|HER WORLD||Sunday, June 8, 2003, Chandigarh, India|
Spirit of enterprise
I feel strongly
health programme for women
HEART disease and not breast cancer is the bigger killer of women in India today. "Women have a ten-fold greater risk of death from coronary arterial disease as compared to breast cancer," says Vivek Gupta, senior cardiologist at Delhi's Indraprastha Apollo hospital. "Research now says that a heart attack or a stroke is more likely to be fatal in women. When women have a heart attack, the amount of heart muscle destroyed is likely to be greater, and they are more likely to go into shock, have heart failure and die," Gupta asserts. He adds that for women, the rate of mortality within one year after a heart attack is 44 per cent, as compared to 27 per cent for men.
Researchers have started focussing on women and heart disease only in the last decade. Sanjeev Sharma, cardiologist at Delhi's National Heart Institute, says that most women don't take the early symptoms of heart trouble seriously — like heartburn, recurrent digestive problems or nervousness.
Although there is a definite increase in more women coming out to report heart problems, doctors believe the issue is more complicated. "Life expectancy among women has increased. But after menopause, women lose the protection of estrogen (female hormone) against heart disease," says Anita Saxena from the Department of Cardiology, All India Institute of Medical Sciences (AIIMS).
"From 1960 onwards, life expectancy for both men and women in India has increased by 20 years, coming up to an average of 61 years," says Gupta. Simultaneously, coronary arterial disease has increased by seven per cent in urban India and by two per cent in rural India for both men and women.
The most disturbing news about women and heart disease is that it is also affecting younger (35-45 age group) women. A.Sampat Kumar, also from AIIMS, attributes this to stress and lifestyle changes. Many young working women today have to perform both at work and at home. The dual pressures play havoc with their hearts. "Stress plays a major role in the deposition of cholesterol in coronary arteries. The safety blanket of female hormones is not enough for women as young as 40 or 45," explains Gupta.
More and more urban women are also leading what Gupta calls "pressure cooker" lifestyles. They eat wrong (more junk food and frequent meal skipping), don't exercise, sleep less and are constantly worrying about work or tasks they have to finish. "They are living in a pressure cooker, and unfortunately the whistle often blows in the form of a heart problem."
There has also been a substantial increase in women smokers in the cities, observe doctors. These women run a high risk of death from heart disease or a stroke. The increasing incidence of diabetes and obesity among women has also made them more prone to heart attacks. Diabetic women have three to seven times more risk of developing heart disease. Recent research is also pointing a finger at the long-term use of birth control pills in increasing such risk among women.
So far, women enjoyed an advantage: of being susceptible to heart problems almost 10 years later compared to men. But once they start smoking, become diabetic or reach premature menopause, they are as vulnerable as men, believes Gupta. Genetically, while Indians are more predisposed to cholesterol deposition compared to people in other countries, Indian women are more likely to get the more dangerous multi-vessel disease.
New research is also connecting heart problems to behavioural patterns and social conditioning. Women are accustomed to not paying attention to their own health needs. They are the caregivers who tend to postpone their appointment with the doctor to fulfil other family duties.
With some precautions, women can regain their advantageous position in the healthy heart race. How? One, through a diet that has five or more servings of fruits or vegetables daily and is low on cholesterol and saturated fats. Two, by walking at least for an hour a week; and three, by quitting smoking.
The benefits of walking
have been reinforced by a study published in the Journal of the
American Medical Association in 2001. It said that walking, even at
a moderate pace reduced the risk of heart disease among nearly 40,000
women, including those who smoked, were overweight and had high
IT is a sheer coincidence that Swatantra Bala Chowdhary is in politics. Nearly two moths back, she was the principal of a senior secondary school, unaware of how destiny was going to intervene and shape up her career in a totally different way. The sudden turn of events after the death of her father-in-law at Shimla on March 27, catapulted her to mainstream politics. For the first-ever woman MLA from Fatehabad, entry into politics might have been by default rather than by design, but she is not ignorant about the consequent responsibilities. A Master’s in political science, Chowdhary has been nominated to the Assurance Committee of the Vidhan Sabha by the Haryana Assembly Speaker Satbir Singh Kadiyan.
