After a string of rather frustrating days trying to make year-long plans for 6 village health committees, that is the silver lining we found in our cloud, no offense to quadriplegics intended.
Preventive health work kind of sucks. No one here cares about health, not the villagers, not the health committee members, not really the Chirag staff, and not even the ANMs and ASHAs. Villagers for some reason don’t make enough of a connection between health and livelihood; health committee members aren’t paid so what’s their incentive (their village’s development/improved health is usually not the answer); Chirag staff are just doing their job and doing the minimum to meet their deadlines; ANMs and ASHAs…there’s just no accountability anywhere. And no one has the right information, so even if people are trying to ‘give information’ about preventive health issues, who exactly is going to give it?
Things aren’t always like this, but it’s tough because successes are so small and you have to work so hard for each one. Health is a ‘soft’ development area, meaning its results are hard to measure and it’s not a very tangible issue. Infrastructure, agriculture, forestry – these things can be measured, there are plainly visible outputs for a each input. With health, you talk to 30 families about boiling water and jaundice prevention and are pleasantly surprised when 2 Chirag staff finally decide to start drinking boiled water. Maybe, a year down the line, once Chirag has finally gotten around to translating and printing my jaundice information sheets, a few more families will decide to boil their water. But who can tell what exactly influenced them? Was it my brochure? Did they get jaundice and decide it was something worth preventing? Did their neighbors convince them? Did the husband land a government job that allowed them to get a gas stove? Some combination of these scenarios? I can’t wait until I’m a doctor and have the knowledge to help villagers directly, measurably. Do women here really all suffer from leucorrhea, or is it just the name they give for yeast infections, reproductive tract infections, and other womanly problems? If so, hygiene needs to be the #1 focus. If not, each condition has its own cause and treatment and should be addressed separately. “If you want to change the world, become a doctor or an economist.” I can’t remember who said this to me, but sitting confused and powerless at health committee meetings, knowing Chirag staff are probably giving the wrong information but not knowing exactly what the right information is, it hits me every day how right that person was.
No doubt, I have learned SO much here about how things work on the ground, about NGO culture and politics, and about the failures of government health schemes and certain approaches to preventive health. I also didn’t expect to change the world in my 5 months here – I know these things take years. But for some reason, I didn’t expect to feel so frustrated and unaccomplished so often. The entire system is frustrating sometimes – the villagers, Chirag, government bureaucracy – but there’s usually no way to get around it, at least not at this stage. We’re just interns. Who are we to think that Chirag, let alone the state government, will take our projects and ideas seriously? I wish that wasn’t true, but I don’t see how we could make that happen.
To end on a bright note, as unpromising as our health committee meetings were, the first event in the year-long plan for Aagar gram panchayat’s health committee was scheduled for today, and it actually happened. About 10 people showed up in Banyatal at 8 in the morning to clear the main path of trash, pine needles, dirt, and overgrown shrubbery. It was a small group, but hey, it happened.
