Wednesday, December 26, 2007

Deep in Drudgery: Women and Health in Uttarakhand..!!

Source Posted by ANON

The consequences of the ever-increasing workload of hill women can be directly witnessed in their declining health status. They tend to suffer in isolation and become accustomed to several of their physical complications. But, on unlocking their silence, immense ordeal regarding their health conditions is revealed, in addition to the mental affliction they have been undergoing timidly. In Uttarakhand, women of varied ages undertake severe physical work in the coarse environment of the mountains. Besides, the cultural conditions have created a biased ambience, which has made women to fail to realize their basic rights.In spite of undertaking hard physical work, a hill woman’s intake of food is always low and less nutritious. The food intake is never balanced to her energy spent on daily activities. Anaemic cases in the hills are found at every other step. Stressful work has also led to muscle pain, back pain, foot pain etc and has severely affected their reproductive health (this will be discussed later). The specific health risks occurring due to women-related work include respiratory problems due to long hours spent indoors on cooking with fuel wood; sore and pain in the hips, shoulders and legs for carrying heavy loads of fodder and water; and bearing infections while working at unclean cowsheds – the tradition of girls sleeping in cowsheds during menstruation is commonly found in the hills.Examining the social aspects of women’s drudgery, the situation is found to be far worse from the mental health perspective. Traditionally, women are denied their basic rights and freedom. Special cultural practices such as women washing the feet of the family elders every night overburden them with more work. The issue of violence against women is vastly spread over the hills and the terai region. The most common factor found in all cases of women abuse is liquor and for this reason, women generally identify liquor as their deadly enemy spoiling their family peace and devouring the household economy. Submissive women are beaten up and harassed by dominant alcoholic husbands. Besides, such beatings are regular and, at times, criminally violent. A woman, who has spent all day in undertaking strenuous tasks, indoor as well as outdoor, is mercilessly battered at night. She barely succeeds in protecting her small children from the husband’s abuse, facing damaging consequences on her physical and mental health. Mental stress during times of reproductive period has its irreparable impact on infants and may lead to mortality or psychological setback in later years.Village women have explained the disastrous effects of liquor taking over them and their subsistence economy. The country-made liquor made of chemicals, sugar lumps, toxicants and dirty water of open streams directly harms the health of the person who uses it. Men usually resort to drinking because of personal socio-economic problems and become addicts. They start spending their limited earnings on buying liquor. The household economy falls down and women are burdened with the task of earning income for the survival of their children and themselves. Prevalence of tuberculosis, liver problems and stomach ailments reduce the working capacity of men. The economic situation deteriorates with increased borrowings and landlessness; all taken away by liquor.In the hills and the terai region, girls are married at an age between 14-18 years because people believe in the traditional thinking that a girl’s real home is with her husband and not with her parents; so she is married off as early as possible and sent away to her husband. But the serious impact causing on the reproductive health of these girls is hardly estimated or known. These girls are expected to bear children from the age of 17-18 years onwards to the detriment of putting both mother and child at the threshold of morbidity. The RCH (Reproductive and Child Health) programmes of the government are still lacking behind with elements of quality and outreach. ANMs’ (Auxilliary Nurse Midwives) inaccessibility to remote villages and community’s low awareness on RCH-related issues have denied a greater number of women with the facility to undergo ante-natal care. Anaemia cases have shown no reduction in spite of good distribution of IFA (Iron and Folic) tablets. Village women have a tendency to either throw away these tablets or leave them behind at the subcentre due to dubious reasons that these tablets cause giddiness or headache. The lack of awareness and low-level of information are visible reasons for entertaining such kinds of beliefs. The ANMs’ lack of motivation and poor knowledge dissemination during distribution is responsible for poor information