|HER WORLD||Sunday, October 13, 2002, Chandigarh, India|
vital S’s of holistic health
women to cope with childbirth
"Why lose your shirt over it? It’s their choice— they can have a hundred sons if they so desire and decide how they will have them. Who are you and I to get mad at them? Besides, do you think it matters to the vast silent majority? Think about it. he could have turned out his wife, married the second time to get a son. At least, he didn’t do that. He couldn’t be such a bad guy, after all," a friend said trying to mollify me.
The story had had me seething. It wasn’t the first time when a man had wronged a woman. In fact, not one or two, but four women. It wasn’t even going to be the last. His lust for a son had wrecked a young life and humiliated his family. And after all this, he still wasn’t such a bad guy. It wasn’t as if even the choice was shared. The normally reviled woman was more than happy with her girls in this case. She was left out in the cold while the man went on to do his thing. And now, she had not only to play a doting mother to a son she had nothing to do with - emotionally or biologically - but also congratulate herself for having a husband who had spared the marriage!
Where am I in this story?
No where. I may have no right, as my friend says, to poke my nose into
it. And merely writing this story is no a guarantee against its
repetition. But I don’t want to hide behind my helplessness. Or shame
myself with silence. I cannot abdicate.
His wife, a fine blend of beauty and brains, had given up a flourishing career to raise a family. If she ever rued her decision, we don't know. But after nearly two decades of marital existence, she couldn't be certain of anything about her husband. Except for one thing—he could do or say anything, anytime, anywhere. She had admitted to herself that life with him was going to be a Rubik's Cube. At the same time, we hear, she had power over her husband. Only two people knew how much, she and he. And for all the ho-hum, she had accepted him and that too not too unhappily.
As had the daughters. The delightful trio was not always delighted with their problem-papa but loved him enough to not hold it against him. After all, he was a 40-something brat, the apple of the family tree, the only son of his mother, the only brother to his three sisters. He was mad. He had made piles of money. And above all, he was a man.
No, don't smile! It still is a big deal, in this hi-tech age of the 21st century, to be male as you shall see. So this man had virtually everything one can dream of. But he yearned for an heir, a carrier of his family name, a performer of his last rites, a protector of his pride—a son. Old stuff, you say?
Yes, the stuff is as ancient as the yearning of a seed to become a flower. A seed, says Osho, travels far to become a flower. The urge is beautiful because Nature gives it.
This man was somewhat like the seed. He began to travel, locally to begin with. The couple went to some well-known gynaecologists in their city. But they all shook their heads. "Another pregnancy could be dangerous for her," they said and sent them home.
To be fair to him, he decided it wasn't worth risking his wife's life.
But some urges are primeval. You can't rationalise them. You can neither put a lid on them and pretend they don't exist. They consume you so completely that complete fulfilment is their only cure.
His was such an urge. He renewed his travel and this time, travelled far—to another big city where a woman was ready to play body-double to his wife. She was the young, unmarried big sister to her orphan siblings. Just right for the role.
He badly needed a son and she, money. It was quits. No guilt, no pangs, no chances either - he wasn't taking any this time. The male chromosome was isolated, a test-tube employed and a womb taken. The countdown for a brand new baby boy had begun.
"Come and look at it," the mother back home had called to say to her friends. 'It' was all she could bring herself to say. She was baffled when she should have been beaming, embarrassed when she should have been eager.
But she will learn? As will the girls. Or do they have a choice?
Every story has a moral. This one has questions. And the least one can do with questions is to raise them lest they drive us insane, without any hope for answers in the future.
Here was a man - affluent, educated, modern and, supposedly, purged of a past where a woman was the bane of society. He had three very capable daughters but the thought of being sonless was too much even for him.
You can't hang a man for wanting a son. The drive is born of a raw instinct. But man is the only animal with both instinct and awareness - the ability to look ahead.
Ages ago parents winced at the mere idea of having faced insecurity. They would lose their sleep at the sight of a young daughter in their house. Marriage was a way out but one that would humble them for the rest of their lives. At the end of the day, she was an investment without returns. So very unlike a son who was Nature's gift-cheque that they could encash at the right time! He was a badge they wore proudly on their chest, which they hoped to convert into a walking stick in their old age. He brought home woman and wealth and filled their home, in more ways than one. It wasn't much fun begetting a girl in such times.
Ages later times have changed. But fears haven't. Psyches haven't. And people, by and large, haven't either. If they had, we wouldn't have had to remind you of the young Latawa sisters who hanged themselves on the birth of their brother.
The man in this tale could have adopted instead of vitiating the life of a girl, the age of his eldest daughter, if he so wanted a son. Did the girl know what she was getting into? Probably she did. Probably, she also knew she could have had a worse fate. She was surely compensated well for her services. But would it last her for a life which she might be forced to live in ignominy—with hurt and bitterness?
Or may be, she won't be so alone after all. Sitting miles away from her would be a mother and her three daughters—all sharing that hurt and bitterness. May be.
