Friday, March 24, 2017

Dreams and pragmatism in rural UP

I've been wondering what I can say about the Uttar Pradesh elections and YA's ascension. Given the amount of time I have spent there recently (almost 2 months during the election and results period), I should have some insights to share, right? Maybe I should just recount my experiences on one day in late February...

A colleague and I were at the bus stand, bound for a village about 40 km from Sitapur city. With the SP-introduced Lohia buses, services to villages had improved but there were very few buses available during the election period. So we were relieved to see a rickety bus headed to Mishrikh, an intermediate point. The bus was almost full when we were asked to step out so that it could be cleaned. Grumbling, we did. A man standing nearby started off - “When Modi comes to power in UP, such things won't happen. He will kick all the workers into shape – they will not be able to get away with this indiscipline.” The people around him nodded their heads or made sounds of agreement.

Later, in Pipri village, I saw another form of the boundless faith people seem to vest in their leaders. An old lady, who has been active in the sangathan, began chatting with me about the study we were conducting in her village. I explained that we were trying to understand what people were eating, whether it was connected to what they grew in their fields, whether it was sufficient for good health etc. “So you will come out with a report?” she verified. “What will you do with it?”. I said that we would share it with all concerned officials, politicians, activists, media. “If Behenji (Mayawati) comes to power, she will do something about it,” she said. “Will you report about the 32 people with pattas?”

Pipri is a predominantly Dalit village and most of its residents were landless. Some of them received land titles in the 70s during Indira's reign and were able to take control of the land. In another round of redistribution, 32 people received land titles in the 90s. Most of this land belonged to a powerful family which has controlled the Pradhani of the panchayat for a very long time, and the land was never relinquished. The family was able to get a stay order against the transfer, and the 32 families tried to fight the case in court but lost.

“This matter should also go into the report, and Behenji will take it up,” the old lady said. I wondered how she could still have so much faith in Mayawati. Other friends that I had talked to had become more pragmatic about the BSP – they still voted for the elephant, but mostly because they were respected here and didn't have a place in other parties. Or maybe some had switched to the lotus, though they wouldn't admit to it.

In the evening, I was chatting with another older couple. The husband quietly brings us tea every time we have a meeting in Pipri. After a recent discussion about plastic, he has begun bringing us 'kulhads' (earthen cups). I realized that he was a beneficiary of land redistribution in the 70s and had received 5 bighas (one acre) of land. He mortgaged it, he told me, to pay for his son's wedding expenses. They need Rs. 20,000 to get it back but after a few months in Dehradun his sons had only been able to save Rs. 5,000. "बडा लडका पढा-लिखा है और गांव में उसके लिये कुछ नही है - the older boy is educated and there is nothing for him in the village”. So he and his younger brother had gone to Dehradun to work in a herbal medicine factory. By the way, 'educated' meant 8th standard pass, I later found out, but that is another story.

I struggled to not sound harsh in my reply. It is sad, I told him, that the precious land he had been given was mortgaged. It further reduces the connection with land. After a few minutes of silence, he told me that his sons were attached to the land. They didn't want to leave, but last year they had leased some land to grow wheat and had incurred a huge loss. Their pumpset had failed and they weren't able to irrigate properly. His younger son had stayed up many nights, he said, trying to irrigate from a neighbour when there was electricity but it was of no use.

Last year's wheat harvest was anyway below average, I knew, due to the 2015 drought and unseasonally warm winter that followed. In fact, after the 2014 rabi crop, there hasn't been a uniformly good agricultural season here. Few people would migrate from these parts, the upper Gangetic plains, a decade ago. Or if they did, it was for a few weeks to Lucknow or Kanpur. But now every family has a member in Haryana, Delhi or even Andhra and further away...

We like our elections, in this country and elsewhere. In the absence of robust local governments or fora for citizen engagement, elections become the do-all and end-all. But the marginalised, those who truly need government support to improve their lives, have given up hoping for it (except for a few dreamers). They are finding new ways to survive, further detaching themselves from the land, struggles and local issues. Maybe, like the NRIs who have funded the Sangh Parivar, these migrants now care more about the abstract, so-called cultural issues. Or maybe they just could not or chose not to return to vote...