resources of the community.The sweeping number of non-institutional deliveries in Uttarakhand is a compelling issue to be addressed. More than 80% of deliveries are conducted by untrained dais (local name for Traditional Birth Attendants) following age-old methods and practices of labour. The research study has shown that this act is steeped in ignorance, misinformation and superstition and has led to the occurrence of several reproductive health complications including maternal and infant mortality and morbidity. The untrained dais undertake deliveries amidst unhygienic surroundings. The method of forcefully pulling the child out of the womb has made the women suffer from prolapse. Dais are always incapable of handling high-risk deliveries in villages and, during such helpless times, suggest taking the pregnant woman to hospital. Most of the maternal and infant deaths in the hills take place while they are being transported to hospital during delivery times; the distance and inaccessibility issues again emerging at such points. In order to reduce the high infant mortality cases, it is important to address the issue of non-institutional deliveries in a holistic manner.Child immunization practices were found to be low during research. Women usually avoid taking their children to immunization camps or subcentres either because of lack of awareness, no availability of time due to heavy workload, long and inaccessible distance and cultivating of false notions that immunization is harmful to children. Huge drop-outs are seen in rural areas and the maintenance of immunization cards is a mere act of formality, rather than signifying facts on immunization status.Colustrum feeding in the hills is quite low and out of practice. Again, complete absence of post-natal services and prevalence of superstition prevent mothers in providing first milk to infants because “it is dirty and not good to the new born.” Traditional practices such as nobody should take anything eatable offered by a woman soon after delivery is profoundly set in the minds of both men and women.Adoption of family planning methods is mostly done by women. The data in the hills on female sterilisation is high. Men avoid using condoms as they are usually under the influence of alcohol during acts of sex. They do not take up sterilisation because of the prevailing myth that “men work harder and they should not be asked to undergo vasectomy.” This is, though, contradictory to the entire hill scenario, but these very words of assumption have come straight out of women. They think it is justified if men do not follow family planning principles and women bear the burden of it as well. Use of oral pills is low because women believe that they cause headaches. IUD insertion is avoided because there is no follow-up care given at government health centres.Women in the hills have a propensity to take up work within 10-12 days after giving birth to a child. This is just another reason for women suffering from prolapse and other reproductive health problems. The prolapse of uterus is so widespread among women that it can be said that it is one of the major causes for their poor confidence-levels and constant mental stress. This problem keeps interfering with their daily work and it discourages them from going out of the village or being in front of men. Some women hardly know what it is although they complain that “something keeps coming out of the vagina” while they walk or work.They adopt the habit of stopping for a while and putting it back, rather than consulting someone on this due to the fear of facing embarrassment. They fail to seek treatment on this either because there is no lady doctor at the PHC (Primary Health Centre) or the cost of it at a private clinic is very high.The ANM (Auxiliary Nurse Midwife) is hopeless in this matter as she just refers the patient. “We are afraid to go out of the village, so how can we go to hospital. And, by the way, there is no lady doctor at there to look into our problem,” says a woman suffering and representing this problem.Prevalence of reproductive and sexual infections is largely seen in women. This is not only because biologically they are more susceptible to the infections, but also because they do not follow hygienic practices during menstruation. They fail to consult to the doctor at the first stage of the disease and, thus, give way to more complications. High chances of contracting HIV exist when their migrated husbands return back home carrying infections. The socio-cultural norms do not allow them to spend the household economy for their treatment, as a woman’s illness is not a matter of serious concern. Women also end up in hiding these problems and thereby, husbands and in-laws remain insensitive to these severe complications and their consequences.

