Why India Needs Sex Education

In a country that reports high rates of teenage pregnancies and sexual abuse, one would think that the need for a curriculum focusing on gender equality, the importance of consent, and boundaries, would not be a matter of debate.

The reality, however, is that sexuality education for adolescents is a highly controversial topic in India. It is seen as offensive to Indian values, and concerns that it might lead to risky sexual behaviour and promiscuity.

Take the reaction when the central government in 2007 announced the launch of the Adolescence Education Programme in schools, along with the NACO, NCERT and UN agencies. Thirteen states called for an immediate ban as they felt that comprehensive sexuality education was against the Indian culture. Little has changed in the last 10 years. There is still a ban on Adolescence Education Programme in at least five states across India, and there is no uniformity in the way the subject is approached.

Sexuality education, as the UNESCO defines it, “provides opportunities to… build decision-making, communication and risk reduction skills about many aspects of sexuality…. encompasses the full range of information, skills and values to enable young people to exercise their sexual and reproductive rights and to make decisions about their health and sexuality”.

“The myth is that everyone is going to talk about sex”, says Dr Sunil Mehra, Executive Director of MAMTA Health Institute for Mother and Child which is hosting the 11th World Congress on Adolescent Health from October 27 to 29.  “In fact, it is about knowing your body, consent, interaction with the opposite sex, colleagues and friends,” adds Dr Mehra.

Research shows that comprehensive sexuality education delays sexual initiation and leads to a fall in sexually transmitted diseases.

“The fact is that there is sexual activity going on,” points out Dr Mehra. “Earlier it was within marriage but it is still happening at an explorative level. “The more one understands that, the chances of risky behaviour are lower. So are chances of coercion and physical violence.”

This is critical in a country like India where rates of sexual violence against women are high and discriminatory attitudes towards women persist. For a meaningful social change, reaching out to boys and girls on issues like consent and gender equality becomes critical.

Programs on the ground like Ehsaas by SNEHA in Mumbai and YP Foundation in Delhi, to name a few, are trying to plug those gaps.

“We have to go beyond looking at controlling adolescent fertility from the perspective of reducing unwanted pregnancies,” says Ishita Choudhry, Ashoka Fellow and Founder of The YP Foundation.

This article was published on NDTV here

The Silent Victims of Punjab’s Drugs Crisis

This exclusive report, carried on NDTV 24/7 and NDTV India is on the hitherto silent face of the Punjab drug crisis – the women and children in the families of male drug abuse victims. Hundreds of young mothers are struggling with their kids, in penury, battling HIV and Hepatitis C virus infections that have been passed on to them. The complete picture of the drug crisis in Punjab has emerged. Or has it? The impact on the men who have fallen victims is being routinely documented now. What is getting left behind in the big picture are the voices of the women and children in the families of these victims, who are infected and in many cases severely depressed. Dispossessed of family resources and left with hardly any healthcare support, these women are also struggling with acute depression and suicidal tendencies. The impact of the vice-like grip of narcotics in the area of women and child health, on a closer look, is grave.

https://everylifecounts.ndtv.com/video-detail/women-the-silent-victims-of-punjabs-drug-crisis-466811

How Asia’s Largest Human Milk Bank In Mumbai Saves Babies’ Lives

A video report on the milk bank at Mumbai’s Lokmanya Tilak Municipal General Hospital, popularly known as Sion Hospital. It gets donations from nearly 40 mothers every day and the milk benefits 3,000 babies every year. According to doctors, breastfeeding within the first hour of birth is one of the measures to fight infant mortality.

This report was aired on NDTV’s Every Life Counts campaign, supported by the Gates Foundation

How Asia’s Largest Human Milk Bank In Mumbai Saves Babies’ Lives

Afghan refugees are cooking up a better future in India

“Back home in Ghazni, I never used to cook. It was only after I moved to Delhi six years ago that I made my first biryani,” says Farhat. A single mother, she moved to India from Afghanistan in 2010 when the Taliban killed her husband, an Afghan Army officer.

