Bal Mandal Childrens Group

In the afternoons we would follow the Bal Mandal Children's group on their usual activities. At DAB it is interesting because the group has been in existence for so long. I met one young man, college bound as well, who joined at age 6 and was a member until age 16. This really creates a sense of community for children. One of the most remarkable and affective aspects of the Bal Mandal organizations, is that it truly fosters empowerment. When I was in fourth grade, there is no way I would have been trusted to administer medicines to sick patients. As a fifth grader, I did not hold any titled positions in a group. In the sixth grade, I was more concerned with fitting into the newly formed cool group than teaching my neighbors about tuberculosis. These children are held responsible for real situations. They step up to the challenge because it is offered. Adults look to them and say, we trust you, we know you can do it, and they internalize that. This builds critically necessary self-esteem at a young age. The fact that the children go around the slum taking care of others fosters the idea of service. Learning from these experiences is invaluable for all young people, but critical for children from the slum. The Bal Mandal serves as a social support network in an environment where families are not always able to provide . These children know how to work together in teams to complete a task. They understand elements of leadership and organization. Most important of all, in a society where they are looked down upon and considered inferior, they know their own worth.
On my first outing with them the project was to clean the waste lanes out. In every slum there is a one foot wide lane cut into the ground, meant to carry water and garbage out of the area. Unfortunately most of these lanes get clogged with trash and sit stagnant, creating a breeding ground for mosquitos. I headed out with a group of fifteen chipper kids ages about seven to fifteen. They paraded through the alleyways armed with sticks of wood. When we reached a particular area they set to work. The president, a tomboy of about twelve, assigned each child to one section. They furiously dug out the clutter, dumping piles of fetid litter along the sides. (VIDEO) For the whole afternoon they cleaned out garbage lanes, calling attention wherever they went. Everyone in the slum knows about the Bal Mandal group and respects them and their work. The kids were beaming with pride when we finished the job.
The next day the mission was to visit the elderly. In each slum, some older people living alone have been targeted by Asha. They are provided with relief in the form of food and basic goods. The most valuable donation however, are these visits from a group of children. We approached a particularly small home, just a single room with no outer decorations. Ranjina entered first and escorted out a sweet eighty year old woman. She sat on a bench and the kids surrounded her. She spoke to them, held Ranjina's hand, and encouraged Madeleine and I to come sit next to her as well. We learned that she had had eleven children. Five daughters had been married off and were now only obligated to their mothers in law. Her six sons had all passed away. If it weren't for Asha, she would be lonely and unhealthy.

STD Survey, DAV

In the mornings at DAB, we did a survey on Sexually Transmitted Diseases. We were stationed in the main Asha building in the slum, and women were recruited to participate if they had any questions relating to personal areas. It was difficult to manage the survey, since neither Madeleine nor I speak Hindi. We had Rani, the regional leader, and the team leader of DAB working with us. The latter however, did not speak very coherent English. She also was not very patient so we would ask her to explain something and she would answer curtly yes or no which did not adequately respond to our inquiry. We learned the questions in phonetic Hindi and I was able to pull most of them off rather well. The downside is that coupled with my Indian looks, naturally the patient would assume I spoke fluent Hindi and would launch into a babbling explanation. I would just have to listen for key words, and then ask them to repeat to the translator. Another issue is that many of the women, understandable, assumed were doctors. One afternoon on a Friday a woman came in with fever and pain, but we had to reluctantly explain that we could not help and that the doctor would be in on Monday.
We asked them about excessive discharge, pain during intercourse, any unusual lumps or bumps, abdominal pain, any abnormal periods, and finally referred them to Ranjina for a breast examination. The majority of women experienced pain in the lower belly area. We would then write out a referral slip for Doctor Sharmila in the Asha Center Polyclinic. Many of them also had symptoms of STDs, Pelvic Inflammatory Disease, and Urinary Tract Infections. Yeast infections also are common in the conditions here in India. It is always hot and humid out, and people do not use toilet paper, instead they rinse off with water, leaving a warm, moist environment which is ideal for bacteria to grow.
It upset me to see how many women had suffered and had nowhere to ask for help. A few women had suffered from symptoms for a year or more! During one breast exam, a lump was found the size of an apple on the side of her chest. She said she had endured it for ten years. Fortunately it was benign, but the idea of just living with such a growth without having it looked at for a decade, blew Madeleine and I away. The Asha women explained; if there's a problem with the husband, its a huge deal and everyone gets upset, same reaction if a child, particularly a male child, has some affliction, but a woman's problem, they gestured, is pushed under the rug.
We surveyed about 120 women during my time there, and a rough estimate would be that at least 75% of women were recommended to the doctors clinic. It was frustrating not to be able to follow up on the diagnosis of the problems. A couple women we overlapped with during our shadowing hours but not many. Another huge problem is that obviously for the treatment of an STD, both partners need to participate. Logistically, many of the men work during the morning hours when the clinic occurs, and culturally, the men often assume it is the woman's problem and she should fix it alone. The disease then is perpetually passed back and forth.
It was a nice environment to work in, all women, working for women's health. It was interesting to be immersed in the Hindi language. In some ways I learned a lot from trying to decipher the exact problem in my limited Hindi. At the same time it was so frustrating not being able to fully communicate. Madeleine and I were saved from any awkwardness regarding the questions since we did not understand word for word what we were saying. Most of the women were quite willing to be honest about their situations. The Asha women clearly helped create a comfort zone where talking about such ailments was safe.

