Traversing India to Support Public Health Programs

 CORE Group's leadership, including Pinky Patel (fourth from left), in India.
CORE Group, a public health organization based in Washington, DC, has an admirable vision: a world of healthy communities, where no mother or child dies of preventable causes. An extremely dedicated and effective nonprofit, I recently interviewed Pinky Patel, CORE Group's Communication Manager, about their recent trip through India to visit, learn from, and support successful public health programs.

You recently traveled through India with CORE Group. Tell me a bit about why you all made the journey, some goals, and also some surprises.

This year, to meet the professional development and learning needs of the CORE Group community, we launched the annual Practioner Academy Community Health Workshop. This workshop is designed to bring together public health professionals from all over the world to spend a week visiting and learning from a successful community health project. For our first site, we selected the Comprehensive Rural Health Project (CRHP), founded in 1970 by Drs. Raj and Mabelle Arole. With the community always in mind, CRHP pioneered the principles of comprehensive, community-based primary care. Communities are encouraged to take health into their own hands through the support of the Village Health Workers (VHWs), community groups such as women’s groups, farmers groups, and adolescent groups, and the mobile health outreach team and CRHP hospital and training center.

Pinky along with women village health workers.
My role was to film the workshop and interview the participants, Village Health Workers, communities, and Comprehensive Rural Health Project staff to capture lessons learned and understand what makes this model so successful. 

I knew I would bear witness to some amazing stories and learn a lot, but I had no idea just how touching and inspiring so many of the women and girls would be. Each and every VHW has such a tremendous story of overcoming incredible challenges. They shared their stores with us about starting out as illiterate, low-caste girls, not able to allow even their shadows to touch another person. They endured early child marriages, early and sometimes dangerous pregnancies, abusive husbands and in-laws, and extraordinary poverty. Most reached breaking points that they barely overcame.

But, then they became a part of Comprehensive Rural Health Project's training program, which empowered and trained them to become VHWs, learning about life-saving community-based health approaches. They were trained to treat diarrhea, check for leprosy, provide pre and ante-natal care, and even perform safe deliveries in people's homes. They also addressed broad community concerns such as the low-status of women, the caste system, poverty, traditional beliefs, agricultural production, watershed development, and appropriate technology. Tackling the social determinants of health and empowering the whole community is the key to their success and central to the CRHP model.

Children, particularly girls, face great obstacles to receive education. 
Having close ties to India, do you feel that the portrayal of women and girl's is accurate in worldwide media? If not, what could be done to change or better illustrate a more accurate point of view and thus perception?

I was born in the States but have traveled to and throughout India many times. I believe that the media and even public health practitioners could do a better job of portraying and promoting the strength and potential of Indian girls and women.

Thankfully, there are many campaigns trying to protect girls against the incredibly high rates of infanticide throughout India. Many of these campaigns are trying to educate parents, families, and communities on the potential of the girl child. As one young girl told me, "Girls are perceived as a burden from the time of birth until death. Yet, it is us that give birth, raise our children, care for our families, and work so hard to make life better for those we love. We are NOT burdens! We deserve the chance to live our lives."

Within the public health, what are the main concerns facing young girls, both rural and urban?

Girls in India face extreme discrimination yet show incredible resiliency.
Unfortunately, for many girls, it is a challenge to simply be born! With the high rates of female infanticide, many are never even given the chance to have a life. If born, many face horrible discrimination, extreme poverty, and incredibly tragic circumstances. Many are denied an education, forced into early child marriages and sexual encounters, give birth before their young bodies are even fully developed, and struggle to ensure the health and safety of their children amongst incredibly challenging circumstances especially if they are living in rural areas without access to services.

The low-status of women throughout India, and the world, MUST be addressed if we ever really hope to change the world. Empowering a girl not only changes her life, but every generation after!

Share one (or some) of the most meaningful stories you heard from females during various trips throughout India.

While everyone I have ever interviewed left a lasting impact on me, there is one story that genuinely broke my heart but also reminded me of how powerful a woman can be. For the sake of confidentiality, I will call her Ambika.
Ambika was forced into an early child marriage at the age of 12 to a man 21 years her senior. She was forced to have sex and became pregnant with twins by age 16. She struggled with the pregnancy and eventually lost one child- the boy- and was left with a girl, which was a death sentence for her and her daughter. Despite having NO control over the sex of her child, she was beaten and BURNED and almost died as a result of having a girl-child. Thankfully, she survived and escaped with her daughter. Amika is now slowly rebuilding her life. Despite enduring such horrible tragedies, she believes in a brighter future, especially for her daughter. She is determined to make that happen by teaching her daughter of her potential, providing her with an education and a healthy adolescence free from marriage or pregnancy.
If you could build a program, share of an effective class, or highlight an overt need you saw being met while there what would it be? 

I think the most powerful thing I learned that should be shared is how the Comprehensive Rural Health Project empowers the COMMUNITIES to transform their lives. They do not go into these places with donor-driven proposals about what type of program must be created to meet donor requirements. Instead, they ask the communities what their problems are. They then work with them to find culturally-relevant, practical solutions, that can provide sustainable change. The communities select the VHWs, decide on what issues need addressing, and even create farmers groups, women and men's groups, and adolescent groups to keep everyone connected and involved. It was wonderful to hear one man say "We are capable of changing our own lives. Even if CRHP went away tomorrow, we would continue to grow." Now that is TRUE development! 

Going forward, how has this experience shaped or reshaped your commitment to the field of public health and in achieving equity for all women and girls? 

Sometimes it can be incredibly discouraging to hear the news or reports about the low-status and treatment of women around the world. You begin to question the real difference that can be made in the face of such extreme situations. But meeting these women and girls, listening to their stories of hardship and triumph, hearing about their future dreams and goals, and witnessing their strength of spirit reminds me of why this fight is worthwhile. Every girl deserves a chance!