- Lives Saved, With a Little Help from Friends
In November 2000, Jharkhand was carved out of Bihar, a state in eastern India, to be a separate state to fulfill the aspirations of its people and [End Page 109] allay their feeling of alienation. It was a good time for me to reflect on how best I could contribute. In 2002 Ekjut, a registered development organization, was set up by myself and other like-minded colleagues. Ekjut, which means "togetherness," was the outcome of a longstanding desire to do something on our own, something that was close to my heart—doing something for and with the people I had grown up with. An invisible cord kept me attached to this region of India and after stints with a few development organizations within and outside the state, my wife, Nirmala, and I decided to relocate to a village near my hometown, Chakradharpur.
Chakradharpur is a small railway township in South Bihar where I spent all my childhood and days of schooling. Beyond the periphery of this township and its satellite market place, live indigenous people, the Adivasi, in villages and hamlets. Even as children we could appreciate the government policy that protected them in the sense that their ancestral lands could not be acquired by Dikus, the non-tribal people living in the towns and cities. The un-spoilt bounties of nature protected and preserved by the original inhabitants of the land—the Adivasi people—was there for all of us to see and enjoy.
A rumor that a doctor couple was building a nursing home led to a regular flow of men, women and children to our unfinished home with all kinds of ailments, including medical emergencies. It was becoming increasingly difficult to cope with the workload of constructing the house and at the same time—overwhelming to see children dying in our home, which was never meant to be the hospital that the villagers thought it to be. They were reluctant to visit the government hospitals, which were primarily meant to serve poor people and their attitude could be summarized in just one word—fatalism. We wanted this to change—they somehow needed to understand their rights and entitlements. The public health care system had to be strengthened and Nitmala and I wondered how our work could make this happen.
The Adivasi people were soon to become partnering communities with Ekjut. It did not take us long to realize how unprotected they were. We had a vague idea that we wanted to build healthier communities. Providing full-time curative care was not an option; it was also beyond our means. Knowing that strengthening the health system would take time, we hoped that our community-based work would strengthen the demand side, since even the minimum services that were available were grossly under-utilized.
India is home to about 10 million tribal people. We had seen and also knew that their health status was poor and that tribal people have the disproportionate burden of child mortality, malnutrition, malaria and death in childbirth. But we could not find a reliable existing data base that could guide our work. The health status of women and children soon became Ekjut's main concern.
We wanted our work to generate knowledge that would be relevant in a wider context. Adivasis are not a monolithic entity and our evidence needed to grow from working with several different tribal groups. We needed to build our research capabilities and willingness to work with several different indigenous groups, as well as, the poor people living alongside them in different districts. A collaboration with University College of London was soon to follow. Professor Anthony Costello who was my teacher more than a decade back, invited me to partner with his department and jointly bid for a grant. This grant was likely to come at the confluence of several interesting developments. First, the self-help group movement in India had made a substantial jump and such groups existed in almost every village. Second, a grassroots organization called PRADAN was working with women's groups to strengthen their livelihoods in several states of India including our district. PRADAN shared with...