Maternal Mortality Highest in India – New Ambulance Service Helps

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By Alka Pande, Womens Feature Service

“Tens of millions of women never get to experience the joy and beauty of childbirth, which for them is filled with dread pain and sorrow”. This was an observation made by Melinda Gates, the co-chair and trustee of Bill and Melinda Gates Foundation, after she visited the rural women of the north Indian state of Uttar Pradesh (UP) recently.

The UNICEF puts UP at the top of the table in terms of maternal mortality, with a woman having 1 in 42 lifetime risks of maternal death. Yet, in a corner of this most populous Indian state, women are working to address their problems.

In Shahgarh block of Chhatrapati Shahuji Maharaj Nagar district (earlier known as Amethi) pregnancy is no longer associated with anxiety, as it was in an earlier era. The villages here have an ambulance service exclusively for ferrying expectant women to the nearest medical centre. The facility costs just Rs 6 or 7 (US$1= Rs 46.7) and what makes this service that began six months back so special is that it was initiated and is being managed by the local women.

Concerned with the poor quality of education in the local primary school, these women have also set up their own school in the block two months back. The fee is fixed at Rs 50 a month and over 100 students have enrolled in it. The teachers, who have been trained by professionals in Rae Bareli and in Mysore, Karnataka – they were taken there on an exposure visit – are also drawn from within the community. In fact, a few village women have started attending the school as well.

Who are the women behind these developments? Members of Self Help Groups (SHGs) under the Rajiv Gandhi Mahila Vikas Pariyojna (Rajiv Gandhi Women Development Programme). They have been able to bring about a revolutionary change in ordinary lives in Rae Bareli and Amethi, the parliamentary constituencies of the Congress party chief Sonia Gandhi and Congress youth leader, Rahul Gandhi, respectively.

The programme was started by the Rajiv Gandhi Charitable Trust in these districts in 2002. In four years, 5,000 SHGs have sprung to life. Today, the Rae Bareli, Sultanpur and Chhatrapati Shahuji Maharaj Nagar districts have 19,000 SHGs – with an average of 13 to 14 members. Of the three million women here, over 10 per cent are a part of this process. In spite of a literacy rate of just 33 per cent, these women have been able to come out of their homes and get involved in income generating activities, such as agriculture, cattle rearing, education, health programmes, solar energy social risk management and many other micro-enterprises.

In the process, they are also developing commendable leadership skills. “Earlier, I could not dare speak with the district officials. My hands used to tremble when I was asked to write my name in front of a bank officer. But, recently, when I went to Lucknow to meet some bank authorities I felt no hesitation in interacting with them,” shares Rajpati Vishvakarma, 35-plus, from Shahgarh block.

These SHGs have become the new draw in the Hindi heartland. Their success has invited the attention of several high profile visitors this year, including Microsoft Chairman Bill Gates, former British Foreign Secretary David Miliband and Congress Chief, Sonia Gandhi. In fact, the purpose of Gates’s visit was to learn how a successful SHG functions.

The women are not political activists but they are enthused by the social interventions of Congress Party General Secretary Rahul Gandhi, whom they affectionately call “Rahul Bhaiya”. Gandhi holds regular meetings with them, occasionally shares a meal, and at times even stays over in their homes. In fact, the project office in Rae Bareli proudly displays a picture of Gandhi sitting on the floor with the SHG women, holding a meeting under the light of a solar lamp.

But despite being in the political limelight – or solar light, as the case may be – Rae Bareli and Chhatrapati Shahuji Maharaj Nagar still figure in the list of backward districts of the state. Agriculture, animal husbandry and small scale industries are the main sources of livelihoods here and something as basic as power supply comes in the day time during one week and at night the following week.

However, instead of focusing on promoting large industries to usher in prosperity, the development model here is rather unique. The emphasis is on empowering women. Explains Kaushal Vidyarthee, Programme Officer, Rajiv Gandhi Charitable Trust, “The essence of these SHGs is that the focus is not on income generation activities alone. The aim is to make the women stronger by uniting them and by giving them information on their rights to education, health and other welfare schemes of the government. Once they are united and aware, there is social cohesion, which enables them to bring development and enhance delivery.”

Take Vimla Ahirwar, 42, secretary of the Village Organisation (village-level federation of SHGs) in Babina block of Jhansi district (Jhansi is a beneficiary of the Rajiv Gandhi Mahila Vikas Pariyojna). Initially, the men of her Ghisauli village resented her power. They came to her bi-monthly meetings drunk, creating brawls and calling the women names. “I found myself helpless in dealing with these men but later I talked to women members of the SHG, gathered their support and then led a team of over 100 women to the local police. After much persistence, the police official agreed to our demand to intervene and from the next day there was regular police patrolling during meeting hours. The village men then not only stopped disturbing the meetings, many of them even gave up on drinking or at least reduced their consumption of alcohol,” recalls Vimla. She adds proudly, “Now we are not afraid of anything or anyone. The officials listen to us and do whatever needs to be done in the village.”

The SHGs have also brought economic stability in homes. Young Kulsum Yadav’s husband was earning only Rs 500 as a private school teacher in Dinsha Gaura block of Rae Bareli. High school pass Kulsum joined her local SHG and took a loan of Rs 500 for tilling a small piece of land and Rs 4,000 to buy two buffaloes to start a dairy business. Both her ventures went well and this helped her borrow Rs 50,000 for her children’s studies. Today, her eldest son is doing B.Sc., the second one is doing a computer course and the two young ones are in high school and intermediate. “With my business I am earning enough to slowly repay the loan. I could not study beyond high school but my children are studying and will get good jobs. I feel happy,” says Kusum.

The programme aims for community involvement at all levels – from identifying the poorest of the poor families to forming groups. The programme staff is there to train the community and supervise their growth. Dedicated professionals like Sampath Kumar, the Chief Executive Officer, an IAS officer from Andhra Pradesh cadre, who is here on deputation, are quietly spearheading change. People like Vidyarthee, an Oxford University research student; A.S. Gehlot, the assistant project manager; or Laxmi Prasanna, the training manager, prefer to let their work do all the talking.

The project has recently been expanded to 17 more districts of UP where 6,500 SHGs have been formed. “The aim is to cover all 820 blocks of each of the 72 district in the state,” says Vidyarthee.

Change is in the air in the rolling plains of India’s largest state. And it is women who are making it possible.