Thursday, July 10, 2008

Everything is connected to health...

June 2nd – July 5th 2008

In the second half of May, we went on a family vacation to Kerala with Dwiji's parents, brother, sister-in-law, sister and nephew. It was good fun and the longest purely touristy vacation that I've taken in India. The sociopolitical part of my mind was on partial hibernate, though it was active enough to think about the negative aspects of tea estates around Munnar. The spice gardens of Thekkady seemed better, especially because of the number of small landholders. And the backwaters of Allapuzha brought forth all kinds of thoughts about land reclamation, intensive cultivation and the instability of such places in light of global warming...

I had been selected as a fellow at Community Health Cell (CHC) and started the orientation on June 2nd. I learnt a lot in the following 5 weeks and will not document it all here. Instead, following is a brief report I submitted at the end of the orientation. I will also post detailed reports of the field trips we made to Hannur, Hospet and Potnal.

CHC Orientation

Having only a vague idea about CHC, I started CHLP with very few expectations beyond getting a grounding in community health. Ravi (Narayan) mentioned in one of his sessions that he thought of CHC as a 'sarai' that provided some space and time to fellow travellers. That is perhaps the best way to explain my viewpoint when I started the program. However, the orientation turned out to be much more than that.

Starting off, the CHLP fellows of 2008-09 couldn't have been better chosen. The diversity in ages, backgrounds and interests of the fellows was impressive, to say the least. There is a lot we can learn from each other and I hope we can manage that during the course of the fellowship. The 'group lab' session and the group assignments helped build connections and the time spent together during the field trips also allowed us to interact to a greater extent. We have learnt much more as a group than we would have individually, I believe, and that has underlined the importance of 'community' in community health.

The sessions that made up the orientation program could be broadly divided into the following categories:
  1. Overviews of concepts such as Primary Health Care, globalization and the public health approaches to disease.
  2. Specific topics of interest, for e.g. tobacco, non-communicable diseases, immunization.
  3. Analysis of existing structures or approaches, for e.g. understanding social movements, the lacunae in public health approaches to disease.
  4. Personal journeys such as Sunil Kaul's experiences with the ant and Lalitha's description of Tribal Health Initiative's (THI) work.
  5. Field trips to organizations in and near Hannur, Hospet and Potnal.

There were overlaps, of course, and interwoven with most sessions were stories that breathed life into dry concepts and definitions. The breadth of topics and the varying styles of the facilitators kept us on our toes and motivated. I could not have imagined further reading after a long day of classes and yet that is what I often found myself doing!

At the end of the orientation, I have gained a much better understanding of community health as a concept, a philosophy and a uniting issue for mobilization. The ideas that I had about livelihoods, education etc. being connected to health have been solidified with data and examples. The sessions covering the history of community health have provided a foundation, those that were about specific issues have provided detail and the analyses have provided perspective.

The field trips were invaluable for understanding how the issues we talked about manifested themselves practically. At the same time, our field interactions with health and development workers, medical professionals and the community were enhanced by our in-class learning. We understood how to apply the lens of caste, class and patriarchy to various aspects of community work. Due to the presence of experienced activists during our field visits, we also got to see some approaches of interacting with and motivating the community. I realized that even in initial interactions where the focus is on our learning from the community, it does not hurt to share some useful information and to speak from the heart.

Finally, the positive and can-do attitude of everyone we interacted with is heartening. The road to good community health is littered with failures, unavoidable detours and roadblacks. Yet those who are working on these issues have not lost their enthusiasm for it and are motivating entrants into the field. The orientation session has left me brimming with ideas and enthusiasm. My thanks to the CHC team for their untiring efforts!

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