Monday, March 17, 2008

Hope Through Asha

I would like to dedicate this post the NGO that facilitates my meetings with the Dai (traditional Indian birth attendants).

Asha (the Hindi word for hope) NGO grew out of a young doctor’s response to a cholera outbreak that occurred in slums during 1988. Despite meager resources, Dr. Kiran Martin began treating patients at a table set up under a tree. These humble beginnings went on to develop into a one room clinic and eventually evolved into a full fledged NGO; which now serves approximately 300,000 people located in 46 slums scattered throughout Delhi. Asha was the first NGO to be recognized by the government – a step that is vital for Asha and the slum dwellers to obtain resources and support/permission for projects.

Asha's methodology of transformation revolves around empowering slum dwellers to amplify and sustain an array of environmental, medical and educational programs. Asha “adopts” slums and then implements programs that give people the power to lobby for government resources and transform ideologies concerning important issues, like sexuality and gender roles. Asha has found that the key to slum transformation is to create small clusters of women, men and children who are willing to advocate on the behalf of their communities. The groups achieve structure through appointing a president, vice-president, secretary and treasurer. The group empowerment theory was first applied to women after Dr. Kiran noticed how little control slum women had over their communities and families - women’s groups called “Mahila Mandals” have now become one of Asha’s most successful implementations. The Mahila Mandals meet once weekly to discuss a range of problems: sanitation, sexual health, safety etc. The Mahila Mandals improve their influence and ability to lobby for resources through identifying women who are willing to become CHVs (community health volunteers) and Lane Volunteers. Lane Volunteers are responsible the health and well-being of approximately 25 families living on their lane. LV's record the number pregnant women; obtain immunizations for all children under five; and spread awareness about gender issues/sexual health/sanitation.

Asha has also extended the concept Lane Volunteers into their “Bal Mandals”, groups of approximately 20-25 children. Granting responsibilities to both young and old creates noticeable solidarity in communities. Asha believes that educating the future generations - through Mandals and other educational programs - is a huge opportunity for prevention and correction of issues that rotate the wheel of poverty. For example, I often meet girls between the ages of 7-14 who can proudly list off the number of pregnant women, important awareness topics and immunizations pertaining to their particular row of houses.

Each Asha slum is outfitted with an “Asha Center” - a nexus for everything from Mandal meetings to trainings and health checkups. The centers - painted vibrant greens and blues - are peaceful sanctuaries away from the surrounding dust and chaos. The haven like atmosphere is further cultivated by beautiful collections of art work - flowers, animals, landscapes - painted on walls by volunteers from abroad. Such fingerprints of love have an amazing affect all those who work at the centers. Many times, during in the midst of a dai meetings, I am pulled away from my outlines by a picture of a vibrant butterfly or an inviting river(an especially enticing image now that the temperature are rising!)

The sucess of Asha also revolves around vibrant health programs that are well on their way to eliminating many of the diseases - dysentery, TB, typhoid, maternal illnesses, malaria, dengue fever and parasites - that typically fester within slums. Healthcare is implemented at a grass roots level by CHV’s and retrained midwives. Cases that can not be solved by CHV’s are referred to a number of clinics staffed by Asha doctors. Asha has also created partnerships with many hospitals for emergency cases. A number of buses and vans have been converted into mobile clinics in order to access people in places that are otherwise impossible. As many health problems result from unsanitary living situations and environmental pollution, Asha is motivating the slum dwellers to lobby the government for: developable land, clean water and adequate sanitation facilities. Asha is also working with the government to fight the AIDS-time-bomb that is currently ticking in India. New programs to fight alcoholism are being have also been started in many slums. are also

Due to the above programs, Asha’s health statistics are far superior to India’s national data:
+ The infant mortality rate in Asha slums is 26 per 1000 live births (the India mortality rate is 63 per 1000 live births, and in India's slums it is 100 per 1000 live births).
+ 95% of under-5s are now immunized against 10 vaccination preventable diseases in Asha areas - there is now virtual elimination of most of these diseases.
+ 97% of under-5 children are healthy for their age. In most Indian slums, only 30% of under-5s are healthy.
+ Every mother in Asha areas receives proper maternal care, whereas only 60% of mothers in India get antenatal care.
+ 100% of pregnant women in Asha areas have a skilled attendant present during childbirth, compared with only 43% in India countrywide.
+ There have been no maternal deaths in Asha slums since 2000.
+ The birth rate has fallen to 18 per 1000 population (the birth rate in India is 40 per 1000 population).
+ The number of patients suffering from tuberculosis has fallen steadily in Asha slums, and 100% of sufferers are receiving regular treatment(quoted from website).

To learn more about the amazing work Asha and slum dwellers are accomplishing, please visit:
http://www.asha-india.org/index.aspx

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