Adolescent Girls, DAB

Next the adolescent girls came in. About twenty girls aged thirteen to twenty one streamed in wearing a variety of colors in both Indian and western styles. They introduced themselves to all of us, name, age and school class. Unfortunately several of the girls had dropped out. One girl had suffered from an eye condition and had left school for awhile. When she convalesced however, she was not allowed to re-enter school. The is an absurd policy that if you do not attend school for a certain amount of time, your name is crossed off the list and cannot be added. Another girl who left after sixth class had had to care for her family. It is not uncommon for an elder sibling to essentially raise their brothers and sisters. For example we met one girl who sold chapatis on the street of the slum all day for money to survive. Her mother had left with a man and she was in charge of raising the family. Another girl's father was an alcoholic so she had to provide for the family. The only option for these girls to continue their education is for them to participate in a program called Correspondence. A student is enrolled, given schoolwork, and graded on completion. There is no actual teaching available. Asha is working on helping some girls get back into the system but for now they are encouraged to learn a trade. One girl sews to make some money during the day. Overall the situation of girls in the slums is in some ways the lowest of the low.
On the bright side, one young woman, Vinita, is going to college! She is a very petite girl, hardly reaching my shoulder, who just began the very challenging course of economics at Delhi University. She speaks the best English by far of the group and I'm sure will go far wit her ambition and commitment. Other girls have ambitions to join the air hostess academy, to be a teacher, or, somewhat in jest, to marry an American man and go to the US. It is so important for these girls to see their peers and even myself and Madeleine as role models for what a girl can do.

The next day, we began our health classes with the girls. We had them write down on a piece of paper any questions they have relating to health education, so that they would not feel shy. Dr. Krishna translated them for us. The girls had a lot of interest in HIV/AIDS, as well as the menstrual cycle and pregnancy. Our first class addressed menstruation. We explained the ovulation cycle using print outs as well as the white board to illustrate what occurred. Then we addressed the social side of it, something which is crucial to be culturally sensitive about. Traditionally here, when a woman has her period she is considered to be dirty. She is not allowed in the kitchen to cook or in the temple to pray, and is generally shunned until it is over. We explained that menstruation is a normal part of being a woman, and does not make you unclean in any way. We then went over how best to keep clean and dry during this time. Sanitary pads are too expensive for some, so they use a cloth which they wash daily. We next explained what a tampon was. The girls were shocked. They had never seen or heard of this before. They winced as we explained how to use it, and were convinced it was either painful or would get stuck. One girl, Anjum, did most of the talking in her strong, low voice, as the other girls giggled or whispered to her what to ask. It was a really interesting moment of cross cultural difference mixed with the commonality of all being young woman; we shared a lot of laughs.

