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

The Young Rise Against Child Marriage in Bihar

The latest Census report says that nearly one in every three married women in India were married off below the legal age of 18 years, a grim reminder of how widespread child marriage is in the country.

Clearly, the practice continues despite the Prohibition of Child Marriage Act because it has strong social sanction.

What is needed is a change in mindset, and that is what the Jagriti Trust, a youth-driven intervention in Bihar, Uttar Pradesh and Rajasthan is trying to achieve. Bihar reports the highest number of underage marriages in India – nearly 60% girls are married off before they are 18, and 74% before they are 20.

The Jagriti Trust tries to motivate young boys and girls from the community to get involved in local issues like sanitation, hygiene and education of girls and become agents of change.

The strongest challenge sometimes comes from within the families.

Pooja, 20, who refused to go along with her parents’ wishes and marry at the age of 14 like her sisters did, said, “My father stopped talking to me and I was ignored in my house. It was very hard to cope but I saw what my sisters were going through and was determined to avoid that fate.”

Today. Pooja is a youth leader with the Jagriti Trust and encourages other girls’ to find their voices. She leads workshops where young boys and girls are taught to question the mindset behind practices like early marriage and dowry.

The Jagriti Trust has set up youth councils in three districts of Bihar. The causes they take up are sensitive, but their patient approach seems to have paid off.

“Village elders initially opposed us”, said Premnath, 19, from Ismailpur, who continues to face intense family pressure to marry.  “But we took our time in explaining our side and participated in other village activities and gained their trust.”

Dr Rema Nanda, founder of the Jagriti Trust says that by reaching out to boys and girls, it hopes to achieve a larger behavioral  change.

“Reaching out to girls alone is not enough because boys too are victims of patriarchal norms and we need to teach them the value of questioning stereotypes. It is time we stopped regarding them as the Other and keeping them out”, she said.

This article was published  in the NDTV website

Not enough in this Budget for Family Planning

Among the most widely reported statements at the International Conference on Family Planning held in Indonesia in January this year was that of the Indian Health Minister JP Nadda who said that the country was committed to meeting the FP2020 goal of providing 48 million additional women and girls with access to modern contraceptives by 2020.

A global partnership, Family Planning 2020, works with governments, civil society and the private sector to enable women and girls to make decisions regarding if, when, and how many children they want.

The Indian Health Ministry team also announced that women would have access to better quality family planning services. A promise that is being met with. Since April, injectable contraceptives and pills are being supplied to all district hospitals across the country.

However, the recent report by the Population Foundation of India points out just how distant that goal of reaching 48 million women and girls is.

While the provision for health in 2016 has grown by 22% over 2015, with FP seeing a substantial increase of 67% compared to previous years, health remains hugely underfunded in India. The rise this year, it points out, is insufficient to compensate for the whopping 54% decline in allocations to family welfare between 2013-14 and 2015-16.

Meeting the 48 million number needs more than simply expanding the basket of choices. It needs awareness campaigns and better rural health facilities to ensure that babies and mothers survive. Campaigns have to be tailored to meet the specific challenges that a country as varied as India throws up.

While the shift away from female sterilization is welcome, there seems to be widespread official myopia in acknowledging just how deep the links between family planning and broader development goals go, and this is disturbing.

How Climate Change Impacts Women More

Amidst the stream of news reports on the severe drought across India, here is one that didn’t make it to primetime.

It’s the story of Yogita Ashok Desai from Maharashtra’s Beed district who died of a heat stroke. The 12-year-old was dehydrated and collapsed after her fifth trip to the village hand-pump to fetch water. Just last month,  a 10-year-old girl from Pimpalgaon village, also in Beed district, died after she fell into a well while trying to draw water.Both girls had been pulled out of school to help their families cope with the severe water scarcity.

The reasons for the worsening drought are many; many of them manmade like the indiscriminate digging of borewells and the cultivation of water guzzling crops. Decisions that women had little to do with. excluded as they are from choices relating to irrigation systems or what crops to grow. However, they are facing the worst impact.

