Getting Started-Trials, Tribulations and Triumphs

The fact that I am setting up this blog 6 weeks before I leave Bhopal is testament to the fact that nothing ever goes the way you think it will.
I arrived in December armed with some good books about community health,a Diploma in tropical Nursing from the LSHTM and a vague idea that I wanted to work with the community health workers in the bastis surrounding the Union Carbide Factory. Surely enough to do something brilliant with, thought my arrogant Western head.

Of course this is India, and, as I should have learned some years ago,timescale takes on a whole new dimension. My idea that productive meetings with the community health workers,bullet pointed action plans and enthused motivated responses leading to a champion project being successfully born my first week there ?

Eh. . .no

I will be honest; as the weeks rolled by in a haze of failures to communicate, cancelled meetings, we ll do it tomorrows and a general lack, or so I perceived, of interest nothing appeared to materialise. The frustrations, anxiety and feelings of failure of trying to be accepted by a well established team of Community Health Workers, who lets face it didn't have to the time or the inclination to listen to a weird Scottish volunteer try to put her point across in pretty rubbish Hindi. I made the classic mistake of expecting too much too soon and in my excitement forgot that the development of ideas can only come from building relationships, sharing skills and ideas and allowing time for trust and respect to be earned. In the process of this came a whole range of emotions; a definite feeling of one step forward ten steps back, learning to laugh at myself as everyone else laughed at me (easier when you actually get the joke let me tell you) and an eventual acceptance that maybe my role here was going to be something completely different to what I expected. And so I gave up on the idea of a participatory child centred health promotion project and focused on what the Community Health Workers really wanted to learn. How to take blood, give IV drugs and do clinical examinations.

The psychological and emotional impact of being in Bhopal, the frustration I felt with my self, and a general lack of contact with the outside world started to take its toll. After endlessly pondering my frustrations with Tori and Michael, a wonderful Australian couple who kept me sane here in Bhopal, and who scooped me up some time later in Calcutta to ply me with red wine and beer, I legged it to the Andaman Islands to gain some perspective. I decided I wasn't going to stress about anything any more and would take each day as it came. If the project I had in mind didn't come to fruition then so be it. And as always the minute I stopped fretting the wheels started to turn. Unbeknown to me some books I had ordered arrived in my absence, and on my return I was eagerly approached by Masarrat, one of the Community health workers. "We've had an idea. We want to do a child based heath promotion project in the basti. Can you help us?" Ummmmmm. . . sure. And so the story begins.

Masarrat and Nasir had identified some community conflict that was having an adverse effect on the maintenance of the community garden in Sri Ram Nagar and though it would be a good idea to create a bond between the children of these families, encouraging them to work together and build relationships. An ideal situation to form a group of young people. Our first meeting was at the beginning of April with 8 girls from the basti of Sri Ram Nagar. Aarti, Jyoti, Dolly 1, Dolly 2, Asha, Mala, Pooja and Vasha, all aged between 14 and 18. The meetings take place on the doorstep of one of the community health volunteers homes. The sociable setting means men, women, children, goats and dogs are continually dropping in to check out what is going on, which can only be good for community spirit.

The idea of participatory health projects is that children identify issues within their community through research and health education and then plan an intervention to address the issues they have identified. This empowers children, gives them confidence and allows them to disseminate useful health information to peers and other members of the community to create healthier, more positive environments. It was obvious this concept of learning was new to the girls, as they sat in a solemn line in front of us and waited to be told what to do, indicative of the tell and repeat system of education throughout the country. However they soon warmed up and came up with some brilliant ideas. They wanted to create a file with information about medicinal pants used in the community garden, that everyone can access, and they decided that they would like to do an art/music and dance project on a health issue in the community.

Masarrat suggested they might like to investigate TB and together we started to devise a plan. It was interesting to listen to the girls fears: Being dismissed or ridiculed by the community because of their age and perceived lack of knowledge seemed to be the biggest concern which we alleviated by explaining we would all learn together about TB before any community involvement occurred. We also reminded them that they have the full support of the community health volunteers, and the community health workers, who would happily support them if necessary, and that their opinions knowledge and ideas are valid and worthwhile.

The girls expressed a desire to improve their English and so we came up with a plan to spend half an hour at the end of each meeting having an English class. For fun we will each learn 3 new words in English (and for me Hindi) and tell them to each other at the start of every meeting, together with a short definition. The one great thing about the language barrier is that it creates great hilarity (usually at my expense)and a more familiar environment where we meet on our common lack of understanding.

It's early days but I'm really excited about the potential for this project. If the girls enjoy it and want to continue they can hopefully create a regular young person based health promotion group, identifying issues that affect their communities and addressing them in fun and interactive ways. In the mean time I am trying to get a handle on English grammar, and Masarrat, Nasirbhai and I are putting together some health education information about TB that we can share with the girls at our next meeting. Its a learning experience for all of us. For me, learning that starting small is a positive thing and that if you remember to stand back and let things blossom on their own, they might look different to how you first envisioned it, but that is almost always a good thing. Lets see what happens.