PG Group!



The Rural Development Interventions in Uttarakhand..

BY : ANON. Ever since the formation of Uttaranchal, developmental interventions at a substantial scale are being carried out, mostly in specialized sectors. The infancy phase of the state, the social and economic marginality of the community living in this mountainous region and the government’s strong livelihood promotion policies have drawn considerable investments from bilateral, multi-lateral and ministerial agencies for improving the socio-economic and cultural well-being of the communities. The state has been receiving ample amount of loans from the World Bank in developing specific sectors such as agriculture, water and sanitation, watershed, health and education. Bilateral agencies like USAID (United States Agency for International Development) and CIDA (Canadian International Development Agency) have even prioritized the state of Uttaranchal in their list of focal states for providing development funding. The Delegation of the European Union represented by the European Commission has been supporting programmes in watershed development and, recently, in health sector reforms. UN agencies such as WFP (World Food Programme) and UNDP (United Nations Development Programme) have collaborated with the Department of Women Empowerment and Child Welfare and Disaster Management Unit of the Government of Uttaranchal respectively.The Ministry of Human Resource Development has launched welfare schemes and programmes such as the Swa-Shakti Programme, Rastriya Mahila Kosh and Swamyasiddha, which are functioning either independently or jointly with state government and NGOs and promoting one or all aspects of livelihood development in Uttaranchal.At the state-level, various units of the state government are also involved in implementing livelihood promotion programmes. The Rural Development Department is at the forefront in putting into operation Central Government Schemes such as the SGSY (Swarnjayanti Gramin Swarozgar Yojana), which has been funding micro-enterprise initiatives (mushroom production, wool production, handicrafts, poultry, medicinal plants etc) of the rural community. The Department has lead banks in almost all the districts to help the community access credit and it has also collaborated with the National Life Insurance Company and Oriental Insurance Company to provide micro-insurance services to marginal farmers. Other programmes of the Department include: Sampoorna Gramin Rozgar Yojana (SGRY), Indira Awaas Yojana, Pradhan Mantri Gramodaya Yojana- Gramin Awaas, Credit-cum-Subsidy, Unnat Chulha, Biogas, Drought Prone Area Program (DPAP), Pradhan Mantri Gram Sadak Yojana (PMGSY) and Integrated Wasteland Development Programme (IWDP). The Department also leads state sponsored schemes such as Vidhayak Nidhi, Sansad Nidhi and Community Development Programme. Some of these programmes are implemented in selected districts and some others on experimental basis. The Department has also instituted training centres to organize capacity building programmes for rural communities. At present, there are: 1 State Institute for Rural Development at state-level, 5 Regional Institutes for Rural Development and 3 District Institutes for Rural Development.In the Cooperative Sector, Uttaranchal has a State Cooperative Bank as an apex institution in the state, following District Cooperative Banks at district-level and at the village-level, smaller units called PACS (Primary Agriculture Cooperative Societies). Other cooperative institutions include the Uttaranchal State Cooperative Marketing Federation Limited and the Uttaranchal Cooperative Sericulture Federation Limited. The Cooperative Department coordinates projects such as the Sahakari Rrun avam Adhikoshan Yojana, Sahakari Krya-Vikraya Yojana, Sahkari Upabhokta Yojana etc. The state has about 763 PACS and 103 Primary Consumer Cooperative Societies. There is also the Institute of Cooperative Management, providing training and management services to cooperators. The Department has recently collaborated with ICICI Prudential Life Insurance Company for provision of micro-insurance services to rural farmers.The Uttaranchal Rural Water Supply and Environmental Sanitation (SWAJAL) Project, supported by the World Bank, has begun its phase II programme covering all the thirteen districts of the state. The SWAJAL project has a focus upon delivering sustainable health and hygiene benefits to the rural populations through improvement in water supply and environmental sanitation services and promoting long-term sustainability of rural water supply and sanitation. The project has considerable focus on livelihood promotion as it emphatically focuses upon SHG mobilization, income generation, savings and thrift, women empowerment, time saving technologies and general awareness.The Agriculture Department’s Watershed Management Directorate is currently implementing the Integrated Watershed Development Project (Phase II) in all the thirteen districts of Uttaranchal with the objective of improving the productive potential of the project area, using watershed treatment technologies and community participation approaches and contributing towards decreasing soil erosion, increasing water availability and alleviating poverty. The Department is also carrying out other programmes such as the Micro-mode programme