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Posts Tagged ‘health’

The Choices We Make

When I was in high school we took a class called ‘life issues’, which was essentially meant to be a sex-ed class coupled with self-esteem and health issues. Everyone joked about it and laughed off the content (what teenager isn’t uncomfortable in a glorified sexual health class?) but the school made it very clear that these were important issues that we needed to understand.

I mention this now because I was thinking about ‘life issues’ quite a lot as I sat in a small room with no windows in Dharavi, sweating through my long sleeved cotton kurta and long linen pants, watching a field worker explain sexual education and health to a group of Muslim teenagers – most of whom were married and many of whom already had children.

At this particular meeting (I’ve now been to so many I’m starting to get the hang of it), the field worker was fearless. Here was a Hindu woman in a sari trying to explain female anatomy to a group of women whose only visible anatomy was their face and hands. She had started on the topic of periods. Did anyone in the room want to open the discussion by relaying when they got their first period?

Silence.

My translator piped up, telling her story to try and break the ice. It seemed to make the girls less uncomfortable as they laughed and giggled at her trials and tribulations. They started sharing more about themselves.

But then the conversation took a more somber tone: “How many of you feel that your periods make you dirty?” they were all asked. Everyone raised their hands. I was really surprised – how can you have given birth to a child and still feel ashamed about your body’s natural reproductive cycles?

But the field worker was not at all surprised by this response. She began a very stern tirade – she explained that this was a beautiful and natural part of our humanity. She was adamant that they not let their religious views lead to unsanitary practices.

Apparently, in their religion (or their practice of their religion within their particular culture), when a woman has her period she is considered unclean. Anything that she touches becomes impure and she cannot go near her mosque. I had seen similar signs relating to Hindu temples in Indonesia, instructing menstruating women to stay away, but it was amazing to me that this practice is so widespread across varying religions.

Most of these women could not afford sanitary pads (and tampons don’t even exist here for anyone) so they used rags. And when the rags were dirty they would often clean them and then hide them away for drying. This apparently can lead to infections when the rag is used the next time, because without sufficient space to dry, the wet rag can become a hotbed for bacteria.

I’m going to pause here for a moment to acknowledge that this is a very uncomfortable and graphic blog post. But it is astounding the things we take for granted – I rarely consider my period because the modern marvel of tampons makes it as insignificant as possible. These women are getting infections in large numbers because they do not have access to something as simple and cheap as sanitary pads, and their shame about having their period stops them from drying their rags in the sun or out above a flame or even on a drying rack. It’s just astounding to me the number of hardships these women face every day.

I watched as the field worker continued to encourage and explain sanitary habits. The women listened, uncomfortably but attentively. Some of the women began to open up and ask questions.

One woman, who is 15 and has been married for 6 months, had not yet gotten her period. She had not met her husband because apparently in her tradition you don’t meet for one full year. She was worried that if she didn’t get her period soon that she wouldn’t be able to continue being married.

The field worker kindly explained that if she never got her period it would not mean she couldn’t stay married, but it would unfortunately mean that she could not have children. The woman looked stricken – apparently she wasn’t confident that she could stay married without the ability to have children.

Again, as with most of the other meetings I have been to with this particular group, the discussion had nothing to do with it’s stated goal of reducing domestic violence – it was just another way to bring people into the organization. Little by little, person by person, they just try to help in the many many places where help is needed.

As the discussion came to a close and most of the women (girls? How do your characterize young teenagers with such adult responsibilities?) said goodbye, we were left with the girl who had hosted us in her home. She was 15 and her mother had ‘chaperoned’ the discussion.

She had stayed behind to ask the field worker about computer classes- she wanted learn but she only could read and write in Urdu, and all of the classes were in Hindi or English.

I asked why she had chosen to go to an Urdu-only school.

She laughed and started talking. My translator said she was explaining that it wasn’t a choice. The only school she could go to was a madrassa, and the only thing they learned was the Koran.

“You mean that’s what you learn most of the time?” I asked.
“No,” my translator translated. “It’s the only thing we ever study.”
“Can’t you go to another school?”
“There is no other school available. And the men in my family wouldn’t let me go to another school anyway.”

This is the point at which I started to get angry. She and her mother and I then began a thirty-minute discussion where I kept asking why and they kept laughing at me and answering that, “This is just the way it is.”

She couldn’t go to a different school because there wasn’t one that would take her.
She couldn’t take lessons in English because she wouldn’t have time for that and the men in the family wouldn’t allow it.
She couldn’t wait to get married because that would bring shame to her family.
Her school couldn’t teach anything other than Urdu because they could only spend time reading the Koran.
She couldn’t get a job because the men wouldn’t allow it.

