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Archive for the ‘initiative’ Category

Initiatives: Women’s Issues

Wednesday, July 8th, 2009

an excerpt from our upcoming website
written by Nivedita Gunturi

Problem Statement
In developing countries like India, underprivileged women are frequently uneducated, which leaves them disadvantaged and financially dependent on their husbands, brothers, and other male members of the family. Women are at higher risk for reproductive health issues, as well as other physical and social hardships. Women’s health, emotional well-being, and ability to fend for themselves reflect a great deal on the socioeconomic indicators of a particular community. In fact, a community in which the women are not empowered cannot move forward until that deficiency has been remedied.

There are several factors at play, the most important of which is the cultural barrier which prevents women from reaching a state of independence and self-sufficiency. In many cases the women hold themselves back, having been born and brought up in a culture which does not value them as contributing members of society. They may devalue themselves, making their empowerment a matter of changing their attitudes in addition to changing their circumstances.

Education levels of women are usually much lower than those of their male counterparts. Female literacy rates are an important indicator of this disparity. As noted in India’s 2001 census, “the disparity in the male and female literacy rates among the slum population is pronounced in almost all cities and towns.1” It is estimated that only 65% of women are educated, compared to 77% among men2. Furthermore, many women are uneducated about matters that are essential for reproductive health; for example, almost one third of women in urban slums have no knowledge of contraception3. Given that culturally, women are given sole responsibility for maintaining households and ensuring the well-being of their children, educating female children is vital.

Other social issues such as alcoholism among men, domestic abuse, and inadequate female representation in policy-making and judicial bodies hold women back, keeping them in a subordinate position. Women need to be taught and encouraged, especially by other women, to protect themselves and their children from injustice, and to give voice to their concerns and apprehensions, demanding equal consideration.

Importance of Women’s Empowerment in Community Rehabilitation
Communities in which the women are given equal governing and economic roles have proven to be more successful in achieving stability and self-sufficiency. “Given the significance of women’s labour based economic contributions to the households among the poor,” notes researcher Preet Rustagi, “improvements… concerning their educational and skill development gain tremendous importance for poverty amelioration.4

It is vital, especially in conditions where the men in the households are not taking sufficient responsibility for the well-being of their families due to alcoholism, gambling, or other detractors, to give women the confidence, tools, resources and support system that they need in order to take financial and political responsibility upon themselves. Empowerment of an entire community has to begin with the empowerment of its women. It is only when the women have the confidence and social mandate to play a part in – if not lead – community policy and financial decision-making that the community can truly move forward.

Our Approach
We feel that the ideal way to empower women, given Sangam India’s value system, is to help women to form self-help groups within the communities in which we work. These self-help groups will provide women with a sense of community and a support system to bolster their confidence. The self-help group model then opens doors across the board for better health practices for women, microfinance and microloans, community funds, and perhaps even a voice in policy-making and establishing rights.

To finish the rest of this article, check back on our upcoming website, releasing July 2009.

  1. Census of India 2001 – http://nuhru.in/?q=disknode/get/2/Slums%2520in%2520India%2520-%2520An%2520Overview.pdf&download
  2. Shraddha, Agrawal and Bharti BM (2006). Reproductive health in urban slums. The Journal of Obstetrics and Gynecology in India Vol 56 No 3 pp255-257. http://medind.nic.in/jaq/t06/i3/jaqt06i3p255.pdf
  3. Chandramouli, Dr C (2003). Slums In Chennai: A Profile. Proceedings of the Third International Conference on Environment and Health, Chennai, India, 15-17 December, 2003. Chennai: Department of Geography, University of Madras and Faculty of Environmental Studies, York University. http://www.yorku.ca/bunchmj/ICEH/proceedings/Chandramouli_C_ICEH_papers_82to88.pdf
  4. Rustagi, Preet et. al (2009). India: Urban Poverty Report 2009. United Nations Development Programme. http://www.undp.org.in/index.php?option=com_content&view=article&id=540&Itemid=646

Initiatives: Hygiene and Sanitation

Sunday, July 5th, 2009

an excerpt from our upcoming website
written by Katie Bush

Problem Statement
Throughout history, the mass movement of people into urban areas has resulted in increased risk to public health. Slums in urban areas are often defined as having low quality drinking water, poor sanitation systems, and little to no household hygiene, all of which are conditions that threaten public health. Poor living conditions in slums are directly related to sanitation. Nearly 64% of slum residences in Chennai are defined as ‘permanent-nature’ slum dwellings, the rest are merely temporary settings1. Additionally, 67% of slum residents live in single room houses. The semi-permanent and condensed nature of living conditions magnify the adverse health effects.

