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In Photos: Poor Healthcare Facilities In This Village Endanger Lives Of Mothers & Babies

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By Rajkanya Mahapatra

“My mother-in-law passed away a while ago. So the task of fetching water has fallen upon me. My stomach aches all the time from carrying heavy pots.” says 22-year old Mamata, who is five months pregnant.

Reality hits us hard every time we dare to seek it. We live in an India today where the rich continually grow richer, and situations continue to worsen for the poor. The aim to achieve a double-digit growth rate seems a highly misplaced priority when the country has been, for years now, consistently ranked high on having the largest number of infant and maternal deaths and poor conditions of living for pregnant women like Mamata.

We lose 167 mothers per 100,000 live births. 1.05 million babies die every year and out of this 56% of them don’t live beyond the first month. These deaths are mostly preventable and happen due to lack of clean water, adequate sanitation and poor hygiene practices. If the above numbers, fail to get you to understand the gravity of the situation, let me try and show you what apathy looks like.

According to World Bank classification, ours is a low-middle income country. Our expenditure on health care is not just less than the rate at which our economy (7.1%) is growing we spend less (4.05 % of GDP) on our health care than those countries who rank below us when it comes to income. Nepal spends (5.32%) more on healthcare than we do.

How long will it take for things that matter to take precedence over issues of a nugatory nature? What does growth mean and who is it for, if millions of young Indians die even before they’ve lived a month? Mothers and children continue to die because not enough resources are being invested to improve the infrastructure of primary and community healthcare facilities in the country, especially in the rural areas.

Here are some poignant images of healthcare facilities in Nizamabad, Telangana, which show how citizens have to settle for what’s available partly due to poor infrastructure and hygiene practices and partly due to the unavailability of essential facilities as well as the shortage of trained medical personnel.

P. Kaveri. Mother of 6 day old baby in Special new born care unit,Area Hospital, Banswada.District: Nizamabad

P Kaveri with her nine-day-old son in a newborn intensive care unit at an area hospital in Nizamabad. Her son was born with jaundice and was placed under phototherapy. The attendants and staff ensure that the hospital premises are clean, but the damp on the wall in the monsoons puts the unit at risk for mould-related andrespiratory diseases.

Satyama is 36 years old. Cleaner. Primary Health Center. Tadwai, Errapahad. Nizamabad District.

K Satyamma is a caretaker at a Primary Healthcare Centre in Nizamabad. Due to insufficient funds and a shortage of staff, many at such small health centres take on multiple roles in, as opposed to area centres which have designated staff. “I sweep the floors here, but I also assist the midwives with deliveries. I administer the enema, clean the  newborns and anything else that’s asked of me.” Any gap in the personal hygiene of the attendants can often place the patients at risk of contracting infections like sepsis or tetanus. 

Swarupa, the mother is 24 years old. Niharika is the baby daughter who is 3 months old.Primary Health Center. Tadwai, Errapahad. Nizamabad District.

24-year-old Swarupa is the mother of three-month-old Niharika. Instances of anaemia due to lack of WASH and adequate nutrition are very high among Indian women. “I was anaemic. So we had to buy two bottles of blood at ₹3000 each at the time of my delivery. My husband earns only ₹5000 a month.” Swarupa doesn’t have a toilet at home and goes out to defecate. “We would like a toilet at home but we live on rent, and the landlords aren’t letting us build one.”

Sudha Chakravartula. Surgeon, gynaecologistArea Hospital, Banswada.District: Nizamabad

Sudha Chakravartula, a surgeon at an area hospital in Nizamabad, washes her hands after delivering a baby at a station equipped with elbow taps. Hand hygiene is critical for reducing maternal and neonatal infections and mortalities drastically.

B. Mamata is 22 years old.Primary Health Center. Tadwai, Errapahad. Nizamabad District.

22-year-old Mamata is five months pregnant. She lives in Tadwai Mandal in the Nizamabad district of Telangana. “My mother-in-law passed away a while ago. So the task of fetching water has fallen upon me. My stomach aches all the time from carrying heavy pots.”

Fatima and Padma. Fatima in white. Labor room.Area Hospital, Banswada.District: Nizamabad

Fatima, a staff nurse; and Padma, an auxilliary nurse midwife, stand in a general labour room at an area hospital in Nizamabad district. Colour coded bins for waste segregation and other facilities that are at par with expensive private hospitals exist. Right opposite the general labour room is the Septic Labour Unit where pregnant women who are HIV-positive are admitted. In this unit, both the staff and patients need better hygiene facilities, but the maintenance of the room is poor due to the stigma associated with HIV.

Aruna.B. Sub Center.Chitayal, Errapahad. Nizamabad District.

Aruna, an auxilliary nurse midwife worries about the weak monsoons and depleting groundwater resources in a remote village in Nizamabad district. “Water is crucial to the delivery process. Especially after administering enema to facilitate the birthing process. Where will the poor mothers go without water in the toilets?”

Peer Amma is 45 years old. Her Grand Daughter is 20 mins old. Area Hospital, Banswada.District: Nizamabad

A 20-minute-old boy cradled in his grandmother’s lap in an area hospital in Nizamabad. The boy is swaddled in a grubby cloth brought from home while the family waits for the mother to be shifted to the ward from the operation theatre. “We presumed that wiping the baby with a wet cloth, and not bathing the mother (because of the stitches from a caesarian) for the first week was all right. If the healthcare staff teaches us otherwise, we are willing to change our ways.”

Primary Health Center. Tadwai, Errapahad. Nizamabad District.

Medical waste is often disposed in a well behind the Primary Healthcare Centre (PHC), increasing danger of ground water contamination in the vicinity.

There’s much work to be done towards ensuring water, sanitation and hygiene (WASH) at healthcare facilities across the country. It’s time the government takes concrete steps, be it collaborating with non-governmental institutions, investing more, and paying extra attention to the state of healthcare facilities across the nation, if it indeed wants to achieve the Swachch Bharat target of a cleaner, healthier India.

With inputs from WaterAid India

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Image credit: Ronny Sen/WaterAid
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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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