heaviest on the backs of Dalit agricultural labourers. The Primary Health Center’s are unable to meet the needs of a chronically sick population of economically distressed women. As the health care system becomes increasingly privatized, inaccessible, unaffordable and malfunctioning the conditions of limited access to clean water, lack of sanitation of facilities, and back breaking demands of women’s work create a situation of health crisis.
In this context 16 women from 7 different villages came forward to volunteer and work a community health workers. In the last 6 years they have been taken through an extensive training on all matters related health particularly the use of herbal medicines, knowing their own bodies, knowing illness and factors causing illness, preventive health etc. Initially the work of the women includes taking up the an herbal garden in different villages coupled with sensitizing the women I the connection between nutrition, hygiene and health. Using the slogan “Our Health in our Hands” the Aarogya Karyakarathas have become healers for their community alleviating the most common ailments using local plants. These karyakartha have also been spreading the message of the herbal medicines and things like that. They have learned a lot about the body and the diseases that effect in. Looking at women’s health not merely as treatment of illness but rather as an interaction between lifestyle, living and working conditions.
Some of the inputs that went in training them are
• Preparation of medicines for common ailments from locally available herbs;
• Understanding causes for Illness and remedies focusing on women’s issues
• Training on understanding Women, gender and health
• Menstrual problems and development of pregnancy
• Participation in health campaigns
• Exposures to different places to learn about community health
• Participation in national health assembly
• Training in snake bite treatment organized by CHAI
The women now run a weekly clinic to counsel and heal people with illness. Every Thursday during the weekly village market day in the Pothnal village, the clinic runs in the office of the JMS. The weekly clinic has become well publicized among the local populace of the poor. The average number of people they that are recorded every year are about 3000. People of all castes come to be treated when the allopathic method fails to successful address many of their health concerns. Menstrual issues like white discharge, irregular menstruation, virtiligo, kidney stones, gastric issues, ulcer, jaundice etc arc some of the treatments offered effectively in the clinic. There are successful stories of healing in about 50 paralysis cases and over 50 vitiligo cases. The women also exhibit and sell their herbal products in the exhibitions organized by government or other agencies. The products include pain oil, skin oil, aloevera oil for hair, choornam for cough/respiratory problems, aloe-vera toinic for anemia, medicine for paralysis/stroke.
Namma Arogya Namma Kai-yalli : Our Health in Our Hands
A Brief Note on the Health Workers of the Jagrutha Mahila Sangathan, Raichur.
Prepared by: Mita Deshpande
PhD Scholar & JMS health work facilitator 2000-04
The Jagrutha Mahila Sangathan (JMS) is a collective of Dalit women Agricultural Labourers in rural Raichur, Karnataka. This women’s organization works in the areas of basic rights, access of Dalit communities to state processes and programmes, issues of caste and gender inequality and dignity, health, education and livelihoods. The two pronged strategy of the collective since its initiation in the year 2000 was to work with the perspectives of both Sangharsh and Nav Nirman (Struggle and New Creation/Construction) i.e. to work on issues of basic rights and justice as well as creating new constructive processes that improve life conditions.
The work in the area of health also moved along both these axes- Struggles for health rights and access to care with dignity at government health services, anganwadis etc. as well as creating a team of health workers to address primary health care needs. Gida Moolike Aushadhi or herbal medicines have been a part of the health culture of the region, however this was a neglected space with the dominance of the allopathic systems of medicine. The Sangathan felt that the health workers of JMS should be trained in traditional health knowledge systems and should work by reviving this system. Several trainings and workshops were conducted and field trips organized to different training centres in Karnataka and women gained knowledge, ease with working with the medicinal plants, skills in medicine preparation as well as a sense of new identity as a health worker.
Women participated in trainings of various kinds- Building perspectives on a holistic and comprehensive understanding of health and well-being and analyzing the social determinants of health, identifying and understanding properties of local medicinal plants, practicals in making of herbal medicines, workshops to understand our body, communicable diseases, basic rights regarding health services and most recently trainings on community mental health and well-being etc.
Health workers worked to address primary health care needs and began with a focus on health needs and issues of agricultural labourers. Joint and muscle aches, skin conditions of all kinds including eczema, respiratory problems, fevers and general weakness and anemia were some of the key illnesses they focused on. They also addressed women’s reproductive health concerns such as white discharge, menstrual complaints etc. Pain oils, skin oils, blood purifying decoctions, strength giving iron tonics and a variety of churnams were prepared. Women worked with people in their respective villages and every week two health workers would run a clinic at the JMS office on the market day as people from several villages all around would visit the market and had access to the clinic.
For examples of the kind of health knowledge that was revived and practiced, please read the report.