At her Basti Bhiwan residence, she was busy attending to the visitors, a majority of whom were women. These women had come with a wide range of problems like non-receipt of widow pension, eve-teasing of young girls by street romeos and property disputes. Chowdhary listened to all complaints with rapt attention and redressed them by talking to the concerned officers over the telephone immediately.
In an interview, Chowdhary voiced her thoughts about her role and responsibilities. According to her, becoming an MLA has not made much difference to her because even in her capacity as a principal of a senior secondary school she believed in sincere hard work. The same is true now, only the area of her work had become vast. Though her responsibilities have definitely increased after becoming an elected representative of people. There is one major difference, she adds in a lighter vein, in her job as a principal and the present job. While her earlier job was of a permanent nature, she will now (as an elected representative) have to work hard to ensure that they vote for her in the next elections!
Her gender, Chowdhary feels, has never been a handicap for her. Neither she nor her family members have ever thought being a woman as a disadvantage. Her family, particularly, her bank officer husband, has been very cooperative, she adds. However, at times, she herself feels the guilt that the family is being neglected. However, she is confident that she will be able to give enough time to her family after the initial euphoria of her win in the election is over. At the moment, party workers throng her house and she hardly has a few minutes for herself, what to talk of her family!
Chowdhary, a strong votary of reservation for women in the Parliament as well as the state assemblies, is of the view that if the lot of women in this male-dominated society of ours is to be improved, women must be allowed to become a part of the decision-making process. She feels those who oppose reservation cite the alleged interference of male members of families in the functioning of women elected under the panchayati raj organisations fail to appreciate the fact that it is just an initial phase. Women will gradually start learning the processes from which they had been deliberately kept away for long, she feels. She admits that she does take the counsel of male members of her party on certain matters. However, while taking a decision, she applies her own mind after taking in to account the advice given by them. The advent of women in politics would cleanse the political process to a great extent, Chowdhary feels. Women, she is of the view, are instinctively more god-fearing and sensitive to others’ problems and more humane than their male counterparts. The induction of more women in state legislatures and the Parliament would automatically solve some problems, she adds.
She plans to launch a special drive in her area to identify and help out women in distress. During the election campaign, she met widows who have not been getting pensions because of bureaucratic hurdles and others whose land-holdings have been usurped by unscrupulous relatives after the death of their husbands. Redressal of their grievances will be a priority with her. She also plans to do her bit for the elimination of dowry. As the principal of the girls’ school, she organised symposia and seminars on this subject to generate an awareness about this menace.
She feels that all women
MPs and MLAs, cutting across state barriers and party barriers, should
work for those issues that were directly related to women. Education is
and will always remain the first priority of Chowdhary. She says that
she has always been motivating parents to educate their children.
Education is all the more important for girls as an educated woman is
definitely more empowered than an illiterate woman.
IN a world where all we hear about women’s lib, empowerment, her dual job as a homemaker and a bread winner; I believe in drawing a line somewhere. In sitting back and enjoying what we rightfully should. For being a woman is no piece of cake. Between dodging eve teasers to haggling with the bhaji-wala, managing a household and making a finicky child have his meals, making time and space for oneself can be quite a task. So, what do you do? Fix a day and time with your friends and have plain unadulterated fun and voila ! You have a kitty party.
In spite of everything being said about a woman being incomplete without a man in her life and vice-versa, there is no male substitute for female bonding. Just sitting there for a couple of hours and pouring out your heart to your gal pals can be much more helpful than umpteen visits to the neighbourhood shrink. Even when I go for a kitty in my worst of frame-of-mind, listening to my friends talk about their lives, has often given me a fresh perspective on my problems. Okay, so you can’t solve major issues by gossip, but if it makes you feel good, why not? And I am definitely not the kind to feel guilty about having a nice time.
