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.

A Changing Mindset on Childbirth in Western Africa

Americans are a bit fascinated with polygamy. Big Love, Sister Wives – it seems men with multiple spouses are getting quite the media foothold in the United States.

In Senegal, polygamy is a daily, accepted reality. But ask a Senegalese person why it’s so commonly practiced here, and the most common answer you’ll receive is that it’s done for one primary reason: for procreation.

Children are revered here in West Africa. Having a huge brood is smiled upon, regardless of the resources one has to provide for a plethora of offspring. If there isn’t enough food to go around, extended family members have no problem pitching in. In general, the more kids, the better.

That’s why I’m curious to see how Senegalese president Abdoulaye Wade’s recent statements on family planning will resonate – if at all – with the public.

“We cannot impose on our people contraceptive methods, but should explain to convince them that they are responsible for the number of children they give birth to in terms of providing them with quality education, health, shelter and all the necessary basic needs in life,” President Wade said at a recent International Conference on Family Planning in Dakar.

My outsider’s viewpoint is that it’s going to take much more than just education and availability of contraceptives for family planning in Senegal to change or happen at all. It’s going to take a true cultural and mental shift, especially in rural places far outside the capital city.

The United Nations is determined to make it happen, though. The U.N.’s Population Fund is getting a grant-funded boost that will give underprivileged women in Africa contraceptive implants. The U.N. estimates the project will help prevent some two million unwanted pregnancies. But in Senegal, the pregnancies often aren’t unwanted (and despite the poverty, the quality of life isn’t nearly as bad here as in other African nations).

Do you think family-planning initiatives will have success in Africa? Why or why not?

Child Marriage: On Health of Mother and Child

Earlier this year Secretary of State Hillary Rodham Clinton visited Yemen where she reunited with Nujood Ali, the first child bride in the country to get a divorce. Pictured here is also Shada Nasser, Nujood's attorney.

In late July, Secretary of State Hillary Clinton took the stage to speak at “Saving Lives at Birth: A Grand Challenge for Development.” A joint effort of USAID, the Bill & Melinda Gates Foundation, the Government of Norway, Grand Challenges Canada, and the World Bank, the event called on the brightest researchers around the world to identify and scale up transformative prevention and treatment approaches for pregnant women and newborns in rural, low-resource settings around the time of birth.

Clinton relayed how great the opportunity was to internationalize efforts and bring change through innovation. “We want to do development more effectively. That is our goal. We want to change systems. We want to deliver highest possible impact for every tax payer dollar we spend,” she said.

According to Clinton, few challenges are as persistent or heartbreaking as the health of women and children. She cited WHO’s calculation that 2.6 million children are stillborn a year and that a woman living in Sub-Saharan Africa is 136 times more likely to die at childbirth than women elsewhere in the world.

Celebrities Join Forces for "Real Men" Campaign Against Sex Trafficking

The latest Hollywood cause, spearheaded by Ashton Kutcher and Demi Moore, is, apparently, child sex trafficking. Although you wouldn't know it from the series of lighthearted videos they hope will turn viral (one of the ads was posted on Funny or Die). Various celebrities such as Justin Timberlake, Sean Penn, and Jamie Foxx star, showing how "real men" behave, with the tag line: "Real men don't buy girls."

Now it's not my wish to disparage an obviously well-intentioned political campaign, especially when it aims to take on a serious issue like human trafficking and sexual slavery. It is estimated that two million children are enslaved in the sex industry globally. According to the U.S. Department of Education, human trafficking occurs in all 50 states.

But what seems obvious to me is that the ads are meant to earn a laugh first and question a male viewer's manhood second. Is this really sending a message to end sex slavery? A man who prefers to "buy a girl" is not any less than a man -- he's a pedophile. And what about the young boys who can equally fall victim to sexual slavery?

Just as discomforting to me is how little the celebrity spokespersons from this foundation seem to understand the complexity of human trafficking. According to the website demiandashton.org (DNA):

DNA hopes to help abolish modern day slavery, deter perpetrators and free the many innocent and exploited victims. We are committed to forcing sex slavery out of the shadows and into the spotlight.

Call me pessimistic, but somehow I don't think creating a hit video on "Funny or Die" is going to achieve such lofty goals. And when I read in the news about severe public funding cuts being made to women's shelters and rehabilitation centers for victims, I wonder just how much of those thousands to millions of dollars spent on ads could have gone toward donations to social programs. But then again I guess donations aren't as sexy as producing an ad featuring Justin Timberlake.

Kutcher recently told CNN: "Sex trafficking is an elastic trade. If you can raise the price for sex you can actually reduce the demand. As you reduce the demand that raises the price.
"[That means] you can, ultimately, put it out of business, and the way to do that is by attacking the demand because the supply is endless."

Actually, Kutcher couldn't be more off point. I'm not sure the former "Punk'd" host is familiar with global sex tourism, but it serves as a major boon to communities worldwide, especially in places like Thailand, proving that those seeking underage sex will seek it out, no matter the cost.

Let's hope this new celebrity endeavor actually donates generously to the victims it seeks to fight for...and that we aren't just being "punk'd."

Rich Country, Poor Children

The other night I watched a disturbing report on 60 Minutes about newly homeless children in Florida who were living in vans and cheap motels, studying by candlelight, and getting ready for school in public bathrooms. A large segment of these children were living with parents who made a comfortable living and owned homes just two, three, or even one year ago.

Now I am not a naïve U.S. citizen -- I know that the poverty rates in the wealthiest nation are at record highs, and the middle class is disappearing. Women, once employed at a higher rate than their male counterparts, are now facing the same unemployment rates as men. According to a recent story in the New York Times, the portion of American women at work declined to 53 percent in February, the lowest levels since 1988.

I have accepted that the jobless rate may remain the same, or possibly rise as projected, for a few more years. But I cannot accept the fact that our children are starving as our economy is booming and our bankers are reaching record profits.

According to the 60 Minutes report:

The government considers a family of four to be impoverished if they take in less than $22,000 a year. Based on that standard, and government projections of unemployment, it is estimated the poverty rate for kids in this country will soon hit 25 percent. Those children would be the largest American generation to be raised in hard times since the Great Depression.

I then discovered something greatly disappointing about my country: since its inception in 1989, only two countries have not ratified UNICEF's Convention on the Rights of the Child (CRC) -- the U.S. and Somalia.

On the presidential campaign trail, candidate Obama expressed a strong interest in ratifying the global initiative; in 2009, his administration then claimed the U.S. would sign on. That was two years ago, and we now have a rising poverty rate that will affect 1 in every 4 children.

Can our policy makers at the very least begin the process of attaining higher standards of living for our children and future generations?

According to UNICEF's site, the CRC:

"...highlights the unalienable rights of children. It establishes that governments will, to the best of their ability, ensure that all children have adequate shelter and a safe living environment, nutritious food, clean water, health care, and education. It grants children the opportunity to voice their opinions and concerns. In essence, the CRC requires governments to protect the humanity and value the potential of all children."

The Obama administration has a lot of policy decisions on the agenda that are surely taking a precedence over the CRC. But without prioritizing the millions of voiceless children suffering right now, the country is not prioritizing its own future. To tell your legislators to ratify the CRC, sign this petition.