I just kept sitting there stunned, trying to find some alternative. Could these women really just allow themselves to be subjugated in this way when they understood what was happening? I asked what kept them from just leaving.

“This is our home. This is our life. Would you want to start completely over and never be allowed to see your family or anyone in your community again?”

I answered that no, I would not want that. That seemed to settle it for them. I was starting to wonder if I had overstepped, so I apologized for asking so many questions. They, again, just laughed at me.

“It’s ok. We understand that you live your life differently.”

I nodded, thinking we were having a moment. But then the mother started saying something that my translator wasn’t translating. I asked her what they were saying.

“You don’t want me to tell you – now they’re asking if you can help them in any way. They want you to maybe help the men in their family find better jobs or for you to give them some money.”

I guess our moment was over. I tried to respond that I was going to be helping by making the film about the organization. They didn’t seem moved.

I walked out still feeling angry. It’s one thing to not understand that there was another world out there. It was another to know that other people are free and to just calculate that it’s not worth it for you.

The meeting and my conversation swam in my mind as I walked out. These women can’t even stand up for themselves by demanding that their rags dry out in the open, let alone demand for education or the ability to work. It was the first time I had left a meeting where I didn’t feel inspired or empowered. So now they knew about their reproductive systems and proper menstrual hygiene – so what? Would they even use the information they would be given? Or would they just continue to be under-educated child brides with no ability to break their own cycle?

I said this to the field worker. I asked her how she keeps going every single day when there are so many battles to fight and change comes in such small incremental steps?

“Because it needs to be done,” she replied. Yes it most certainly does.

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I have to be perfectly blunt and say that I can’t possibly fathom what it is like to live in a 10-foot by 10-foot room with one window and one stove and no bathroom with my entire family.

In fact, I don’t really know how to realistically process and respond to my first foray into residential Dharavi without falling into the trap of minimizing, dramatizing or romanticizing the experience.

All I can really say is that now I have seen with my own eyes the living standards that I have heard so much about since moving to Mumbai. And there are a lot of impressions and thoughts that came with my first visit.

I went back to the hospital to meet up with the supervisor who I had been shadowing. He informed me that today, instead of a group meeting, he and his field workers were going out into the community to distribute information about hygiene. This monsoon is the worst in five years and there has been a serious outbreak of malaria and dengue.

I tried to ask in the most polite way, as I had every day, what this had to do with curtailing domestic violence (since that, ostensibly, is their main mission).

“It has nothing to do with violence. But we give information, which is good. Then some people will come to meetings about health care, which they are interested in. Then, once they are involved, we can talk about ending violence. If we start with violence, nobody cares.”

I followed him out of the hospital wondering how he and his field workers get the energy to go out every day when they can’t even raise the topic that they are interested in. It just seemed so daunting.

He informed me that we had to drive to the area we were going to (Dharavi is, after all, very large. At least a million people live here). As we drove he tried to warn me.

“Just… be aware of your feet.”

“My feet?”

“Yes, your feet. They will get dirty. I hope that’s ok.” He didn’t elaborate, but I got the general gist.

We pulled over once we’d gone as far as we could go – I very quickly realized that walking was going to be difficult, let alone driving.

The method for the day was to go “door to door” (I put that phrase in quotes because most of the homes did not have physical doors beyond a makeshift bed sheet).  We walked in from the street and it immediately felt like we’d entered a maze.

They path between houses

Walking into a residential section of Dharavi is actually kind of reminiscent of walking through the tightest alleyways some small European town – if the town were made of poorly constructed cement structures and if you’d been transported back to a time with little plumbing and amenities.

Each home is directly connected to the home next to it, and you maneuver through the area with only a small 2-foot wide pathway serving as your sidewalk. In the middle of this pathway is a hole running the entire length that serves as both a place to lay small pipes and as a moat of sewage.  This is the part that really gets to you if you’re not used to it – there’s a constant pervasive smell of garbage and sewage, which is only exacerbated by the lack of fresh air making its way in. The lanes are so narrow much of it is covered with tarp, so the smells and the heat combine together throughout.

This also creates a trap for the heat– so even though I hadn’t been too hot before we entered the slum, once I was inside the narrow pathways the stale air, confined quarters and number of people surrounding me ensured that I existed in a permanent sweaty state.  But, on the other hand, it started making me cognizant of the small victories: every time a breeze came through I felt it was the coolest moment of my life. I quickly appreciated every wisp of the wind in a way I never had before.

