Reflections on my last few weeks in India

Hello everyone

As you may have gathered, I am now back in the UK (and no, I am not to blame for the snow!). Since I've been back I've been thinking a lot about my experiences over the last 5 months and in particular my last few weeks in India.

I left the mountains on the 14th January and from then until I left India I was travelling around to Delhi, Bangalore, Pune and then back to Delhi. Some of this was for work and some was for leisure/pleasure - take your pick! Thinking back, it feels like I experienced as much during this time as I did during my time living in the mountains, however I think that all these experiences are incomparable. It really struck it home to me complete disparity between Indian cities and rural areas. In Delhi and Bangalore I really got the feeling that I could be absolutely anywhere in the world and to some extent this demonstrates the far reach of the so called 'homogenised urban age'. Many of you will not believe me, but when walking around parts of Delhi I felt like I could have been in Kensington or Chelsea in London. Partly because of this, and maybe because of the time I have spent in India now, I found myself feeling so comfortable in these places and I could really imagine myself living there. Thanks of course must go to my lovely friend Asha who is living in Delhi - she was responsible for my shopping trips and visits to the hip bars in Delhi :p

The reason for trip to Delhi and Bangalore was for fundraising events that Aarohi was holding. I had been involved in some of the organisation of the events and had been listening and watching the students rehearsing for the shows for near on 2 months so it was a fantastic opportunity to be able to see the final product. It also gave me an opportunity to experience a 2 day train journey (possibly to be never done again, and note to self, don't eat too much of the train food or touch ANYTHING on the train) but the best part was travelling and spending time with the students and the staff at Aarohi. Before this, I guess I hadn't really felt like I had a chance to bond with many of them - because of the geography and culture of where I was living the was not much socialising in the evening! But during the trip, I developed such a deep and profound respect and admiration for these people and for the effort they put into everything they do. I couldn't help thinking that if we had been in the UK, the same team would have been chewing everyone's ears off about being tired, fed up or overworked. But quite honestly, they were just happy for the opportunity to be involved and to experience new situations themselves (including not being able to communicate with south Indians - quite an interesting situation to watch!). It is the time spent during these 2 weeks that has really built a bond between the organisation and I, for this reason I am sure that I will be back there sooner rather than later.

The rest of my time was a whirlwind - a weekend spent in Pune with Kunal and Megha, followed by a week in Delhi. Before I knew it, it was time to return home. To be honest I'm still trying to process everything and am finding it quite hard to put my thoughts into anything comprehensible right now. With time though I hope that I'll be able to write a complete reflection of my entire time in India - I have had some realisations but most significantly, I think that I have really grown up. Being in a different situation and experiencing the the lives of rural communities in India has helped me to formulate and clarify some of my own thoughts and beliefs. I have also had the opportunity to meet so many new people, many of whom were truly inspirational and these I will never forget. I just hope that now I am back (and back out of the different situation) I can continue to develop these and further my commitment to working in this sector. If I could pinpoint one thing that India has taught me - anything is possible at anytime, you can do whatever you want and will always find a way to get there.

For those of you that I haven't yet spoken to or seen, I can't wait!!! I'm in London from Sunday - Thurs, so I hope to see a lot of you :) I'm also hoping to continue blogging so watch this space.

Love

B xxxxx

Malnutrition...

I promised that I would write about my trip out to our health office to do my field research, so here I am fulfilling that promise to you all. No, it’s not as a result of a New Year’s resolution I may or may not have made (who believes in them anyway!), but in fact my research brought to light a few things that I thought you would (may) all find interesting. I hope so.

Our health office is located in Jhadgaon, another village in the block of Oklakhanda which is another area of the district I’m normally in. It may be hard for you to imagine, but this place is even more isolated than where I normally stay. In Satoli, the village where the main office is located sees at least 3 or 4 vehicles passing every hour – in Jhadgaon, you’re lucky if you see 3 or 4 in a day. It’s very badly connected and as a result the public provisions are worse and development is also further behind. I’m really finding it hard to write that the communities are ‘less developed’ because while the majority of people have lower educational attainment and the mindset is very different, they are not necessarily ‘less developed’ as a community only in the way that we think of development. Mind sets are different though and as the benefits of things like maternal care have not yet been realised completely and cultural stigmas stick (mainly because they are not exposed to better alternatives), maternal and infant mortality is high, and sanitation and hygiene leaves a lot to be desired. 