providing subsidies to rural farmers in accessing agricultural technology, seeds and pest management. Innovative programmes such as crop insurance are also being experimented in pocket areas. Financial assistance to marginal farmers is given through crop-based programmes such as Makka Vikas Programme, Dalhan Uthpadan Vikas Programme etc.The Department of Industrial Development has allotted certain schemes for rural masses such as the Pradhan Mantri Rozgar Yojana (PMRY) to provide financial assistance to agriculture and industries in rural areas. The Department has a specialized unit of Khadi and Village Industries with multi-disciplinary training centres in different parts of the state. These centres provide regular training to rural entrepreneurs in small industries such as woolen hosiery, embroidery, bee keeping, diamond cutting, candle making etc. The unit also runs financial assistance schemes such as interest-cum-subsidy scheme and margin money scheme in the interest of small-scale rural industrialists.Other departments such as the Horticulture and Livestock Departments have also various programmes for livelihood improvement in Uttaranchal. The State Government’s development focused activities have also led to formation of autonomous bodies, initially promoted by the government itself, on specific sectors such as organic farming, bamboo, livestock etc. The boards in place at the moment are Forest Development Board, Bamboo and Fiber, Livestock and Cattle Development, Uttaranchal Mandi Vikas Parishad and Organic Boards.The Department of Women Empowerment and Child Development is carrying out ICDS (Integrated Child Development Scheme) programmes with the support of WFP and the World Bank to improve the nutritional security of the community. The programme is currently implemented in 40 blocks of the state and has created a force of community-based aaganwadi workers and has established 6378 aaganwadi centres to cover about 15000 habitations all over Uttaranchal. Mahila Samakhya is another major programme of this Department implemented for working towards women empowerment in the state.In the health sector, the Department of Medical Health and Family Welfare has recently established the Uttaranchal Health and Family Welfare Society (SCOVA), an autonomous organization working to carry out health sector reforms and improve the efficiency of the management systems of the health programmes. SCOVA is implementing Sector Investment Programme (SIP) of the European Commission covering Fixed Day (immunization) services, policy reforms, emergency obstetric care, Chikitsa Sudhar Samiti, drug policy and other health management-led concepts such as IEC, (Information, Education and Communication), logistics etc. It is also in the process of planning programmes focusing upon integrating SHGs with community health services and creating a large cadre of trained community health workers at hamlet-level or village-level, as the need be, all across the state.NABARD, the apex institution for rural credit is providing investment and production credit for promotion of various developmental activities in Uttaranchal. It is working towards institution building for improving capacity of the credit delivery system, including monitoring, formulation of rehabilitation schemes, restructuring of credit institutions, training of personnel, coordinating the rural financing activities, preparing rural credit plans for all districts, undertaking monitoring and evaluation of projects refinanced by it and promoting research in the fields of rural banking, agriculture and rural developmentThe Community Based Economic Development Project (CBED) is an important project implemented by NGOs (CECI, KAGAS and HSC) and funded by CIDA. The project is working to reduce poverty in 250 villages of Pithoragarh and Champawat Districts. The four-year tenure project is being implemented on pilot basis, replicating a similar model successfully experimented upon in Nepal. CBED has a focus upon promoting self-reliant institutions and has played an active part in advocating and promoting the Uttaranchal Self-Reliant Cooperative Act, upholding community-owned cooperatives for economic upliftment of the hill communities. CBED has also promoted NTFP production, agricultural technologies, CBO management, institutional strengthening, responsive development funds, economic literacy, gender development and sub-sector analysis. The project has been working closely with the Government of Uttaranchal and has been actively providing policy feedback.The Department of Energy established the Uttaranchal Renewable Energy Development Agency (UREDA), as a nodal organization working on non-conventional energy. It has established solar units and solar fencing in remote villages of the state for provision of lighting facilities and supply of electricity for cottage-based industries. It also develops the capacities of rural communities in managing solar units. Rural workshops have also been set up and village youths have been trained in repairing and maintenance of solar technology. In addition to this, village-level funds are mobilized to cover the maintenance costs of the systems and village-level solar committees have also been formed to supervise their functioning. UREDA has offices in all districts of the state.



The Pauri Garhwal Group!

The Pauri Garhwal Group!