The scene that was laid out in front of me at each turn of the corner was similar– every home had one room, the structure was made of some combination of cement, brick and wood, the roofs appeared to be made of a kind of sheet metal.  Inside every room there was usually a stove, some mats for beds, and a few personal items. A good number of the rooms had televisions – one of the many contradictions that existed in the slum. When at one point I found myself standing at a vantage point where I could see above the structures, I noticed that every third home appeared to have a television dish.  And for every person watching television there were five more staring down at his or her mobile phone.

Color along another path between houses

There was also color everywhere – walls were painted in bright hues, varying clothes dried on the outside of every single house, and children in school uniforms were always running through, brightening the alleys. I don’t know whether it was purposeful or not, but the constant explosion of color gave the slum a vibrancy that seemed to defy the darkness that pervaded in each of the individual rooms.

I mostly just watched as the field workers approached each home and handed out pamphlets  (which had words and text depicting healthy bathing habits, proper garbage disposal and boiling water properly). Some people would only politely accept the handouts without any discussion. Others would take more time and ask questions.

I asked the supervisor what sorts of questions were most common. He said that some people couldn’t read the pamphlet and so they needed to understand the content. Others wanted to know more about the organization. It was in these instances that the field workers could try to encourage the residents to come to a meeting (and they were going to hold one directly following their leaflet distribution). It was their first stage in getting people involved.

Sometimes the discussions took longer – a few people wanted to share their difficulties with the field workers and they would stop to listen and encourage. One woman got angry. She started yelling and talking very animatedly. I had to ask again what was happening.

“She thinks we are useless,” the supervisor said matter-of-factly, “She says if we really wanted to help we would bring medication and other supplies. She says no one will help her and her family.”

“How do you answer that?” I asked.

“Well, we gave her information on clinics that she could go to and places that do give out medication. I understand why she is angry though.”

I didn’t respond. It was still hard for me to shake my previous thought: how could these people be strong enough and motivated enough to do this work every day? These community workers were standing there being yelled at, and instead of being frustrated they were sympathetic of where the anger came from.  I was constantly struck by their enormous patience.

I felt pretty useless in the whole endeavor, but the women kept nudging me along and helping me find my way. They still seemed to accept me, and I felt sort of flattered that they’d actually let me come along for the task. The Dharavi residents themselves mostly just stared at me. Since the pamphlets we were handing out were from Unicef most asked if that was where I was from. It usually started with pointing towards me and then I’d heard the words “gora” and “unicef” thrown in until the field workers responded with “Ali” and “film”. I could usually tell once the conversation had ended because they’d all stop paying attention to me.
The only people who never stopped staring were the children. Every single one, from toddlers to teenagers, looked at me for however long I was standing in their doorway. At many points children would just appear, clearly after having heard that a white person was in their midst. The ones who were learning English wanted to practice. They’d ask to shake my hand and they all wanted to know my name.   When I tried to respond to them in Hindi (saying what my name was or letting them know that I spoke only a little Hindi) they laughed and tried to repeat what I had said in my clearly very foreign accent. But their laughter filled up the constricted alleyways and brought it to life.

The only difficult point for me came when I almost fell headfirst into the narrow sewage stream in the middle of the pathway. Every time I walked I had to focus on putting one foot in front of the other – the pathways were certainly not paved in any standard way and there were often steps or cracked tile or a steep inclines. One turn that looked like a path ended up being mud and I started to slip. But I quickly had at least 10 pairs of hands on me – every field worker and every woman they were talking to had reached out instantly to stop my fall. When I didn’t fall in they all smiled and patted me on the back.

I don’t want to extrapolate too much from one isolated incident, but it certainly made me feel the sense of community that existed there. Maybe that’s my outsider desire to see the good in a dire situation, but it appeared to me that everyone’s instinct was to protect even the visitors. It’s a difficult life and it seems like everyone has accepted that they all need to come together to co-exist.  And maybe it’s from there that the field workers keep the momentum to do the difficult work that they do.

I don’t know if any of these instincts are right. But I’m certainly looking forward to delving in further and trying to tell these women’s stories.   Watching the number of people who showed up for the post-distribution meeting I certainly started to feel more empowered. I sat in a schoolhouse – one room with a broken fan with one chalkboard and no chairs – as the field workers gave an in-depth discussion of disease prevention to the fifteen women who’d showed up. It’s slow work, but little by little they are enacting changes in their community.

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