 So, I am going to increase this experiment. So, my name is Yindan. I am from Irvinea and we are really looking forward to hearing your answer. Thank you very much. Hello, I am Shoma Mukhopandhai from West Bengal in Eastern India. I am doing research on the traditional midwives of Bengal. And I want to share my research experience which I am researching since 1996. And I have a lot of experience about this poor, brave women of our country. So, I want to share with you and after my presentation you can ask my question. Okay, let's go to the next slide. A friend is in need is a friend indeed. This is a very common proverb you know and this proverb is very much applicable to the women folk of rural India who are near livelihood through midwives easily known as guy or the hind. And they have been doing all the work related to child birth for centuries in exchange of nothing but they live in financial crisis and face social problem. In present time there are many researchers who are working on exploited marginal people but very few took interest in our traditional midwives and their profession. So, the time has come to reassess their role and importance. And I just tell you the history of the midwives ring. And midwives ring is one of the oldest, oldest professions of the world in Gilgamesh and ancient epic of Siddhika 2000 BC. We found the existence and important social position of the midwives. As far as India is concerned in their treatise the two MNN Indian physician Charaka and Shusrathu also mentioned the respectable social position of the midwives that is midwives. And now we consider midwives as professionals who are who cut umbilical cord and clean the line in room but during the days of Charaka and Shusrathu the concept was totally different. Charaka and Shusrathu Samgita we don't find the mention of a midwife in connection with delivery system. We found the difference of a good number of female attendants having some important qualities like who are multiple affectionate, constantly attached to the lady, well mannered, resourceful, naturally disposed to love, free from grief, tolerant of hardship and equitable and they are helping the pregnant woman during the time of the delivery. Then what about the midwives or the dhatsi in Sanskrit and dying in our kalukal language? Charaka and Shusrathu instructed to call a midwife after 11 days of style bath only to best fit the newborn. According to them the midwife or wet nurse not only would come from a higher caste family but also used to be young, beautiful as used to process a good moral character. The duty of a midwife during this period it is clear from the above discussion that the duty of a midwife during this period was limited to best fit the child and that is why she known as Dugdodharthi or the wet nurse. We don't know their salary but for negligence she was punished and this is known from the Arthusastha of Kothilu the classical writer of ancient India. In view Kothi's history we have noticed how the duty of a midwife gradually changed and you know the name of Kalidasha, Bhanavarta and Bhavabhuti they are classical writers of ancient India and in their writings we have noticed the changing social status of a midwife and how she became a governess of the child. And then we have noticed that it is very strange to understand that when and how this function gradually associates itself with the woman of the lower segment of the society. It seems to us that according to the rigorous instruction of the harmonical society of late medieval period the higher caste women abandoned the profession of the midwife. This was no doubt very unfortunate but one thing is very clear that at the time the midwives never faced any professional hazard or struggle for existence. They were all gradually accepted by the society for their incompetent role during the childbirth. The actual professional crisis of the midwives, mainly the traditional midwives started from the colonial period onwards. In the first half of the 19th century the Christian missionaries who blamed the native midwives and the prevailing system of delivery for the high rate of maternal mortality. In the literature of the a clearly addressing the traditional midwives as dangerous guide as guide stands from the traditional midwives. In the mid of 19th century after the establishment of medical college hospital in Calcutta in 1935 the British government wanted to introduce western medical practices in childbirth. For that purpose midwives training program were organized to develop trained midwives. In this trained situation the traditional midwives in Dengol mainly I put my emphasis on Dengol. Dengol faced a very serious crisis because which is government most of the training program of the British government required knowledge of English and regular attendance. And the traditional midwives or guide were also fearful of losing their job as most of their clients were satisfied with the indigenous system and would never have allowed the western medicalization of childbirth and their most of the midwives were illiterate. So, they do not follow the course the English course of their time of the training of the midwives. So, they started this is the crisis in their professional in their profession and unfortunately our newly educated women of this period also agreed with the view of the colonial state and they wrote a good number of articles in support of replacing the midwives with functional midwives or the trained midwives who are coming from the families of very well-to-do families or most of them are widows or Anglo-Indians etc. And thus began this struggle during a time considered an age of female empowerment to sustain this traditional budding communities. And it is very interesting that and on one hand this English educated women saying about economic empowerment of the women of our country and on the other hand they want to stop the midwifery the traditional midwifery and without knowing that this is the complete earning of the of the poor our poor great sister. The midwifery was their only earning. So, and we have a good number of records that some doctors that some very well end doctors like Jyudinath Mukhopadhyay or Damondash Mukharji who wrote a good number of book to train the traditional midwives and side by side