A lilting tribal tune catches the attention of a group of women gathered at the Integrated Child Development Services (ICDS) centre in Jidu Pandra village, Ranchi district. As they keenly listen to the beautiful voice of Suman Devi, 25, singer and composer, gradually the Nagpuri lyrics explaining the ill-effects of child marriage start to sink in.
When the melody comes to an end, in the ensuing stillness, Suman opens a discussion on healthcare for women and adolescents. Songs have greater appeal than lengthy speeches. They help me break the ice with the community. I write, compose and sing songs on health, sanitation and regressive social practices such as child marriage and dowry. I start every meeting with a musical number and when everyone’s listening I go on to talk on subjects like the need for immunisation, taking iron pills and nutrition for pregnant women,” says Suman, a barefoot auditor for the village.
There are 70 barefoot auditors, or Gram Arogya Sakhas, of which 60 are women. They work in villages across 15 Gram Panchayats in two blocks of Ranchi and Hazaribagh districts, sensitising rural communities on government health schemes and helping them avail and monitor these services. They have been trained through intensive workshops conducted by Child in Need Institute (CINI), an NGO in Jharkhand, working on mother and child health under Oxfam India’s DFID-supported Global Poverty Action Fund initiative, ‘Improving Maternal Health Status in Six States of India.
“The trainees were identified by the Village Health, Sanitation and Nutrition Committee (VHSNC) in each village on the basis of their networking skills, ability to communicate, awareness levels and commitment to the cause of social development. About 25 of them were already working as ‘Sahiyas’ under the government’s National Rural Health Mission (NRHM) and had experience in community mobilisation,” says Faiz Ahmed, CINI’s Project Coordinator.
“I had to go to every home in the village and ask women to come for meetings to talk about health matters. Despite being from the community, I faced a lot of resistance. There was a general unwillingness to take time out. The progress was gradual, but once the benefits became apparent, more women started turning up on their own,” says Poonam Devi, another barefoot auditor of Chetanbari village.
The barefoot auditors take advice and guidance from CINI trained field animators. For every seven villages, there is one field animator who plans awareness strategies and monitors the implementation of health services. “With our dedicated approach we have managed to earn the trust of the villagers. The work we have put in over the last three years since the project began has started to bear fruit now. The excellent results ensure that service providers take our inputs, suggestions and complaints very seriously as they realise that we have the backing of the entire community,” says Siben Devi, a field animator.
Her masterful assessment is bang on. In each of the 70 villages, the impact of the intervention is visible. Today, the ICDS is functioning without a hitch, infants get their government-sponsored meal on time everyday and their height and weight is being tracked to monitor malnutrition. The Anganwadi workers and Sahiyas carry out routine immunisations without fail; pregnant and lactating women get their monthly nutrition packets; women and adolescent girls are taking their iron pills and regular blood testing for anaemia is being done and expectant women are regular with their pre-natal check-up. Almost all childbirths in the last three years have taken place at a hospital, and infant and maternal mortality have notably been very low in all these villages in this period.
“Our barefoot auditor Rita Kumari has changed our lives. Earlier, we had no idea about the government health services, let alone availing or benefiting from them. It is her repeated counselling and campaigning that has made everyone in the village realise the significance of these services. Now we treat her advice as gospel truth,” says Gudiya Devi of Palu village.
In the last three years, only one woman in Palu has died in childbirth and that too because her husband failed to call the barefoot auditor or the free Mamata ambulance service when her labour pains started. “We give our number to the pregnant women and their husbands and also write on the walls of their homes and the village office the phone number of the free ambulance service available under the Janani Suraksha Yojana (a safe motherhood intervention under the NRHM). The moment we get the call, we ring for the ambulance and reach the pregnant woman’s house. I have often accompanied the women to the Primary Health Centre or the hospital,” says Rita Kumari.
Apart from counselling pregnant women and their families, these barefoot auditors have become trusted friends of teenage girls in the community as most of them are young — between 20 to 30 years — and are able to relate better to teenage concerns. “I was using cloth during menstruation and it was very uncomfortable. Due to constant itching, I got infection but I could not even tell my mother,” recalls Suman Kumari, 17, of Palu village. Fortunately, the youngster was able to shed her inhibition in front of Rita. “I spoke to her as she was more approachable. She took me to a doctor for treatment and told me to use sanitary napkins being provided by the government through the Sahiyas. Now every girl in our village uses napkins that come for Rs 6 for a box. I even convinced my mother to start using them,” Suman adds.
Besides solving their health problems, the barefoot auditors have won the confidence of the younger girls as they staunchly stand up against child marriage, domestic violence and dowry. Take the case of Gudiya (15) of Bada Ulatu village. When she discovered that her parents had fixed her marriage, she sought the help of Poonam Kumari, a barefoot auditor. Not only did Poonam speak to the marriage broker, Rashmi Devi, and pointed out that she could end up in jail for facilitating an underage union, she even got Rashmi to convince Gudiya’s parents to break the alliance.
Talk about barefoot auditors in any of the 70 villages and there are many glorious stories that people come forward to share. Clearly, they have emerged as a skilled force that is providing much-needed counsel, improving access to healthcare and gradually turning the wheels towards positive social change.
(© Women’s Feature Service)