Holding out Hope in Dharavi

‘My son had cow’s milk from birth. He looks healthy. What is so great about mother’s milk?” Sabawn’s voice resounds in a narrow, cramped lane in the heart of Asia’s largest slum, Dharavi. A local priestess, she cuts a dramatic figure in her yellow sari and orange tikka.  Gathered around are a group of women, listening in rapt attention. Many of them are heavily pregnant, some are holding newborns.

Sabawn’s comment is an indication of the challenges that lie ahead for the Maharashtra government, corporates and NGOs who have come together in a first of its kind partnership called the AHAR project. A project that aims to change the face of Dharavi, a densely packed slum, home to over a million people, mostly migrants. A well-known Mumbai landmark, immortalized in the Oscar-winning film Slumdog Millionaire, the slum is a maze of narrow lanes, shanties and overflowing gutters.

Not surprisingly it reports among the highest rates of malnutrition in the city. About 35 % children between the critical 0-3 years are malnourished.  While anganwadis or day-care centers have been set up as part of the government’s Integrated Child Development Scheme (ICDS) to provide nutrition, education and health services, the workers here are overburdened and poorly paid, with the result that many children are left behind.

It is here that the non-profit group SNEHA or the Society for Nutrition, Education and Health Action plays a critical role by training sakhis or community link workers who go door to door and advice women on nutrition, breastfeeding, family planning and maternal health.

“Imagine this is your baby” says sakhi Mangal Shinde pointing to a lifeless doll hanging on one end of a scale used to weigh vegetables.  At the other end hangs an empty bag. “What you put inside this bag decides your baby’s future,” she says adding factsheets with pictures of healthy foods for children. As the bag gets heavier, the doll rises. The women smile and clap. Sabawn still looks sceptical and clearly requires several more sessions!  Convincing her is critical as she wields tremendous influence in the community.

“It’s not easy,” admits Dr Evelet Sequeira, Head of Nutrition with SNEHA. “We tell the mother her milk is for her baby and this milk will help in brain development. So when the baby weighs 3.5 kgs at birth it has already passed Class 10. If she were to breastfeed exclusively until 6 months, the baby has cleared Class 12. For every mother her child’s intelligence is very important and this helps drive home the point.”

Simplistic though the approach may sound, it is showing results. Rates of exclusive breastfeeding have gone up. So has immunization. “More and more women are delivering in institutions,” says Priya Agarwal, Senior Advisor with SNEHA. “ Earlier women would register at the local health center in the last trimester of pregnancy. Now it’s in the first trimester.”

Another critical service SNEHA provides is crèches where working mothers can leave their babies. Now mothers no longer leave their infants with neighbors or older siblings when they go back to work. Instead they drop them off at the crèche where their health is closely monitored and they are given supplementary meals.

SNEHA believes the Dharavi experiment will lead to a sustainable model which can be replicated in urban slums across the country. “We have the government and ICDS on board and we are looking at global protocols that have been tried worldwide to see how we can adapt it to our settings”, says Dr Sequeira.

Words that hold out possibilities to thousands of children like Mehboobi, who at 2 years weighed 8 kilos, the healthy weight of a 6-month-old. When she came to the crèche last year, she would not lie down. Tests showed she had spinal TB and suffered from severe back pain. Today she is nearly 3 and weighs 10 kgs.  She has a long way to go.  Watching her perky, shining face shout out alphabets, there is hope she will get there.

For a vdeo link to the Dharavi project visit

http://www.ndtv.com/video/player/news/republic-of-hunger-malnutrition-plagues-in-maximum-city/222383

Fighting Gender Stereotype : The GEMS Way

“There are times when a woman deserves to be beaten.”

“Girls cannot do well at math and science.”

 “Since girls have to get married, they should not be sent for higher education.”

These are views that hold huge currency in India even today. Look at our sex ratio. It speaks volumes. In 2011, 914 girls were born to every 1,000 boys. We may pride ourselves on electing a woman Prime Minister way before many developed countries and bask in the achievements of our women corporate leaders. But the fact is boys are preferred to girls. Girls don’t carry on the family name, entail huge dowries and are less than equal at the workplace.

Worldwide, there is growing recognition that it is critical to reduce gender inequality for a country’s overall development. The best way to do this is to reach out to the youth. In India, however, there has been a limited attempt in this regard. Schools, where youth spend a large part of their time, more often than not, end up reinforcing gender stereotypes.

An important initiative showing the way forward is the Gender Equity Movement in Schools started in 2008 by the Committee of Resource Organization for Literacy (CORO), Tata Institute for Social Sciences (TISS) and the International Centre for Research on Women (ICRW). GEMS works in 45 public schools in Mumbai reaching out to 8000 girls and boys between the ages of 12 to 14.

Through campaigns, role-playing games, discussion based lessons, comic strips and interactive activities, students are encouraged to rethink social norms and question gender biases. Led by facilitators, the children talk about puberty and what makes for healthy relationships.  Initially girls and boys were placed in separate groups to help them open up. From the second year, they were mixed, in response to requests from the students themselves.

The GEMS approach is recognized worldwide as an effective way means to reach out to the youth. At the recent International Conference on Family Planning at Dakar, Senegal, I had the opportunity to listen to Pranita Acharya, ICRW Gender, Poverty and HIV/AIDS specialist who administers the GEMS program. To an audience packed with adolescent sexuality experts and activists from across Africa and Asia, she explained why a school-based approach could work.

 “Classroom discussions help students think about and question social norms”, says Acharya. “Facilitators encouraged them to challenge stereotypical ideas about men and women. Those interactions clearly moved students to look at their world differently.” 

A facilitator describes a group session on “Labeling” held with 40 boys. At the beginning, they were noisy and restless. They were told to write a label they used or knew of on the blackboard. There were many responses, based on physical descriptions such as “sukdi” (malnourished), and “takli” (bald) and some with sexual innuendoes like “raand” (girl who has sex with many men), pataka (fire cracker) and bayalya (a feminine boy).

The boys were then asked to close their eyes and imagine that these terms were being used on them. They said they felt “angry “, “hurt”, “like hitting someone” and wanting to ask “what did I do wrong.” The facilitator then asked if these terms were used often against girls. The boys agreed that girls were often on the receiving end. The facilitator then went on to say that if a word could hurt so much, perhaps it was time to think about why we use them. The last question asked was, “Is labeling a form of violence?” The class fell silent and after a while the hands started rising slowly. The class agreed that labeling was indeed violence.

At the start of the program, little over 20% of boys and girls supported gender equality. A year later, this grew to 53% of girls and 39% of the boys. There was greater support for girls pursuing a higher education and marrying later, and of boys helping in the household work.

At her presentation, Acharya recounted the words of a 13-year-old. “I used to think that only boys should do outdoor chores. Now I think they should help women at home.”

The program also teaches the children how to fight back when faced with violence, be it physical or verbal. A 14-year-old girl said, “I could not stop harassment in the past. Because of the sessions we got to know that harassment of girls should be stopped. Boys should understand the feelings of girls. And girls should oppose violence.”

The GEMS experiment, experts say, shows that group activities can be effective in opening up discussions on sensitive issues linked to gender inequality. Encouraged by the results, the program has been started in 1200 civic schools in Mumbai. And over 600 schools in the states of Rajasthan and Goa.