As for the little boy who is likely to hear the story of his birth when he grows up, we leave it to you to consider his fate and future. May be, he could compare notes with the brother of the Latawa sisters.
This is a bitter tale. It
is also true - at least most of it. And like all bitter tales that are
true, it would be neither nice nor necessary to give you the names of
the characters in this one. They could be x, y, z. But if chromosomes
had a tongue, they would call quite a few people quite a few names.
Three vital S’s of holistic health
IN a quiet corner of Mumbai's bustling, upmarket suburb of Juhu, two women sit together to plot a health chart for Everywoman:self-care, self-reliance and spiritual support.
The Suburban Health Centre draws inspiration from the Health Awareness Centre, run by well-known nutritionist Vijaya Venkat. This 'mother' institution, as it were, emerged over a decade ago and has already made its mark amongst Mumbai's health-conscious people, providing health counselling and specially devised diets of organically-grown vegetables and cereals, cooked without oil and free of preservatives.
The Suburban Health Centre, set up in April by Prabha Krishnan and Bina Daftary, seeks to explore other dimensions of the search for holistic health care. They raise important issues of medical ethics and proffer a critique of health practices, both within the mainstream and without.
"We need to find alternatives in our personal life, our diet and our lifestyle as we question the effects of public policy on us and our environment," avows social activist Dr Krishnan. Central to this scheme is the emphasis on a "feminist" approach to health and indeed, a feminist critique of health policy and planning. Women are at the focus of the Centre's exploration of the equation of health care to earth care to self care. The self-help unit of the Health Centre counsels clients both men and women - on health issues and problems. It charges a nominal Rs 500 (1US$=RS49) for four sessions.
The counselling includes drawing up a diet plan and discussions to get to the root of the problem, with the ultimate aim of tackling the illness by reducing or eliminating one's dependence on drugs and using natural healing methods. The clientele is mostly middle and upper middle class service professionals and other stressed-out individuals from the corporate world. Providing yet another dimension to the equation of health care and self care is the 'Aatmik' unit of the Suburban Health Centre. This unit, handled by Bina Daftary, explores the aspect of spiritual healing in a non-denominational context through the use of yoga, meditation and other such therapy. "Our clients have experienced a vast improvement and we do follow-up with them. Some of them find it easy to strike the right balance but others struggle to maintain their changes. They are, after all, a part of society," Dr Krishnan admits. "I find a level of diffidence in some of them, while many others have made the transition to good health more easily," she says. Armed with her lifelong commitment to women, media and health, Dr Krishnan published Health Care = Earth Care—Interrogating Health and Health policy in India' in October 2000.
The book draws parallels between the systematic degradation of the environment, governmental policies and programmes that are detrimental to the health of society as a whole and women and children in particular. For instance, the inordinate use of ultrasound scanning of pregnant women, the increasing use of iodised salt in a family's daily diet or the inadequacy of mammography as a technology to prevent rising breast cancer. Dr Krishnan draws attention to the research on irradiated chappatis conducted by multinationals in conjunction with Mumbai's Bhabha Atomic Research Centre and questions the mantra of liberalisation and globalisation that has destroyed indigenous practices and methods.
Dr Krishnan points out the politics of government health policy and pharmaceuticals in pushing hormone replacement therapy (HRT). Few women are aware that the drug 'Premarin', prescribed for menopausal women, is a short form for 'pregnant mare's urine'. The product, which is the third-largest selling drug all over the world, is an extract from mares that are kept permanently pregnant and denied sufficient water just so that their urine will have a high concentration of the hormone estrogen! The Health Centre counsels women that menopause is not a disease but yet another phase in the life of a woman. Instead of this unhealthy dependence on drugs, it is exercise and meaningful activity, along with a healthier diet, that will help women cope with the changes this stage brings.
Funds for the Health Centre's activities, in keeping with its philosophy of 'ethical' self-reliance, are entirely drawn from counselling and sale of products produced by it. No corporate or foreign donations are accepted while other donations, if forthcoming, are from actual users of the Centre's activities. The Health Centre is clear that while it can provide orientations for interested groups of people and conduct awareness programmes on health, it will not sell or endorse any products manufactured by corporate houses. The Health Centre brooks no tampering of this policy and jealously guards its independence.
Two years ago, the multinational Hindustan Lever Ltd, in a huge marketing gimmick, stuck its stickers onto dabbas, the hot-case lunch-boxes of scores of office-goers in the metropolis. The company managed to do this by entering into a contract with the trade union that runs the army of dabbawalas, the workers who ferry the lunch-boxes from various homes and catering services to the office-goers at their place of work.
Unfortunately, one such
catering service was the Health Centre, which provides health food to
members on its programme. Each and every sticker of the multinational
was removed from its lunch-boxes while the trade union's
representative was reprimanded for extending the company's advertising
gimmick to the Health Centre's dabbas. It was scarcely a
coincidence that Hindustan Lever Ltd is the largest manufacturer in
the country of fortified wheat and food soaked in preservatives and
additives to cosmetics and detergents. One of the biggest advertisers
in the country, the multinational's main target audience and market
women to cope with childbirth
SHE started off as just another neighbourhood gynaecologist more than a decade ago. Today what sets Sushma Noheria apart from rest of her ilk is the fact that besides bringing joys into thousands of families, which obstetricians are credited to, she runs ante-natal classes that are attracting expectant mothers in droves.