A recent World Bank reportShock Waves – Managing the Impacts of Climate Change on Poverty, highlights how ending poverty and addressing climate change is key to achieving sustainable global development. Addressing climate change is critical as it directly impacts availability of food and heightens health risks.

Most vulnerable are the poor and marginalized, and within that group, women and children. There are various studies that show that women, especially in developing countries like India, suffer the impacts of natural disasters and climate change more due to cultural norms.

In rural areas, women rarely work and are economically dependent on their husbands for survival. Faced with a severe drought, men have the resources and the independence to find ways to adapt. Women are denied those options.

Faced with a shortage of food, women place their husbands’ and sons’ needs above theirs or their daughters’, making them vulnerable to diseases.

Faced with income or food crunch, girls’ get hit the hardest. They get pulled out of school and are expected to help with the household chores. Their nutrition and health gets neglected. Climate change also affects availability of water. Women and girls’ are expected to fetch water for the family, often traveling long distances to do so.

As Rachel Yavinsky points out in her 2012 study, their secondary role and lack of decision-making power severely limits women’s ability to adapt to climate change.

“Without participation by women, programs to replace traditional crops with those better suited to the changing environment might focus only on the needs of men’s fields and not address the problems women face with household gardens’, says Yavinsky.

She points to various studies that demonstrate how women can be effective agents of adapting to climate change if equipped with information and power. In Bangladesh, for instance, women farmers switched to raising ducks because they kept losing their chickens to frequent floods.

Empowering women, especially rural women, is necessary to address climate change effectively. Climate change will affect all os us, most of all women, and unless we empower them, building a sustainable future will remain a distant dream.

This article was published on the site healthyurbanworld

Meet the street children making their own newspaper in India

“We get pushed around and treated like garbage because there is no one to speak for us,” says Chandni, the 18-year-old editor of India’s only tabloid paper produced by street-children journalists, Balaknama (Hindi for “voice of children”).

Like all editors, Chandni’s biggest challenge is to decide which stories will make it to the front page, and managing the egos of those whose stories don’t. “As editor, I want to play up stories that are most impactful,” says Chandni. “But many reporters get upset when their stories don’t make the mark. So, yes, I do have to tread carefully.”

Related: Can India’s military veterans join the fight for women’s rights?

The monthly newspaper has a team of 60 reporters between 12 and 20 years old and is based in Delhi and neighbouring states of Haryana, Madhya Pradesh and Uttar Pradesh. Most of the street-children reporters were recruited from learning centres run by NGOs the Federation for Street and Working Children (Badhte Kadam) and the NGO Childhood Enhancement through Training and Action (Chetna), which started Balaknama in 2003.

A lot of time is spent on writing the stories. “Many of our reporters started school after joining the paper so writing is a struggle for them,” says Chandni. The copy is written in Hindi and later translated into English.

Each paper is priced at a token 2 rupees and over 8,000 copies, most of them in Hindi, are published every month. Many of them are distributed free to police stations and NGOs working in the field of child rights. The paper makes no profit and is entirely NGO-funded.

Regardless, the sense of pride and accomplishment is evident.

“We filed a report on how the police was forcing children living in railway stations to retrieve the bodies of people who were killed on the tracks,” says Shambhu, 20, a senior reporter. “Imagine forcing a child to go down those dangerous tracks and retrieve bloody, mangled limbs!”

Mainstream news outlets picked up Balaknama’s report and it led to a huge outrage. Eventually, the National Committee for Protection of Child Rights stepped in and action was taken against the police.

Related: Pedal power: how bicycles are changing what it means to be a girl in India

An estimated 51,000 children live on Delhi’s streets, some as young as five-years-old. They make a living by begging or rag picking and are subject to verbal, physical and sexual abuse. Many are abandoned by their families or have run away from home.

Twelve-year-old Rustam is one of the lucky ones. He lives with his construction-worker parents but, like his three brothers and sister, missed out on school because he had to supplement the family income.