She is a member of Ilham, a catering service that serves traditional Afghani dishes to people in Delhi. Ilham, which means “positive” in the Dari language, was launched in late 2015 by the UN refugee agency, UNHCR, and its partner Access. The initiative brings together seven women, all refugees from conflict-torn Afghanistan.

“There are too many restrictions on women there,” says Farhat, who tried to support herself and her six-year-old son with odd jobs after her husband’s death. “Neighbours started calling me a bad woman for leaving the house and I was afraid of attracting the Taliban’s attention. So I left for India.”

There are nearly 11,000 Afghan refugees registered with the UNHCR in India, mainly living in Delhi and bordering areas. The influx began in 1979 after the Soviets invaded Kabul and continued through the fall of the Taliban regime. The early refugees were mainly Hindus and Sikhs but with the security situation getting worse, more ethnic Afghans are coming in.

Historically too, India has been a favoured destination for Afghan traders or Kabuliwalas, who would travel across the mountains to sell spices, dry fruits and attars (perfumes), an association that has been immortalised in many Bollywood films and works of literature, including a popular short story, Kabuliwala, by Nobel Laureate Rabindranath Tagore.

“India is also an obvious choice because the government allows UNHCR mandate refugees to apply for long-term visas that regularises their stay and enhances employment opportunities and enables easier access to higher education,” says Shuchita Mehta, a spokesperson at UNHCR India.

As of August 2015, there were a total of 27,000 refugees in India registered with the UNHCR. The total refugee population across the country runs into well over 200,000. India’s liberal approach towards asylum seekers attracts large numbers but there is no specific policy or legal framework regarding refugees. The country has not ratified the 1951 convention on refugees.

Refugees registered with the UNHCR find it easier to get long-term visas and work permits. They are entitled to free education in government-run schools and free healthcare. Others face a miserable existence, confined to illegal settlements, where access to water and electricity is irregular.

Finding a steady, well-paid job is hard too. Zameera, a schoolteacher in Afghanistan, had to work as a domestic help in Delhi for years before she became a part of Ilham. “It was a struggle to communicate as I could not speak English or Hindi. I had five children to feed and educate so I was desperate,” she says.

She lives in Lajpat Nagar, home to a large number of Afghan refugees. The community is concentrated in small pockets in parts of Delhi, the ghettoisation preferable to living in a mixed colony where they stand out, their accents and clothes regarded with open curiosity, and occasionally some hostility.

“There is an urgent need for sensitisation programmes,” says Aditi Sabbarwal, project manager at Access. “People have no idea what they are fleeing from, their back stories, so there is a perception among some that they are freeloaders. The government should conduct awareness campaigns so people come to know what’s going on in their countries.” She points to stray comments on Ilham’s Facebook page pointing to the turmoil in Europe over the refugee crises and making the case that India should not take in outsiders.

The idea of starting a catering initiative was born after hours of talks between Access and the Afghan women enlisted with them. “People in Delhi are open to trying out different cuisines but there were very few that served Afghan food,” says Sabbarwal. “So we decided to try some dishes out at a fair last winter. We were sold out in less than an hour. We realised that starting this on a larger scale could guarantee them fixed employment and financial independence.”

The range of dishes is limited but great effort is taken to source the original ingredients to ensure authenticity. The American embassy in New Delhi is among their most regular customers.

The women cook the dishes at their homes and deliver to the designated pick-up centres. Given the growing demand, there are plans to set up a community kitchen.

“We make a profit of Rs 3,000-4,000 a month, which is much more than what we earned working odd jobs,” says Qadria, who left Herat in west Afghanistan six years ago after she was lashed in public for not covering her face properly.

“The orders are growing everyday and the money is good,” says Qadria. “I am able to pay my daughters’ school fees and buy them what they want. I feel happy when I see them enjoy the freedom I never had in Afghanistan.”