One of the largest challenges to public health in these slum areas is access to potable water; only 26% of the slum population has access to safe drinking water. Hand pumps supply 42% of the population with their drinking water and 31% have access via a tap. In addition, 33% do not have access to latrines. The lack of latrines leads to open air defecation, leading to disease and malnutrition due to parasitic and bacterial infections. Efforts to improve hygiene and sanitation must aim to reduce transmission of infectious agents. It is the goal of this group to investigate the effects of hygiene and health education in these slum areas on human health by carrying out surveys in the communities we adopt. Using this data, we will be able to develop more effective methods of solving sanitation and hygiene problems.

Importance of Sanitation on Community Development
Microbial contamination leading to diarrheal disease is one of the leading causes of death and disease worldwide. According to the World Health Organization, approximately 2 million children die of diarrheal disease each year. An even higher number of people fall ill due to poor hygiene and sanitation. Those suffering from diarrheal disease are also likely to suffer from malnutrition, impaired physical growth, and reduced immune response. High illness rates result in missed days of work and school for both the sick and those caring for them. Improving hygiene and sanitation will not only improve health, it may also lead to other social benefits such as improved school attendance, less time gathering drinking water, and less time caring for the sick.

Our Approach
Our approach will focus on hygiene education in the home. It is our hope that as people become more aware of the dangers associated with poor hygiene, a shift in behavior will result in improved health. We will also work with the community to promote a clean environment. It is our goal to help the community acquire the means to improve their water supply and garbage removal. There will also be targeted interventions aimed at promoting sanitation infrastructure.

Our Work So Far
Through the course of our educational programme, various lessons on health and hygiene were taught; emphasizing the importance of simple activities such has hand washing and personal cleanliness to children as a first line measure to reduce the transmission of disease. Children were taught, then asked to reinforce their lessons by demonstrating what they had learned to the group and by washing their hands under supervision. During our women’s camp we were able to give women in the slum one-on-one instruction regarding reproductive hygiene. Additionally, dental hygiene was taught at our dental camp.

Plans for the Future
Future work will largely be dictated by the community we seek to help and their specific needs. Health education will always be a main focus of our efforts, regardless of the location and condition of our next project.

To finish the rest of this article, check back on our upcoming website, releasing July 2009.

  1. Chandramouli, Dr C (2003). Slums In Chennai: A Profile. Proceedings of the Third International Conference on Environment and Health, Chennai, India, 15-17 December, 2003. Chennai: Department of Geography, University of Madras and Faculty of Environmental Studies, York University. http://www.yorku.ca/bunchmj/ICEH/proceedings/Chandramouli_C_ICEH_papers_82to88.pdf

Initiatives: Healthcare and Nutrition

Sunday, May 17th, 2009

an excerpt from our upcoming website
written by Sriram Ramgopal

Healthcare: Problem Statement
Healthcare – and the lack of easy access to it – prevents people from upward social and economic growth in India. The lack of healthcare stems from two important issues:

The first issue is a lack of access. Healthcare facilities in India are difficult to access. Government hospitals, though technically free, are so burdened by a massive population of patients and a deficiency of qualified medical staff that they simply cannot cope with the load. They have a perpetual shortage of essential medicines and are simply unable to do essential diagnostic and therapeutic procedures. Corruption in such hospitals also plays its role in limiting access to ordinary people. Thus, people are unable to utilize these hospitals in their time of need. “Experts and the general public perceive public hospitals as inefficient, dirty, unhygienic and their staff as rude, negligent and callous,” writes Ratna Magotra, for the Indian Journal of Medical Ethics1. However, while ‘free’ government hospitals are unusable, impoverished people in India simply cannot afford to go to more expensive private hospitals, where the costs of treatment are exponentially higher than what they might earn in a year – or even in several years. The long-term costs of treating chronic ailments such as diabetes and hypertension put a heavy, often unbearable burden on people with a limited income.