He started feeding Balaknama reporters stories last year and got a front-page splash when he alerted a senior reporter about a child marriage in June 2015. He was taken aback by what followed. “Local activists held protests and the police were forced to step in and stop the marriage from taking place. I became known in my neighbourhood and my parents felt so proud,” he glows.

For nearly a year now, Rustam has stopped begging and studies at a learning centre. He is paid a small fee for every story lead that he gives.

This feeling of empowerment is what Balaknama wants to foster among street kids. It does this by highlighting, not just the difficulties they face, but also stories of hope.

Positive reports about street kids who return lost items or help get back stolen goods get prioritised. “Street children feel worthless and hated by the world and we are trying to change that,” says Sanno, 20, a former Balaknama editor, who now advises the team.

Related: The women who refuse to do India’s dirtiest job

Balaknama also looks at larger policy-level issues. The paper campaigned to get street kids in Delhi national identity cards called Aadhar, which give proof of residence and when available, date of birth.

The paper has recently been focusing on the implications of the changes to the Juvenile Justice Act that allows children between the ages of 16-18 years to be tried as adults for crimes like rape and murder. The amended act has been criticised by child rights activists who say it could be misused to implicate innocent minors and that it would undermine the aim of reforming juvenile criminals. Balaknama has taken a strong position on the issue.

“Many street kids don’t have families,” says Chandni. “They don’t even know their date of birth and they have become vulnerable now. A 15-year-old can be turned into a 19-year-old.” She believes it’s a sign of how much farther they have to go to make India’s estimated 400,000 street children visible to those who matter.

“When authorities talk about children’s rights, they are looking at school-going children, with homes and families. No one is looking at the child living on the streets, or labouring inside homes and hotels. They still don’t exist.” Balaknama is determined to change this attitude by enabling street children to tell their own stories, in their own words.

This article was published in The Guardian dated April 14, 2016

Tackling the diabetes challenge

That the Indian government is thinking on the lines of imposing a tax on sugary drinks and junk food is welcome news. Given the alarming rise of diabetes in India, there is active intervention needed to control the rise.

A WHO report says that the number of people with diabetes in India is likely to cross 101 million by 2030, while Lancet published a study  just a day before World Health Day that said there has been a fourfold increase in the number of diabetics from 1980 to 2014 – from 108 million to 422 million. It ranks China, India and the US are among the top three countries with the most number of people with diabetes.

Prevalence has more than doubled for men in India and risen 80% among women. While the incidence is higher in urban areas with states in the South reporting especially high rates, what is worrying is the rise in rural India, a result of rapid urbanization.

Of special concern is Gestational Diabetes Melitus (GDM), which remains neglected in India and has a severe impact on child and maternal health. G
DM is linked to hypertension, eclampsia and obstructed labour, and is among the leading causes of maternal deaths.

India has one of the highest rates of GDM in the world, with over five million women affected every year. While the worldwide prevalence figure is 15%, in India it is 22 to 25%.

The increasing prevalence of GDM is linked to growing urbanization, reduced levels of physical activity, and changes in dietary patterns and rising obesity

Women with gestational diabetes are also more likely to develop Type 2 diabetes in the future and therefore special attention needs to be paid to this population in India.

A 2013 study by the Kerala-based Achutha Menon Centre for Health Science Studies found that women diabetics are even more vulnerable as they cannot abandon their role of looking after the family and are expected to put the health of other family members above their own. This leaves them with far less time and resources for their own health.

One major reason for the rapid rise in India is lack of awareness. A 2012 study by the Brussels-based International Diabetes Federation found that over 60% of diabetics in India had never been screened or diagnosed because of this, while over 63% were unaware of the complications that arise from the disease.

A combination of food patterns, sedentary lifestyles, obesity and genetics makes Indians more vulnerable to diabetes. It is time we acknowledge that and tackle the problem at a war footing.

Apart from nationwide screening programmes, early detection and treatment must become a part of primary health services. Awareness has to be created about dietary habits as well, with greater emphasis on fiber rather than sugar and starches.

This article was published on the SNEHA website 

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