When I find the time to shoulder my responsibilities, I definitely deserve to go out and enjoy. And whoever says kitties are a ‘non-productive-waste of time’ venture should get their head examined. After all, all work and no play, sure makes Jill a dull girl. Any gossip that relieves me of my tensions and makes me feel fresh to take life head on is definitely healthy.
When was the last time you saw a group of PYTs ( I don’t mind putting myself in the category of pretty young things) having a sumptuous meal without worrying about gaining a milligram? Chances are, not since you last went for a hip and happening kitty. It’s a delight to see that your friend with the figure you envy, actually pigs out on the same food that you do. It makes me feel good to know that I don’t have to give up my favourite food to be like her (there must be something else that she does to be so fit, which I can always find out in the next kitty!). And you get to order something which your kid may not want to eat.
So you went to the new boutique and bought the most chic (and costliest) dress there. You spend an hour trying to look your best in it and another two hours hovering around your husband on the flimsiest of excuse, leave alone complimenting the dress, I can bet he will never realise it is something you have never worn before. Fishing for compliments? Try your friends any day. Imitation may be best form of flattery, but never underestimate the power of praise. I would rather hear a few words of praise (however-half-hearted), than none at all.
Whereas else would you dare to wear a heavily embroidered choli with skin-tight jeans just because it is a fad, and get away with it? Once when we had a ‘retro-Bollywood’ theme party, every one turned up looking like clones of Sharmila Tagore, Asha Parekh and Mumtaz, et al; complete with the elaborate hairdos. The sniggers from the restaurant staff did nothing to dampen our spirits. Dancing with all the jhatka-matkas that day, we decided to schedule the next party as a ‘Star trek’ special.
Kitties are a great way to set aside a fixed amount of money and getting it all back together at your kitty. Women who can’t resist the urge to spend on every new shade of nail paint, lipstick or the beautiful suit that she just must have, often find themselves short of dough for a piece of jewellery or a new curio for her room. In such a scenario, a monthly saving (which also ensures a great time), comes to our rescue, You can finally get your cherished dream thing without your husband reprimanding you on your extravagant spending habits. My friend, Jyotika, who is a self-confessed jewellery freak, can’t thank me enough for introducing her to my kitty group. Earlier, she had a tough time convincing her husband to buy her some jewellery or a really heavy sari. Now she sports a new set for every kitty she hosts. And her husband is not complaining either. After all, all he does is part with a sum equivalent to a pair of shoes, a suit or a simple sari. Both of them feel great about the win-win situation.
I have a blast, right from the time I start dressing up to the time I recount every enviable detail to my husband.
Then there are the
occasional trips to the movies which no one but your gal pals will go to
with you. I remember having seen quite a few Govinda flicks with my
friends. Between Govinda’s comic antics and our original PJs, we
merrily munched popcorn and downed it with gallons of cola. You can have
‘romantic fun’, ‘according-to-him fun’, ‘according-to-your-kids-fun,’
etc., with your hubby and kids but what about ‘girlie-girl fun’and
the ‘me-my-type-of fun’? Come on now, join my kitty!
health programme for women
THE Mahila Swasthaya Sangh (MSS) scheme in Punjab was conceived and initiated with good intentions. However, it could not be implemented because of radical socio-economic changes that are taking place in rural Punjab.
A substantial rise in income, increasing facilities of transportation to the nearby towns and communication, easy access to private medical practitioners and big hospitals, and desire for getting specialised treatment are creating an environment where the intervention by the MSSmembers is not very significant for the well-to-do sections of the rural society. The scheme remains of great relevance to the poor.
An evaluation of the MSSscheme was undertaken by Ritu Sharma and Neetu Gaur of the Population Research Centre at the Centre for Research in Rural and Industrial Development (CRRID), Chandigarh.