Doctor Ambedkar Basti

Madeleine and I decided somewhat reluctantly to move to a new slum called Doctor Ambedkar Basti, DAB. We were swayed by the opportunity to teach health education. I had worked for 4 weeks at Zakhira and while I was hesitant to leave my students who had finally opened up to me, I was also excited to expand upon my experiences with Asha. We were promised a female translator who could sit with Madeleine and I as we taught important health lessons to a group of adolescent girls.
Another intriguing part of Ambedkar Basti is that it is one of the very first slums Dr. Kiran entered twenty years ago. Madeleine and I were welcomed again with a wreath of marigolds draped around our necks and flower petals were tossed around us.
Paul acted as our translator as the Mahila Mandal gathered in front of us on the floor. We introduced ourselves, Mera nam Lali hai, Mein American se huun, me bis salki huun (spelling is probably atrocious) but that generally means, my name is Lolly (spelled the Indian way), I'm from America, and I am twenty years old.
We met the president of the Mahila Mandal, a few Community Health Volunteers, the Asha staff, some of whom live in DAB, and the regional director of several slums. It was fascinating to ask the women about their lives before and after Asha became a presence. Ranjina, an elegant, extremely intelligent woman who has since moved out of the slum and is now an employee of asha explained that she was about twenty years old when Dr. Kiran came to DAB.
She, like many of the women present, had moved from her village here when she got married so that her husband could look for work. The women explained that "where your husband is, you are". It is traditional for the wife to move in with her husbands family and be obedient to their demands. Ranjina was married at the age of ten years because her older sister was getting married at that time. Luckily they came together to DAB. Many of the women were officially married at very young ages, lived at home for a few years, and then moved in with their husbands as a teenager. Child marriage is gradually decreasing in prevalence here but it still exists. One generation ago it was the norm. In Zakhira I met a woman who had been married at the age of five, although she didn't move in with her husband until age 13. I asked how far in education the women had reached. No one had gotten further than fifth class and some had left even earlier. The role of women is very clearly a domestic one. Only in the current generation are there beginning to be signs of change but overall the patriarchy in traditional communities is smothering.
The women described the conditions of the slum twenty years ago. There was a significant Cholera epidemic going on. People suffering were not given water because it was believed to make the disease worse. Sadly, this lead many victims to die of dehydration. There was intense flooding and peoples homes would basically disintegrate during the monsoon. Dr. Kiran Martin then entered the scene and was appalled by the conditions these people were living in. She went to the local slum lord and requested permission and assistance to treat Cholera patients. She was given a single table to work from, and began addressing the ailments of the poorest of the poor. She realized that she would need the help and support from the community she was working in. The first Mahila Mandal, womens group, was established by some of the women who sat in front of me that day. Some volunteered to be trained as Community Health Volunteers, assisting Dr. Kiran with the numerous Cholera patients. Others agreed to be in charge of several areas of DAB and looked after the health of their neighbors.
I asked how the women's husbands felt about them joining such a task force. I was curious as to how the men would react that their wives were working together outside the home, exercising their first bit of independence.
One woman, her name is Asha, is a licensed midwife. She is a striking character, filled with a wry sense of humor. She has a dull face with bright black eyes and a witty smile. She bragged about her skill at delivering babies, even offering to be present for Madeleine and my pregnancies if we would buy her a ticket to the US. We all appreciated this bit of light heartedness after discussing such grave issues.
A former CHV remained quiet during most of the meeting. She is a bit chubby, with sunken eyes behind round glasses. We eventually got to hear her story, which was remarkable. At the start of Asha she had been very involved in the community. Gradually however, she lost faith in the cause, lamenting the tragedies of the slum and stopped working for Asha. Unfortunately, she was diagnosed with cervical cancer. This often fatal disease afflicted her at a time when she did not have many people to depend on. Ranjina and Rani and the other Asha women were there for her. Many diseases in the slum carry stigmas with them as they are not properly understood. When she became ill her own family was not there to support her, but Asha was. Thanks to the best medical treatment arranged by Asha and Dr. Kiran, she has fully recovered and has now redoubled her efforts working for this incredible organization.
We allowed the women to ask us some questions as well, though I was fascinated by their experiences. They inquired about the usual; if we were married and how many siblings we had. When the meeting ended I was stunned at the tranformation these women had been through and created. If there is such a thing as a dream come true, this is it. Ranjina studied for a particular exam in order to get a job and scored one of the top marks. She since has moved out of the slum with her children and dedicates every day to Asha as an employee.