they go to the villages and starting training of the traditional midwives or the native midwives and they said that without their training we could not take the maternal mortality because most of our Indian families or Bengali families depended on the traditional midwives. This is the system of the colonial period. Next the I have concentrated on the midwives of Bengal and there was a hope that the situation might change after India's independence in 1947. But then also we find nothing but the literacy of the colonial era. There are some so-called training programs for the guys but again these were not satisfactory and this was more or less the deputation of the colonial system of midwifery training and the guys though sometimes they are very benefited by the by this training but this training cannot touch their heart. They say that they do not want to know about the anatomy but they want to know about the training from the deep core of their heart and they know that they know something about the anatomy according to their own experience and they want to change the experience with the doctors who giving their training but the doctors doing a routine work that they started the training and it is a training of most probably 10 days and after the 10 days they stop the training and they give a certificate or some money and dies this to them and allow them to just practice and sometimes they are given a job in some primary health centers at a very low cost salary and sometimes they had to remain unpaid month after month due to the lack of the regular public of the funds very recently the government has discontinued the training program saying that the guys are not suitable for delivery now they want more and more ANN and GNN but without training a good number of rural midwives who are practicing in the rural areas and who are the only care giver to the mother and the child they just announce that they stop the program and they want to train the ANN and GNN in our country so this is very critical situation in here particularly in Bengal and after extensive study of the life and culture of midwives in Bengal I have this the conclusion that most Indians have very little knowledge of traditional midwives so I put emphasis to find out their skills, their way of training, their way of thinking and how they are very close to the rural families particularly to the mothers and the mothers in the extreme rural areas of Bengal they won't go to the hospital because of the fear and they are not very satisfied with the hospital circumstances and they are very free with their midwives as they are very close and they feel that midwives are like their mothers and they want to know that during the time of labour the women feel a different psychological phenomena with that see in her or the name that feeling some psychological problem during the time of delivery and a midwife, a rural midwife I have my own experience to see how she can help the lady with tender cuts or etc who they won't find in the hospital bed ok so and this is you see the picture she is Alokha Bauri a woman of lower class, untouchable lower class Bauri is considered as one of the lower class of Bengal and she is also an agricultural labour because during the this time she cannot depend on midwives in total because the rate of the growing rate of the hospitals are hospitals and sometimes she has no job so she must depend on the agricultural labour or house work like meat serving etc etc this is an interesting picture and I think this is most probably found in Bengal they are the folk at midwives I am working in a office which dealt with the folk and tribal culture of Bengal and I find a good number of midwives in the rural areas are engaging with practising for folk art this is an interesting feature of Bengal in the rural areas of large numbers of midwives are folk artists such as dancer, singer, painter, actress and date they earn their livelihood through it and side by side practising midwives too midwives too in this picture you see Usha Boysho who is a traditional midwife and traditional man and basket artist she made beautiful basket and clean work this is you see from this picture and she also a drama artist she is the writer of many dramas folk dramas which is known as Han in Bengal and she put emphasis the training of the midwives and perform in the presence of the local audience about the crisis of the midwives in rural area she is trained at the midwife but she has no job and she requested every time whenever I meet her that please give us the job because we are trained midwives this is the picture of Bengal and among them the most important important is the folk painter who is a who are known as Kothuva or Kothuva or the call centre call centre is a very ancient art form of India and now the people who have settled down in Midnapur district of Bengal and they are known as Kothuva and they are mostly following the Muslim religion and using the two names one Muslim name and one another is Hindu name because according to the Hindu tradition ancient times they according to the Hindu tradition the painters are considered as the lower class and so they converted to the Muslim religion during the time of medieval age or some later of that time I don't know the exact time and I am researching on this thing so you can see the two midwives in the next slide and which is very important and this is Baharjan Baharjan Pithakar is a trained midwife and she is a good painter and the call centre and her Hindu name is Joana Pithakar but now she is using Baharjan Pithakar and she is a trained midwife and she knows every tidbit of the midwife and in her community she is the only midwife in western Midnapur she lives in Naya village of western Midnapur and she is the only trained midwife in her community and she and another is Serizan Pithakar of Christian Midnapur district and she is untrained though she is untrained but she also knows every tidbit of midwife and she told me that her daughter-in-law is denied to go to the hospital due to the fear that the atmosphere is not good for the delivery she said and the child, you see the child and she is the granddaughter of Serizan and Serizan gave the delivery of her son daughter-in-law and she is her granddaughter and she is a new midwife