By Shreya Jakhmola:
Whiling my time away on the internet waiting for the rains to stop, I came across a short-film titled “ACID”. This 6-minute film brings to light one of the very common, yet a topic of immense importance requiring attention – menstruation. In India, the word has been loaded with all kinds of stigmas and taboos that make it more unchaste than simply biological. The film exhibits a 12-year-old boy narrating an incident, from school to his mother. A young girl of his class, who probably had got her first periods, was mistaken to have peed in her skirt. Having been noticed by her peers, they decided to label her ‘ACID’. Leaving the mother disturbed about what her son and his friends intend to do, she decides to educate him on the matter. Too simplistic, isn’t it? Nonetheless, in reality, it happens more infrequently than it should.
It is not just menstruation that our society is averted to, but most or any issue that relate to sexual and reproductive health. From being considered impious to embarrassing, neither are we allowed to speak about them nor is there any permeable education that is imparted. Recently, however, ad films and movies have become outspoken about such issues making their way through the popular discourse. In spite of the visible change in such matters surfacing through popular culture, a large chunk of the population, especially those from socio-economically backward classes remain unenlightened about the issues related to these.
The importance of educating adolescents, girls as well as boys, of having a healthy sexual and reproductive life cannot be debated. Reported increase in the number of sexually transmitted infections among the Indian youth is a hysterical concern for not just Indian government but also the society on the whole. Many governmental and non-governmental organisations have been working towards creating awareness about these health-related concerns.
One such organisation making ardent efforts to sensitises young people on sexual and reproductive health is Niramaya Health Foundation. Based in Mumbai, Niramaya incepted as a health program of Pratham Mumbai in 1999. From being focused on basic health interventions to promote health in children, the scope of the programme eventually expanded leading to the formal establishment of Niramaya in 2001. With its commitment to ensuring a disease-free childhood and a responsible adulthood, it undertakes many healthcare practices across all health paradigms. One such program run by Niramaya is SPARSH – Sensitization Program for Adolescents in Reproductive and Sexual Health.
Growing into young adults is primarily marked with certain physical changes that occur in the body. At puberty, girls begin to have bodily changes such as breast development and growth of hair in private parts, as well as hormonal changes that cause periods. Boys too, experience voice-change, growing muscles and pubic hair. Acknowledging these changes that a teen body goes through, Niramaya understands the physical, mental and sexual transformations that accompany. These developments lead to hyped curiosity in children that escalate newer levels of needs in them upon their interaction with other social changes. These social changes that are influenced by factors such as urbanisation, media, alcohol and others tend to induce unhealthy habitual and behavioural patterns that need to be catered to in order to avoid unsafe digressions in life. It is not only the expected changes that build up the need for educating adolescents but the alarming increase in sexually transmitted infections in young people, such as gonorrhea and syphilis, of which HIV/ AIDS remains the most prevalent. Further issues related to premarital pregnancy have also been rising. Given the situation thus, Niramaya through SPARSH works with adolescent girls and boys across schools and communities from low socio-economic strata to educate them on reproductive and sexual health matters. It does so by communicating with these kids in innovative and engaging ways. Niramaya health volunteers involve in participatory discussions with these kids to gauge their knowledge on sexual health and improve the anomalies accordingly.
In a recent venture of theirs, Niramaya has collaborated with a group of Harvard students to revamp SPARSH by incorporating ‘Girls Health Champions’ model. Employed to train adolescent girls as peer health educators and leaders, the model astutely tries to disentangle the deeply entrenched issues of gender inequality woven in the Indian societal fabric. Centred on girls, the model is moulded around enabling them with skills of leadership and effective health communication. These health champions are selected at random and trained on topics related to nutrition, sexual and reproductive health, mental health, gender-based violence and similar other areas that are positioned in the curriculum designed by the organisation and their partners. Upon being skilled with the required knowledge, they are encouraged to educate their peers on the same through presentations as well as personal talks. A pre-training and post-training test, at an interval of six months after the program, is taken to assess the levels of knowledge addition as well as retention in these kids. The effectiveness of the model can be explained in terms of the comfort level peers share among themselves to debate and discuss on these topics as often such matters form a part of ‘awkward’ conversations with parents or even teachers. While the immediate goal is to increase the existing awareness among these people, the long-term impact of the model envisions cultivating self-confidence while improving health behaviour and practices in people of the community.
Unhealthy living conditions continue to sweep across the Indian panorama. These conditions further extend to the institutional spaces, especially schools where children from low income and poor background go. Sites of dilapidating buildings, noxious washrooms, and poor infrastructure are very common in government and low-income schools across India. In spite of everyone everywhere wrangling about the importance and its concerns, little seems to be done about actually transforming this insalubrious scenario. However this ‘little’ includes conscious and dedicated efforts by many of the organisations that are working towards improving the health status of the communities around, the one like Niramaya.