Monday, August 29, 2016

'Left Out' - a short film on denial of health rights in Karnataka

Over the past few years, I've helped organize meetings and consultations, produced reports and participated in research studies which documented various forms of denial of health rights in India, mainly Karnataka. Recently, while documenting cases for a planned public hearing with the National Human Rights Commission (which was later cancelled), I had the opportunity to collaborate in a project to video-document some testimonies. Thanks to Dipti Desai's persistence, these testimonies have been compiled into a short film 'Left out', which is available on YouTube here.
The stories are from across Karnataka and reveal how hard it continues to be to access health care and to pay for it...

Monday, March 14, 2016

The Universal Health Coverage Numbers Game

Some years ago, during a sojourn in Sitapur, we began discussing Rashtriya Swasthya Bima Yojana (RSBY), the National Health Insurance Scheme which provides 'cashless care' for hospitalisation at 'empanelled' private hospitals. The RSBY coverage limit is Rs. 30,000 per year for a family of five. I was already involved in the research of government-supported insurance schemes in Karnataka, and knew that while they gave poor families 'access' to private hospitals (there are denials as well), the devil was in the out-of-pocket expenditure that followed.

Here the tale was different:
"हमने उनको भगा दिया", "किन को ?”  "अरे, कार्ड छापने वालों को!"
which roughly translates to: “We chased them away”, “Who?”, “The card printers!”
Every year, the RSBY card has to be re-issued, so Third Party Administrators (TPAs) go to these villages to enrol people in the scheme at a cost of Rs. 30. But my friends in SKMS (Sangtin Kisan Mazdoor Sangathan) were fed up of getting a useless card - “We go to Sitapur city with this card to all the private hospitals, but no one gives us free treatment”. So they refused to get enrolled and asked the TPA to leave. One year, the District Collector got involved – he went to some villages and requested the villagers to cooperate! But as far as I know, some are still holdouts.

Tuesday, March 08, 2016

Addressing health inequities through community-led advocacy in Bangalore – experiences, successes and challenges

For some reason, I have not written much about my work in Bangalore. Maybe because it was 'paid' work and I spent so much time writing reports, updates etc. in the style that the organization and funders required. Well, now that the project has wound up, here goes... Below is a paper I submitted for the Medico Friends Circle (MFC) annual meet in February - I modified it slightly for this post. It is a long write-up (almost 2500 words) and a bit technical. But I think there are interesting stories in there...

Monday, February 29, 2016

The return of Mayawati...

After the Uttar Pradesh assembly elections in 2012, it seemed like the era of Mayawati was over. All the scams in her government, plus the massive statues in the parks she built - these are routinely tolerated from other leaders, but for a Dalit woman at the head of a Dalit party to do so! Her upper caste support evaporated...

Now her star is on the rise again. Which is good. As a health activist, I am dismayed at what happened to the National Rural Health Mission (NRHM) under her. Almost all the funds were siphoned off during her tenure - though some accused are behind bars and others committed suicide, crucial time and money were lost. Since the Samajvadi Party (SP) government took over, health services have improved slightly, as has rural transportation among other things.

But, at the heart of it, the SP is a Yadav party in a society that is relentlessly casteist. A few days after it came to power, a Yadav farmer in Pisawan block, Sitapur dt. fired at a neighbouring farmer (who happened to be Dalit) because apparently the latter's cow had entered the former's field. There may be a back-story to this, but the general feeling was that the Yadav farmer would not have dared to take up a gun when the BSP was in power. Later, Sangtin Kisan Mazdoor Sangathan (SKMS) activists were beaten up by police in Qutubnagar when they had just gone to the chowki to give their side of a village dispute. The policemen asked which caste they were before thrashing them. To get an FIR filed in this matter, SKMS had to agitate for more than a month.

I don't think I need to state what the BJP stands for in its 'karmabhoomi' UP.

Coming back to Mayawati, maybe most of what she did when in power was symbolic, but symbolism matters in a society that is so unjust and unequal. Security and respect are pre-conditions for any social improvements. So here's hoping that if BSP comes back to power in the 2017 elections (and there is now at least a chance for it), that they will not squander this opportunity. Because, like it or not, unless the challenges of our most populous state can be tackled, our nation's progress will always be incomplete.

Note: After I posted this on Facebook, my nephew (Vishesh) remarked that what remains of the Congress UP state unit could fit into a Nano! Strangely, I didn't even think about the Congress when writing this :)