Ziyagul, the most vocal of the group, who has dreams of starting her own restaurant, says: “I feel so happy that I am able to share some of my culture with people here. When customers praise my dishes, I feel so confident. I realise that I am as capable and independent as any man!”

Some names have been changed to protect the women.

This article was published in The Guardian – https://www.theguardian.com/global-development-professionals-network/2016/jul/21/afghan-refugees-are-cooking-up-a-better-future-in-india?CMP=share_btn_fb

How Technology is Improving Maternal & Child Health

mMitra, started in Mumbai slums with the support of the civic body, is a free mobile voice call service that gives information on preventive care and simple interventions to reduce maternal and infant deaths. It is given in the language of the user’s choice and sent weekly or twice a week. Launched in 2014, it reaches over 5 lakh women in slums in Mumbai city, up to its far suburbs.

Domestic violence accounts for five in 10 of reported crimes against women in India. Many cases go undocumented, nearly 7 out of 10 women have suffered some form of domestic violence. Domestic violence is linked to posttraumatic stress disorder, gastrointestinal infections, suicide, chronic pain, and increased risk of unintended pregnancy, which, in turn, compromises maternal, infant and child health. The Little Sister’s Project, an initiative that works among victims of domestic violence in Mumbai, has 160 local women to identify and report incidents of gender violence using Android smartphones and an app called EyeWatch.

This documentary was done for the NDTV-Gates Foundation campaign, Every Life Counts. To watch click here 

With Support From An App, Women Stand Up To Domestic Violence In Dharavi

A two-year-old app is helping women in Asia’s largest slum, Dharavi, to stand up against domestic violence. The Little Sister app, working in 3 languages, is helping women report instances, however small, and get help.

Home to a population of over one million, Mumbai’s Dharavi sees many such cases, say the women who are part of the initiative started in 2014 by a non-profit, SNEHA – the Society for Nutrition, Education and Health Action.

“Physical abuse and sexual violence is most common,” said Rashida, a sangini or worker in Little Sister.

Violence against women is listed as one of the top 10 reasons of death for women and domestic violence, also known as intimate partner violence, accounts for five in 10 reported crimes against women in India. Even so, many cases go undocumented, and various studies show nearly seven out of 10 women in India have suffered some form of domestic violence.

A report released last year by Population Reference Bureau, a Washington DC-based think-tank, said India — along with Nepal, Pakistan and Sri Lanka – shows a very high rate of violence,  with one in three women reporting sexual and/or physical violence, mainly from a partner.

One of the many reasons why domestic violence goes unreported is because it has cultural sanction. “Everyone, including the mother-in-law, thinks the man has rights over the woman’s bodies, regardless of her feelings,” said Rashida.

“We recently counselled a woman who had been beaten by her husband for 22 years, right through their marriage,” added Saira Shaikh, another Little Sister sangini. “She kept thinking it was OK because her husband was providing for the family.”

Married twice, Rashida was abused both times. She finally found the courage to walk out when she nearly died after consuming poison in a fit of despair. “While in hospital I realised that by suffering violence, I was damaging my children.”

These are not easy decisions for any woman, especially those who are poor, uneducated and lack family support.

This is where the app greatly helps, believes Rashida – its biggest advantage being that women can express their pain in safety and secrecy, until they are ready to speak out.

Registering instances on the app gets immediate response.

Depending on what she wishes, the sanginis contact her and provide counselling. In case of physical violence, they can even contact the police and hold family counselling sessions.

“The project was designed to mitigate under-reporting of violence by providing a tool for women to record instances,” said programme coordinator Damini Mohan. “Most cases are reported to authorities as a last resort, when the violence has severely escalated. It helps us capture instances of violence at an early stage and helps us prevent its escalation.”

Since it was launched in June 2014, Little Sister has recorded 1,062 cases of domestic violence, compared to 200 cases recorded in 2013-2014.

While there are laws against domestic violence, what is not widely understood at the policy level are the health consequences, doctors say.