The second issue preventing access to healthcare is a lack of knowledge, awareness, and initiative and an ignorance about the importance of health. Such a statement is not intended to allocate blame to these people. However, they are unaware that treatment is available for many conditions, that it is affordable and easy to obtain. They do not know that many diseases – such as debilitating complications of diabetes – can be prevented by simple and inexpensive means. Perhaps more ominously, we have found in our short work here at Ramavaram that patients are unwilling to receive treatment, even treatment that they perceive as necessary and that our group has been willing to sponsor. This can be attributed to a cynical attitude towards the healthcare system and the importance of good health in their lives.

The economic and social toll that lack of proper healthcare takes in such urban communities cannot be calculated in any straightforward way. Children suffer in school because of undiagnosed refractive problems. Adults suffer from bone aches due to osteoarthritis. Acute trauma such as fractures from road traffic accidents, when improperly treated, prevents adults from being economically productive in the future. Death tolls in children due to untreated diarrheal and respiratory diseases are also distressingly high. The tragedy is that many of these people suffer from conditions that can be treated easily – and often inexpensively.

The Importance of Healthcare in Community Rehabilitation
We have chosen to work on heath care for several reasons. Most of our members, being students and workers in the healthcare field, grasp the vital importance of health in the chain of human suffering and poverty; we share a keen sense of empathy for their pain. Our belief is that ethically, the choice of providing health care when we have the power to do so is a matter that requires little deliberation. We see it as a clear responsibility with few shades of gray to complicate the issue. Helping those who are sick serves additional advantages as well. It allows people to get to work and to school and to become productive – thus breaking a chain in the disease-poverty-disease cycle. Socially, it shows our solidarity with those who need help and creates a strong bond with them based on our concern for their welfare. This leads to trust, and over time, it allows us to work with these people in other arenas as well, such as education and vocational training.

Our philosophy of health care is that of ’self care.’ When someone is sick, we believe that the immediate course of action is to help them get better. However, this is not the end-all of health care as it does not provide a long term solution for health problems that are an inevitable part of life. People from impoverished backgrounds lack access to healthcare for a number of reasons. But armed with information and support, they can make the right healthcare choices and play a positive, active role in their health.

Our Approach to Health Care
Our approach to health care has a number of facets. As the axiom says, “An ounce of prevention is better than a pound of cure,” and this certainly applies to underprivileged communities. Health education is an important part of this process. Teaching children and adults alike the importance of basic hygiene and sanitation is critical to combating common infectious diseases. Preventing children from using drugs forestalls long term, chronic health problems ranging from alcoholism to lung cancer. Informing women about contraception and its importance decreases complications associated with excessive and frequent childbirths. Thus, health education is the cornerstone to our approach in underdeveloped communities. It is the cheapest and the most effective way to avert disease and debility.

Prevention, though better than a cure, by no means replaces it. It is also important to develop ways to treat patients who are in need of curative therapy. We plan on increasing access to health care by two means – bringing health care to those afflicted with minor conditions, and for more serious conditions, taking them to centers for definitive treatment. Bringing health care to the community involves running health camps and bringing qualified medical professionals to help the residents deal with their medical complaints. By eliminating the cost of treatment and bringing doctors to their own neighborhoods, we can surpass many of the barriers that they face in getting treatment. By individually assisting the patients, we help them overcome their fear of what seems to them as a complicated and menacing system and get them the treatment they deserve as human beings.

To finish the rest of this article, check back on our upcoming website, releasing June 2009.


  1. Magotra, Ratna. “Revitalising public health care.” Indian Journal of Medical Ethics. 1995. Forum for Medical Ethics Society. 14 May 2009 <http://www.ijme.in/034ed068.html>.