Jamkhed CRHP Village Health Worker

(visit www.jamkhed.org for more information)

The Village Health Worker (VHW) acts as the local agent of positive health and social change. She is selected by her community and receives training in health, community development and organization, communication skills, and personal development from CRHP. Her primary role is to freely share the knowledge she obtains with everyone in the community, to organize community groups and to facilitate action, especially among women, the poor and marginalized. At the outset, many of these VHWs were often illiterate women from the untouchable (Dalit) caste. The concept and utilization of the VHW has been internationally recognized and often emulated for its dramatic positive impact on public health at the community level.

VHW training was designed to empower these often oppressed women by increasing their knowledge, building skills, and demystifying medicine so as to truly put health in the people's hands. The initially high rates of diseases and premature deaths in the area were primarily linked to malnutrition, water-borne diseases resulting in diarrhea and infections, untreated communicable diseases, lack of family planning, and harmful superstitious beliefs and practices. The training these women received opened a doorway for effective, locally-managed and relatively simple interventions to halt this vicious cycle that was causing so much pain and suffering.

The VHWs, working entirely as volunteers, became empowered by learning skills with which to earn a living through micro-enterprise. As community acceptance and trust in these VHWs began to grow so did the health of their villages. As individual villages dramatically improved their quality of life and overall level of health, other villages came forward asking to participate.

Several of the Village Health Workers trained by CRHP have been invited to address international conferences on public health. An example is Muktabai, who became an exemplary health worker and had an opportunity to speak at an international conference held in Washington DC, USA. A bit of her experience is given below: In a huge conference hall in Washington DC, over a thousand participants listen with rapt attention to Muktabai Pol, a village health worker from Jamkhed, India. The listeners include officials from WHO and UNICEF, ministers of health, health professionals and representatives of universities from many parts of the world. Muktabai shares her experience of providing primary health care in a remote Indian village. She concludes her speech by pointing to the glittering lights in the hall. "This is a beautiful hall, and the shining chandeliers are a treat to watch," she says. "One has to travel thousands of miles to come to see their beauty. The doctors are like these chandeliers, beautiful and exquisite, but expensive and inaccessible." She then pulls out two wick lamps from her purse. She lights one. "This lamp is inexpensive and simple, but unlike the chandeliers, it can transfer its light to another lamp." She lights the other wick lamp with the first. Holding up both lamps in her outstretched hands, she says, "I am like this lamp, lighting the lamp of better health. Workers like me can light another and another and thus encircle the whole earth. This is Health for All." The audience rises to its feet in a standing ovation.

Category:

News & Politics

Tags:

• Public
• Health
• Medicine
• Global
• Development
• Rural
• India

[FIREFLYPOWER]

In most cases injustice, oppressiion and economic disparity is based on religious beliefs and culturally passed down superstitions. It is infact a necessity to change such a mindset in the villages even if it does clash with culture and religion. Nothing drastic can be done to bring about the change, but the change is necessary. I think CRHP is on the right track.

[mtvolly]

Indeed, the people of Jamkhed have a strong sense of ownership in all health and development activities and would never say that they are being forced to abandon their beliefs. But, if a snakebite victim is now brought to the hospital to receive anti-venom, which will save his or her life rather than being taken to the village temple where death is almost assured, such change is most certainly welcome.

[mtvolly]

They did this through very simple and culturally appropriate interventions that were largely led by the communities themselves. Sustainability has been a key goal as well and you will often hear the following in the project villages of CRHP, "we would be very sad if the project disappeared but the progress we have made would not disappear."

[mtvolly]

Raj, himself, was born and raised in the same area in which the project was later founded. They were both keenly aware of the cultural context in which they were to work. Their vision from the start was to empower the poor and marginalized to be able to rise to their fullest potential by eliminating such obstacles as malnutrition, caste violence and of course, poverty.

[mtvolly]

You're absolutely right about the need to be careful not to belittle or minimize the traditional belief systems. And again, I'll reinforce that CRHP has never engaged in that type of behavior. In fact, the project has always been critical of that aspect of biomedicine which tends to assign worth on traditional health systems. What's unique about this project is that it was founded by 2 Indian doctors, Raj and Mabelle Arole.

[feldsteen]

The essence here is the ideal of superiority, we create superior/inferior relationship (we supposedly have the answers to your problems), but we don't, we have the answers to our problems, and through this we only build dependency, for example, how long will this organization supply the tools needed? What happens when these tools run out? Will villages be left with stronger strains of viruses, or just have forgotten the ways in which they dealt with the issues before the new implications?

[feldsteen]

I commend the attempt, and at first viewing did believe this to be a great idea, but than comes "outdated superstisions," and "relic" parts of culture, we must understand that these transmit cultural information, and may not be superstitions, but actual beneficial Our part must be one of comprehesnion, instead of superiority (we know how to fix your problems), come on, we can't even fix our own, and yet we think we are so much better than everyone, and can fix their problems

[CRHPJamkhed]

We have also taught them how to detect complicated pregnancies and when to refer these women to our health center for medical evaluation or emergency C-section. This has considerably lowered the IMR as well as the maternal mortality rate in this area.

[CRHPJamkhed]

I'll give you another example. CRHP actually encourages women to deliver at home, as is the custom in rural India. Yet this practice has previously resulted in a very high infant mortality rate due largely to infections and poor hygienic conditions. So we have trained these health workers to conduct safe, home-based deliveries using very simple yet effective techniques to sterilize the sheets, thread, and blades.

[feldsteen]

We must understand that most believe we are living incorrectly, yet no one attempts to solve our problems, in the end, each culture will adapt to the changing circumstances.