Community action: love in action

30 Community a1tion Love in action Jitendra Tuli Staged by health and community workers, a little play serves to demonstrate how to prepare oral rehydration solution to treat diarrhoea. Omvati 's day starts at the crack of dawn, just as it does for most other women in her small village of Jhimerheri, in Haryana, about 130 km from India 's capital, New Delhi. After tending to the cattle and taking care of the house- hold chores ("a woman's work never ends", she says with a smile), she prepares the morning meal for her two young sons and husband. She then quickly cleans up her modest front-yard which also serves as a "balwadi" or children's day-care centre. By 9 a.m. most of the 25 children brought to her creche for care and supplementary nutrition are assem- bled. Every Saturday afternoon the older children enliven the centre with their excited chatter and their songs, while Omvati 's gentle but firm voice tells them how they can stay healthy and help others in their family do the same. Through short plays and songs and demonstrations, the children par- ticipate in activities that drive home the message of good health. During these sessions, Omvati 's husband, Ram Phal, a farmer, joins in the sing- song and helps when he can. This happy picture, however, is not the way it was even eight short years ago. Then, as Omvati tells you haltingly, her life was not much better than the cattle she tended. Their home was nothing more than a thatched roof propped up with some poles. There was constant bickering at home. She, like the other women in the village, observed strict "purdah" which made contact with outsiders virtually impossible. As she recalls those sad, earlier days when her younger son was only a few months old and the older one was about three, she would hide them, and herself, when she heard that the doctors had come to give them injections. Why? "Because I knew that the children would get fever and, with all the problems I already had, there was no use adding the burden of a sick child. Who would look after them? Who would look after me? How would I ever cope with the work?" The questions tumbled out. Then, one day, the local teacher came to her husband and told him that the nearby Arpana Hospital was World Health • 47th Year, No.6, November-December 1994 During this year's World Health Assembly, delegates and other health experts participated in Technical Discussions on the theme of "Community action for health". The story of Omvati, described below, shows how health professionals can train individuals in the community to improve each community's health status. looking for women to be trained as community health workers. "I over- heard this and decided that I would approach the hospital. I had only passed my 5th class, but was desperate to do something useful. Of course, there was opposition at home, but I was determined to go ahead and was delighted when I was accepted for training". After three months of intensive training, she started her assignment in her village. A life transformed "And my life was truly transformed. Gradually, with experience, I began to take part in various other health activities. See, these are the records I maintain," she says proudly, showing her registers and the forms that she fills in meticulously and gives regularly to the Arpana hospital. Having started out with an allowance of 300 rupees (US$ 1 0) per month, she now earns 800 rupees per month, which, she says shyly, is more than what most of the menfolk in her World Health • 47th Year, No.6, November-December 1994 31 income as well as training opportun- ities to the rural women. So far, more than 1300 women have been trained and their exquisitely hand- embroidered garments and linen are finding ready markets in the country and abroad. Recently, Arpana established a centre in Himachal Pradesh where similar facilities and services are being offered. All this, as Omvati says, has been realized because of a group of people and their devotional offering, Arpana, which has literally brought health, wealth and happiness to thousands of lives. • Omvoti, who used to hide from health workers, is today on active health crusader in her village. Mr )itendro Tuli is the Information OHicer with the WHO Regional OHice for South-East Asia, lndroprostho Estate, New Delhi 1 10002, Indio. village earn. Arpana, which means devotional offering, has not only transformed Omvati 's life but the lives of nearly 45 000 inhabitants of the 36 villages which the Arpana Research and Charities Trust has "adopted". In recognition of its outstanding inno- vative work in health development, the Trust received the Sasakawa Health Prize for 1993 during last year 's World Health Assembly in Geneva. The dedicated volunteers of Arpana see this recognition not as the culmination of their dreams, but as the beginning of a new thrust with the blessings of "Ma" or mother, the divine guiding spirit who has always urged those around her to render true service, through which "you elevate and exalt others, and find the path to happiness". Today, just over a decade after they ventured into health care in a holistic manner, Arpana's "love in action" programme covers diverse In the next issue "Target 2000 - A world without polio" is the sloga n and theme for World Health Day on 7 April 1995. The next issue of World Health will mark thi s event, describing the worldwide effort to free humanity of th is c ri ppling disease. Poliomyeli tis stil l exists in different parts of the world , but no new cases have been recorded in the Americas since August 1991. • health-related areas focused on eliminating illiteracy, ignorance and malnutrition, and on controlling preventable diseases and reducing economic deprivation. As Omvati recalls, before Arpana came into their lives, the infant and maternal mortality rates in her village were high; these have now improved dramatically. Arpana has a three- tiered health service programme which consists of a 75-bed base hospital, at present being expanded, primary health care units catering to the villages, and mobile units which visit each centre once a month. The hospital serves as a referral base for the rural health care programme and as a training centre for all village- level health workers. As with the other facilities pro- vided, these are highly subsidized for those who can pay and free for those who cannot. In tum, Arpana raises resources through donations, and through the sale of its handicrafts which provides welcome additional Photo Credits Front cover: WHO/ J. & P. Hubley Page 3: WHO /f. Farkas Page 4: WHO/M. J. Santamaria Page 5: WHO/ Diyavanga Page 6 & 7: WHO/ J. & P. Hubley Page 8: WHO/ J. & P. Hubley; WHO/ PAHO/ A. Waak Page 9: WHO/ UNICEF / N. Toutounji; WHO /Zalar Page 9: WHO/ ILO/ J. Maillard; WHO/ L. Taylor; WHO/ Zofor Page 10: WHO/ L. Taylor Page 11 : WHO /Zalar; WHO/ L. Taylor Page 12: WHO/ PAHO/ A. Woak; WHO/ PAHO/ C. Gaggero Page 13: WHO/ PAHO/ C. Gaggero Page 14 & 15: WHO/M. J. Santamaria Page 16: WHO/PAHO/C. Gaggero; WHO/PAHO/ A. Waak Page 17: WHO/ PAHO/ A. Woak Page 18: WHO/ J. & P. Hubley Page 19: J. L. Roy/ AKF © Page 20: WHO/ R. Landy Page 21 : WHO/ UNICEF / C. Fregier Page 22, 23 & 24: Photos courtesy of the Herold and Evening Times, Glasgow © Page 25: L. Sirmon © Page 26: L. Sirman©; WHO/ L. Taylor Page 27: L. Sirmon © Page 28: WHO /Zalar Page 29: WHO/Zafar; WHO/L. Toscani Page 30: J. L. Ray/AKF © Page 31: WHO/ J. Tuli Back cover: WHO/ M. French Did you enjoy this issue? Why not toke out o subscription to World Health and enjoy reading about the world's major health issues six times a year. 1995 subscription prices are listed below. WHO also offers its popular "Health Horizons" subscription, a combined subscription (at a reduced ratel to World Health and the quarterly World Health Forum. 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