Women who suffer domestic violence are twice as likely to suffer from depression and about 50% more likely to become HIV positive. Other outcomes are post-traumatic stress disorder, gastrointestinal infections, suicide, and chronic pain. It is also linked with higher risk of unintended pregnancy that compromises maternal, infant and child health.

“Whenever there is violence, physical or otherwise, the physical impact shows up in the form of scars but the impact, internally, is 25% more,” said Praful Kamble of SNEHA. “There is depression, a sense of shock and a major impact on children who witness it. Even verbal abuse can affect pregnancy outcomes.”

This article was published on the NDTV website. To view the video report click here

Empowering Women With Choices In Family Planning

From April this year, injectable contraceptives will be available in district hospitals across India.

At the recently held International Conference on Family Planning in Bali, top health ministry officials from India said that they were determined to meet their stated target of providing 48 million women with access to contraceptives by the year 2020.

In 2012, at the London Summit on Family Planning, India had pledged to commit almost $2 billion dollars until 2020. As a result, today more women and girls have access to family planning. In 2013 alone, three million additional women and girls in India were equipped with the tools and the information needed to choose a modern contraception method.

To fulfil this goal of 48 million, the government will increase the basket of contraceptive choices offered to women, and promote spacing between births. Apart from injectables, this will include Centchroman, a non-steroidal agent, and POPs or progesterone only pills.

Centchroman, marketed as Saheli, is a once-a-week oral contraceptive that acts on the hormones produced in the body, especially progesterone. POPs thicken the mucus in the cervix, stopping the sperm from reaching the egg.

“We are determined that no woman should be left behind and no partner be left behind,” said C.K Mishra, Mission Director, National Health Mission.

Phase 1 results from the fourth National Family Health Survey or NFHS-4 for 2015-16 that covered 13 States and two Union Territories are quite promising with total fertility rates or the average number of children per woman dropping considerably, ranging from 1.2 in Sikkim to 3.4 in Bihar.

All states in this phase, except Bihar, Madhya Pradesh and Meghalaya have either achieved or maintained replacement level of fertility and this is a major achievement in the past decade.

However, what remains problematic is the female sterilisation rate, which at 34% is very high. Health officials hope to bring down the numbers by offering more contraceptive choices and improving service delivery.

“All along there has been greater emphasis on terminal methods of family planning and we have not given spacing the attention needed,” said Mishra. “The goal ahead is to focus on adequate spacing”.

Also of concern is the total unmet need for contraception in India, which at 21.3% is the highest in the world. Bringing down the unmet need was a key Millennium Development Goals target that India was unable to meet.

A high unmet need for contraception translates into a high number of unintended pregnancies and has tremendous health implications. India accounts for 19% of the world’s maternal deaths and meeting the need for contraception is critical to saving lives.

“Today more girls and women have access to contraception but we are still 10 million behind in terms of what the figure should be,” said Chris Elias, president of the Global Development Program, Bill & Melinda Gates Foundation, while speaking to a group of journalists on the sidelines of ICFP 2016.

Last November, the Gates Foundation had announced that it would invest an additional US$120 million in FP programs over the next three years to meet the Family Planning 2020 goal of giving 120 million additional women and girls’ access to contraceptives.

“If there is spacing, half of the lives lost would be saved. Women should be able to decide when they should have babies,” believes Elias.

Health ministry officials in India seem to be moving forward in the right direction. However, there is quite some distance to travel before the revised plans are implemented, cautions Poonam Muttreja, Executive Director, Population Foundation of India.

“Apart from issues like inadequate budget allocation, the bigger challenge India faces is wide disparities and inequities in women’s access to healthcare and family planning. Access to health services still depends upon where one lives, how educated one is, and economic and social status”, says Muttreja.

Clearly, the approach will have to go beyond simply making these choices available at various health centres. “It is not just about making the full range of methods available,” says Elias. “Women have to be empowered to make those choices”.

This was published in ndtv.com