The work that I have been doing with the health team has been to assess the implementation of growth monitoring of children under the age of 3. Growth monitoring is a tool that is used to assess whether a child is growing and developing normally – we use weight as an indicator, however height is also commonly used. As growth is largely determined by nutritional intake it is used worldwide as an indicator of whether a child is receiving adequate food and nutrients. I say largely because there are many diseases that can also affect child growth including worms (ew) and re-occurring diarrhoea and dysentery. It’s a really important activity because alongside doing the growth monitoring, the health worker is meant to give counselling on child nutrition. Undernutrition and malnourishment is a HUGE problem in India. In this state 40% of children are malnourished, and there are more malnourished children in India than any other country. Fair enough, there obesity rates are also rising in the cities, but malnourishment still remains a large scale problem across most of the country. The fact that obesity is on the up just demonstrates to me that there is a huge disparity between the wealthy (mainly) city dwellers and those living in the remote rural areas.

Growth monitoring of children is carried out by health workers trained by Aarohi in their villages. Basically they weigh the child, mark it on a growth chart which shows whether the child is underweight or not, and whether they are growing at a normal rate. I went along with health workers to observe their work and I also conducted interviews with families in 3 different villages. My survey contained questions related to family income, crops grown (most people have land), child nutrition and their attitudes toward growth monitoring.

It was a wonderful experience to interact with communities in some of the villages we work in and to gain more of an insight into their lives and challenges they face on a daily basis. Wow, do those women have their work cut out for them. I may have said this before, but it’s worth reiterating that here, women are responsible for everything in the house, and on top of this they are responsible for working in the fields and collecting water (which by the way they don’t boil despite the fact that they know it is unclean – their reason for this is because they don’t have time. I think this demonstrates a real difference in education and is an indicator of just how hard things are for these families). They have no time to think about what food they should be preparing for their young children and as this knowledge maybe isn’t second nature to them and they may have to spend extra money or time getting the right foods, child’s nutrition does suffer. During my visits, the number of malnourished children fits with the profile of the state – about 40% were underweight which suggests undernourishment.

In fact, many of the younger mothers were really quite deluded about what a good diet includes and in some cases couldn’t answer the question. At the time I guess I thought this was strange because they grow all their food, and in my deluded and naive mind I was thinking that they probably chose what to grow. No, they grow what they can on their small piece of land. Don’t forget we’re in the hills here so all land is stepped and nutrient run off from land is high (especially after the rains) so the productivity of the land isn’t brilliant. As a result of the introduction of fertilisers (thank you Britain) they are also now dependent on these to increase productivity, however it makes farming a really expensive business with not many gains. Families I spoke to said that their land does not produce enough food for their own use so they have to buy extra food. Let’s just say that they don’t really get a varied diet and many families only eat 2 meals a day. Given that children under 5 are meant to have 4-5 meals a day, this is a major worry.

Another major worry I have is the number of women who feed their children the expensive Cerelac supplement made by….guess who, yes, the lovely (not) Nestle. Women here told me that because it is expensive they believe it is the best thing to give their children. What they don’t understand is that because it is a supplement it is supposed to be given alongside a full diet, and should be mixed with clean water. Yet again, I think I see Nestle creating more problems for people living in poverty. Actually, when I was looking into this I read that it is illegal for companies to market any alternative to breastfeeding, and while Cerelac isn’t technically an alternative, women here believe it is, so are Nestle violating laws again? Wouldn’t be the first time, right? Women also told me that because it is on TV they believe it is the best for their children. Despite being told that good whole food is better, it appears that the Cerelac craze is a widespread one in India. Another corporation strikes again, well done.

Anyway, my research will help to inform further training for our health workers and also some alternative interventions at village level within the health program. This work again demonstrated for me the need for ‘development’ to happen at a local level and by NGO’s who know and are respected by the people and communities that they are trying to help. They are the people who know the lay of the land and can work to better involve the community (all of our health workers are from the village that they work in) thus working to implement a better informed ‘development’ solution for these people.

I have one more week left in the hills and then I will be city hopping for a bit until I head back home at the beginning of February. I’m so glad that I have been able to complete this work and hope that it will help the ever so stretched health team to combat this problem of undernutrition in Uttarakhand. 

Now please excuse me, I need to go and handwash my underwear - :p now that's something I really won't miss!

B

xoxo