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How To Control Pandemics At The Grassroots Level? Decentralisation.

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We are living in the 21st century, the century of climate change. With the rise of mean global temperature and anthropogenic activities, the population of disease-causing vectors will also increase. These vectors are carriers of many deadly diseases like diarrhoea, dysentery, plague, Nile virus, cholera, chikungunya, dengue, Covid-19 etc. According to IPCC’s Special Report on Global Warming of 1.5ºC (October 2018), there will need to be an increase in global forest cover equal to the land area of Canada (10 million sq.km) by the year 2050 to avoid temperature rise by more than 1.5 degrees above pre-industrial levels.

In 2019, atmospheric CO2 concentration was 47% above the pre-industrial level. At present, Earth is under severe pressure due to the emission of greenhouse gases (GHGs). The world is on the brink of ‘household explosion’. The total number of global households are growing much faster than the growth of the world population. The average size of household in India as per 2011 census was 4.8 members per household, while in the 2001 Census the size of household was 5.3. Increasing the number and decreasing the size of households means the same number of people are living in more than one home and causing more pressure on forests and the environment.

Representational image.

The world is facing COVID-19 pandemic. Humans are confined to their homes. This epidemic is destroying the socio-economic framework of nations. It is said that environmental degradation and ecological imbalance are responsible for this pandemic. It is the result of anthropogenic climate change and deforestation. It is said that the disease spillover to humans may increase as the climate becomes warmer. The current human population of about 7.6 billion people is expected to be 10 billion by 2050. Such a growing size will create pressure on our ecosystems. Further degradation of habitats, forests and biodiversity will result in more such pandemics and epidemics. 

Deforestation is making the situation worse and accelerating the transmission of infectious diseases by vector displacement. Such vector animals, which carry viruses, move into regions where they’ve never existed before and increase our vulnerability to diseases. This creates a greater possibility of dispersion of zoonotic diseases like HIV, Ebola, Nipah, Zika, current COVID-19 etc. 

We Cannot Change Our Past But We Can Change Our Future

It is now the perfect time to think about the future we want to live in. Our future planning and development should be able to fight against climate change, global warming, environmental degradation, biodiversity and habitat loss, lethal diseases and economic loss due to anthropogenic impacts of humans on planet earth.

For this, India and the world need decentralisation of health facilities and ‘health democracy’ at grassroots level; especially at the village council level. In India, it will be a big revolutionary step after ‘sanitation democracy’. According to the Liberal Democracy Index, which is produced by the Varieties of Democracy project at the University of Gothenburg, democratic regimes obtain higher scores. For example, in 2015, each of the 36 countries with a Liberal Democracy Index of at least 0.7 had a life expectancy of at least 72 years; and conversely, all 21 countries whose life expectancy was less than 60 years had a Liberal Democracy Index under 0.55. 

Here is a suggestive model by me to control pandemics and epidemics at the grassroots level. At the village council level, in India, health democracy can be achieved through ‘Health Parliament or Village Health Council’. Such Parliament may comprise of villagers, elected village Council Head, village Council’s Secretary, school headmasters, sanitary workers, Asha, Anganwadi, Auxiliary Nurse Midwife (ANM), Doctor of the near Primary Health Center (PHC) or Community Health Center (CHC), revenue officer and representative of the agriculture department. Such Parliament will work on ‘Awareness, Education and Campaign’ (ACE) to establish a healthy society, at the village council level. This Parliament will also be responsible for primary and immediate health services and transfer of serious patients to advanced hospitals for medical help.

Members of ‘Health Parliament’ will work collectively and voluntarily to encourage villagers for sanitation, better health through yoga, use of traditional Ayurvedic medicines, following social distancing, use of masks, immunization and better nourishment. This Parliament will help to ensure high ‘Green Governance’, ‘Carbon Negativity’, ‘Forest Cover’, ‘Sustainable Development’, ‘Household Size’, ‘High Yielding Varieties (HYVs)’, ‘Agriculture Mechanisation’, ‘Agriculture Production’ and ‘eco-friendly society’. This will help to change climate change and fight pandemics and disasters. 

Members will act as ‘Health Ambassadors’ and ensure a healthy life at the grassroots level. Every week, members will organise a ‘health drive’ to aware people and surveys of sick people. Female members will encourage the use of ‘sanitary napkins’ by young girls and women. Doctors will look after the patients, provide the necessary medicines and cause awareness. 

Members will cooperate with ANM, Anganwadi, Asha, government officials and doctors to ensure ‘Clean and Healthy Society’, and will help to bring ‘social and behaviour change’ in daily rural life in every household. ‘Health Parliament’ will help ‘Swasth Bharat Mission’ and District Administration to make ‘Disease Free and Healthy society’ at the grassroots level. It will be a revolutionary step. Globally, this model will be helpful for making a ‘healthy society’. 

The most authoritarian aspects of the Chinese political system is the main reason behind China’s failure to control the famine of 1958–1961, severe Acute Respiratory Syndrome (SARS), HIV/ AIDS epidemic of 2003 and recently COVID19. But, India represents a successful, strong and biggest democratic system at a global level. The democratic system of India will be helpful to make an eco-friendly, sustainable and healthy India. 

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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.

Read more about the campaign here.

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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