from her young age and she said that this is very interesting as in the case of Jumna Jumna's mother also knows the art of video series but Serizan has an interest to know this art so she is stepping to the window of a delivery room when she was young and the elders ask them not to do that but she has had a very curiosity and in this way she knew the art of midwifery and she is now a traditional midwife but she does not have a training and is only waiting for a training and you can see in the next two slides that what is the role of these two midwives one is trained and one is untrained and I ask them to draw pictures they can draw any picture any picture out of their mind or the event which happened in the society and I ask them to draw any picture about the birth practice in the rural area so they draw according to their own experience and you can see the two pictures one from Baharjan and in this picture you can see that this is the outcome of a trained midwife here you see that these are the boiling water and the technique of the midwife using a line and whereas you can see the picture of the rural remote village of India and also in Bengal this is the picture of the delivery system that one midwife is assisting the birth and any three of the householder or any neighbor they are helping the lady and she is using a pain birth test for Dhamma for the for a good delivery or for the labor pain for easy labor pain so you can see the designs of a trained midwife the picture of a trained midwife and the picture of an untrained midwife and next you see that this is the birth painting I just invent this type of painting and I think that that would be help the midwife during their training if we can arrange training now in Bengal we arrange training from NGO or any social service group though this is stopped by the government so we can go to the remote villages and arranging training and I think that if we have so many training like literacy and birth control and so why have not we introduced this type of birth painting and I ask specially Bahadjan to draw this type of painting and you can see that this is the picture of a trained midwife with her kids on one hand and this is a very white red bodied sari wearing a sari dress especially dress for the midwife and she is the mother and the child and held the mother during the time of the delivery and in the women areas the pupil depend to the midwife thus after the concierge with the lady so this is the picture of a trained midwife next you can see some sample of birth painting here you can see that Bahadjan when I ask Bahadjan what they are knowing from their training and she said that they asked to take new tears food for the mother and take sufficient rest so she can draw the picture that the mother is taking new tears food and she should take rest enough rest for the mother here you see the picture the express is filling through the painting and this is very important for the pregnant lady in the rural area in our countries because the indoor house never allowed to the ladies for new tears food or enough rest they are working almost in the household work and so she draw this picture for me that this is the first type of birth painting she draw sorry sorry and next that a trained midwife regularly take a lady there you see that she can take her tongue and her head she knows that what is the problem during the time of the pregnancy she knows some of her training and she has already some practical knowledge form of her own and this is another thing that is very interesting that she allows the pregnant lady to go to the health centre for treatment and here you can see that the lady in the A&M mother doctor A&M she is taking the iron tablets and which she gets to the pregnant lady and the midwife will see health heart to go to the clinic and collect the iron tablets and that you can have injection for this delivery and this is very important and sometimes if there is problem or there is no problem she must have a check as in the early stage of delivery she also affids the lady to the health centre and the doctor here you find the doctor and this is in the sub centre and the doctors are taking the lady and if there is any trouble during the home birth then she take her to the hospital or the health centre and this is very good in the remote villages you know that in the remote villages like Shundurban a spring area is covered with jungle and soil where it is very difficult to go to the health centre crossing the river but the village which is very near to the city or the related area there is hospitals or the sub centres and the midwife also assist to the lady if there is any problem to take to the doctor and this is one of, this is very important that she must take the weight of the newborn just after birth this is the weight machine or this is a hanging weight machine a low cost machine she might just weight the newborn and washing after the delivery just delay after delay cut cutting then she was the newborn and also just take this newborn's weight and this is the training centre for which I connect to and I am connected with this training centre run by an NDO Shundurban, Shimanto, Sattapur, Porisheba or the Shundurban Environmental Research and Health Centre and just I mentioned the name of Shundurban which is a spring area of South Bengal and here you see the this is the training centre and the clinic, a small clinic and there is no electricity so we have some arrangement of solar light and this is the midwife this is the midwife so this is the midwife and this is the midwife and this is the midwife here attending the session of training programme sorry there is a problem of the slides just wait and attending our training and they are very good and they want to know about midwife's performance and there are also doctors from cities they can arrange medical set up along with the training of the midwife we frequently go there and train them up there you can see that there are so many midwives from this area and who are very willing to know about the midwife this is the picture of the Bengal and as before I conclude I will say something about the position of the midwife the traditional midwife in our country these are the things we in India cannot ignore the work of the traditional