Perhaps, she is the first gynaecologist who started conducting such classes in Chandigarh or it’s vicinity more than seven years ago. "I’m not too sure on that," Noheria says rather modestly underplaying the fact that it was through her skills that a world record 5.7 kg healthy baby was born through normal delivery at her nursing home. She even intends contacting the world record compilers in this regard.
In fact, it all started off spontaneously. Noheria used to talk about ante-natal therapies during the normal course of consultations at her clinic in Sector 8, Panchkula.
"Then I realised it was time consuming as most of the persons were unaware of it. So I formed a class and started addressing them collectively on alternate Sundays," she says. "We discuss newer concepts of delivery management through a few asanas, biorhythm and breathing exercises. I tell them, Look! this is the last time you are getting time for yourself. Next time could be 10 to 15 years hence," she adds laughingly.
She says that younger generation deliberately prefers caesarian section perhaps fearing the pangs of what is natural. "This is a dangerous trend. This is precisely why I started taking classes. Medical science is about clearing all fallacies and false fears," she says sounding philanthropic.
To remove all myths connected to
childbirth, Noheria wants to make a Website for those who cannot
attend the classes personally. But then the Net cannot be a substitute
to personal interaction," she says but adds that this might prove
useful for those who come from far-flung areas to attend her classes.
OVERALL performance of the states in the implementation of the Integrated Child Development Services (ICDS) scheme shows that four states—Gujarat, Haryana, Orissa, Maharashtra and Madhya Pradesh are amongst the better performing states, while Punjab, Jammu and Kashmir, Uttar Pradesh, Bihar and West Bengal have performed much below the average.
The ICDS scheme aims to improve the nutritional and health status of pre-school children, pregnant women and nursing mothers by providing a package of services. This package includes supplementary nutrition, pre-school education, immunisation, health check-up, referral services and nutrition and health education.
The scheme has now come to be regarded as the most viable for achieving the goals set in National Plan of Action for children. These goals include, inter-alia, reduction of infant mortality rate (IMR) to less than 60 per thousand, reduction in child mortality rate (CMR) to less than 10 per thousand, reduction in maternal mortality rate (MMR) by at least 50 per cent, reduction in severe and moderate malnutrition among children under 5 by at least 50 per cent and universal enrolment and retention in primary schools.
The nation-wide evaluation, according to the annual report of the Department of Women and Child Development, Union Ministry of Human Resource Development, was undertaken by the Department following a pilot study conducted by the National Council of Applied Economic Research (NCAER). The evaluation was aimed at examining the performance of the scheme on the ground with a view to assess the capability of the functionaries. The study is based on a field survey of nearly 60,000 Anganwadi Centres and 1,80,000 beneficiary household selected from 4000 operational blocks spread over 32 states and union territories.
The survey results show that the ICDS programme in the country has benefited over 50 per cent of the eligible children and women. This, despite the fact that most Anganwadi Centres are located within a distance of 100-200 metres from the beneficiary households.
Another feature revealed by the survey was that only 36 per cent of the Anganwadi Centres (AWCs) in the country were housed in pucca buildings, with the states in the western region showing an edge over the remaining states. About three-fourths of the AWCs were functioning in a temporary open space, school premises, or even in a cattle shed.
Further, the overall availability of a toilet facility at the AWC was alarmingly low with less than 24 per cent of the AWCs reporting such provision in majority of the states. About 54 per cent of the AWCs had no provision of a separate cooking space.
The AWCs were found to be adequately staffed and most of anganwadi workers were residing within accessible distance from the AWCs. However, inadequate availability of inventories and inadequate provision of in service training to functionaries were major constraints in the effective functioning of the programme.
A survey revealed that some states (and even particular districts) were at the receiving end of frequent training courses organised by a variety of departments and organisations, and that in the states, the anganwadi worker was absent for long periods of time to attend these training courses at the cost of the beneficiaries.
Another aspect of concern is the high degree of duplication as intensive studies are being separately carried out by different departments and organisations on the same area, training modules are being developed independently and these are then sought to be implemented. This is indeed a very big loss for the ICDS programme.
This only highlights the fact that convergence and cooperation both within and between the departments for ICDS has been limited. The initial results of the survey also indicate that the support from community has been somewhat lukewarm and community support was found to be poor or average.
The NCAER survey has pointed out that this has helped in increasing the child’s communication skills, social and emotional development. This has also helped in the entry of children to schools.
The most important
impact of the scheme is clearly reflected in significant declines in
the levels of severely malnourished and moderately malnourished
children in the country as also insignificant decline in infant
mortality rate. The relationship both between maternal mortality rate
(MMR) and infant mortality rate (IMR) and institutional delivery
showed that wherever institutional deliveries are high, mortality
rates are low.