According to the study, three factors were responsible for its failure,: lack of motivation among health functionaries, inadequate awareness on the part of MSS members who, in several cases, were not informed about the purpose of the scheme, and absence of any incentive for the MSS members.
The scheme was introduced in 1990 with the objective of making the community self-reliant in health-related fields as well as bringing about behavioural changes which will, once again, put Punjab in a leading position at the national level.
Three districts, namely Sangrur, Jalandhar and Gurdaspur, representing three geographically and socially different regions (Malwa, Doaba and Majha, respectively) of Punjab were selected. All the 16 tehsils (six from Sangrur district, five each from Jalandhar and Gurdaspur district were covered.
The MSS members hail from families dependent on cultivation, agricultural labour with no substantial source of income. A majority of households does not come under below poverty line criteria, yet most of them are underprivileged. Nearly two-fifths of the MSS members were illiterate. As a result, their understanding of the functions required needed to be strengthened. Since there were no monetary incentives for these members, most of them, particularly those belonging to a lower socio-economic status, were not motivated enough to work for the scheme. As a result, the scheme suffered.
Health awareness had increased to some extent, mainly through anganwari workers, T.V. and radio. Efforts towards promoting welfare of the girl child have been weak, except in Gurdaspur district where elderly ladies, panches, sarpanches agitated against female foeticide.
The MSS members surveyed in all the three districts were housewives; in the age group of 30-45 years. Their profile indicates that their nomination did not follow any strict criteria. the number of members in each MSS varied with the population size of the village. The multi-purpose health worker female) nominated 83.3 per cent members; 89.6 per cent had given their consent before nomination and 83.3 per cent had prior briefing of their responsibilities. Only 25.6 per cent of MSSmembers had received induction training and hardly 18.2 per cent had attended referral courses.
Activities of the MSS were restricted mainly to registering of pregnancies and newborn babies, and to promotion of immunisation and family planning programmes. Their role in ANC and PNC, distribution of IEC material, promotion of welfare of a girl child and neutralisation of son preference was minimal. MSS role in promoting skill development among households for preventive and promotive health was reported the least. Gurdaspur district was noted for its success in controlling female foeticide towards which MSS members had played a critical role.
MSS held monthly meetings, usually presided over by the area’s multi-purpose health worker (female). However, only a few members attended it. In general, members were not found serious about their assigned duties. MSS hardly enjoyed any recognition among the villagers. Only a few motivated ladies from the village acted as a link between village population and the MPHW(F). Evidently, there is an urgent need to inculcate community spirit in MSS activities. Most critical is to strengthen awareness and upgrade skill among the members. Although most of the MSS members and others were found satisfied with the functioning of the MSSs, under the prevailing conditions, many underlined the need for reform.
Suggestions to improve the functioning of the MSS ranged from assigning of specific responsibility to individual MSS members, providing them a token honorarium, and making them accountable. The need to popularise the scheme through mass media was also highlighted.
The study has further revealed that the motivation on the part of health functionaries, especially MPHW(F), is weak. The observable reason for this is that she is overloaded with work and she has to implement many other such schemes. It is not only the incentive that is missing; even the material and equipment provided under the scheme is of poor quality.
Normally members do not
volunteer themselves. Members are nominated as per the convenience of
the health functionaries. Over the years, health functionaries at the
grassroot-level have been able to develop a rapport with some select
families. They have nominated women from these families as members of
MSSs as also of other such schemes. Usually, they do not know which
scheme provides what and cannot differentiate between the objectives,
methodology and significance of various schemes. Steps suggested in
order to remove shortcomings are: Modification in the taxonomy of MSS,
clubbing of all those schemes meant for promoting maternal and child
health, identification of members on the basis of their inherent
interest, incentives for highly motivated members, a minimum educational
criteria for members and women above 35 years should be chosen as
members of the MSS.