midwife they are an effort to our country it is interesting to note that many traditional private practice like squatting position I will already the terracotta plaque the first picture of my slides where you can see the birth scenes where the lady in squatting position and attending by her three midwives so it is interesting to note that many traditional private practices like squatting position, cranial message the midwife squatting and continuous caregiver support have recently found scientific validity in today's this late midwives face a new challenge to their existence it is unfortunate that under the strong illness of globalization some people oppose the indigenous delivery system specially the doctors in our state the endogenous doctors or the gynaecologist there are few who are very benevolent and very good but most of them insist the people to go to the hospital for three sections and they were allowed to train the midwife they said clearly that they don't do anything they don't anything and rubbish they use this very strong rubbish and I am very much arguing with them and say that just go to the remote village and see the position of the people specially the Barbie movement I have an experience that in 31st January of 2001 I went to the Sundar one for the medical camp and I have seen the position of a delivery and the position of a lady named Duna Gain and she delivered in her home and that delivery is very critical that was a big presentation and this is the second time of Dina and the midwife with her school and the grandmother and the mother of Dina helped her during the night when she had no chance to go to the health centre and while they called they came to us after her delivery and we went to her home and our doctor checked her and advised something and it is interesting to note that the same thing is told by the grandmother of Dina and the delivery though this was a very very complicated delivery and at that night I said that the training of the midwife is very necessary for this poor woman of the village and the doctors who are practicing in the city areas and said that they are rubbish is this fair? I do not believe that this is not fair this is not fair without knowing the history of our midwife that Indian midwifery has a good history as I told you something about the history so we cannot ignore the service of the midwife we cannot ignore them we have to respect them and we must train them up that if we train them they can blend their knowledge with modern midwifery they can do wonders I think in every respect I respect them all I have meet and every day converse them and they are very very nice women and they want to do everything for the sake of the midwifery as you see the birth printing I think that this is an innovative thing in Bengal if we are using the four parties that those who are the dramatists and they can even have the child specially that take care of girl time and in our Bengal this is a very very unfortunate thing that we have female city side that is very very dangerous in our country and it is the and one midwife can stop this because she is very close to the family if after the birth of a girl time we have take the care of her she has no problem during the time of labor who said that this is the fault of the midwife no this is not the fault of the midwife this is the fault of the family who are not taking the care of the girl time you know that the problem begin with the malnutrition malnutrition is the main cause for the complicated delivery when the child is in her adult age and we are learning on the midwife we have to stop this fast and one midwife can do this she can convince the family please take care of your girl time she is the future mother of the nation so we can stop this female city side or take care of the girl time even the sex education and the training of the midwife through a train with rural midwife they are very very close to the family this is the point of my research and so I want them want the Bahar Jan to draw this birth painting and we are using this painting during the time of our training in Sundarbans and this is very very easy to understand about the rural mothers and the untrained midwives how to take care of the lady how to take care of the new mother and here I just put some one or two pictures not the full set so the time is problem so I just this is the example for the birth painting and this is I think that that will help not in Bengal throughout the India where there is rural midwife this is untrained midwife and though untrained we cannot ignore them we have to respect them we have to respect them through the difficult of mothers thank you Hello Soma thank you so much that was a wonderful presentation and we are some of those slides because sometimes the images are pictures you did a brilliant job Soma I congratulate you considering you are over there with no help and all by yourself getting this through to that my congratulations to you we are pretty much nearly out of time is there anyone who has a question to Soma before we finish up for the second so Mum just asking if anyone has got any questions they would like to ask I guess I'm just going to have a look in the chat and see if anybody wants to leave that question otherwise we'll Is there any questions Saya I am looking for a question and any suggestions I think that we have lots of comments thank you very very much and clearly we have lots to learn from you and lots to learn from midwife in India and there's some people here saying that we hope that these sorts of conversations are continued at the ICM and particularly the ICM conference next year so Soma thanks you once again I'm sure everybody agrees that you've done a marvellous job okay hang on before we go Heather here is just wants a question I'm going to enable your microphone Heather if you want to speak Heather I've enabled your microphone if you want to say something Heather you've got your hand up if you want to make a comment I'm not quite sure Heather do you want to if you want to put your question in the text that's lovely Heather Soma Heather needs to say that she loves your last comment for that respect so thank you very much for that I'm going to I'm going to bring this session to a close I'm going to turn the recorder off