Dr. N. Devadasan was invited by the WHO HQ on 17-18 September 2013 to attend the workshop on Measuring UHC(Universal Health Coverage). This workshop was attended by experts from 14 other countries and have drafted a generic tool for measuring UHC .
The Institute of Public Health (IPH) conducts a PhD programme in public health in collaboration with the Institute of Tropical Medicine (ITM), Antwerp, Belgium. The programme is a part of a long term partnership with ITM and is funded under the Belgian Government’s DGDC grant. The PhD programme is for 4 years and the focus is on research in health systems.
This is not the first time we are writing about Juliet….but this will be the last blog we can write for her. A Call from the team member took me back to memory lane…
When we first time met young Juliet (name changed) she was pregnant with severe anaemia and reluctant to go for check-up (Why Juliet is reluctant to visit Public Hospital? https://iphindia.org/why-romeo-is-reluctant-to-visit-public-hospital/). Then we supported her through the pregnancy to delivery (May be it was dead before seeing the world https://iphindia.org/may-be-it-was-dead-before-seeing-the-world/). Not just during delivery in the hospital, also supported when she disappeared leaving nearly a month old baby at home. We got a call from one of the community member saying the baby will not make it if you don’t do something…we were not sure what is that “SOMETHING” we could do at that time!
When we went to see the baby….the baby was malnourished, with severe dehydration and 
grandparents had decided to give the baby away! YES all they wanted was someone to look after that little boy. The sheer poverty and lack of social support can force people to take extreme steps….and added to that the substance abuse by all the elders in the family had not left space for responsibility and emotions. For the first time we witnessed whole community united to save little baby. After one month of intensive care at hospital, the baby was back in the safe hands of kind people in the orphanage.
Few months later Juliet was pregnant for the second time and she wanted to have another child! I was shocked and angry….our advice not to conceive had not helped. But this time she was taking care of herself and was going for regular check-up. “She is matured madam” said field team member. I was wondering with no family support, what will happen to her and the baby this time! What should be our role…many more questions while her baby was growing in the womb! But we didn’t have to do anything this time….Juliet was in critical care unit.
During a spat, a punch from her husband had caused head injury and she was unconscious in critical care unit and husband in Jail. After few days of struggle, doctors gave up…caller from the other side said “sorry madam Juliet died”!
Few months ago Juliet’s mother-in-law also died and the community is requesting to leave her children in orphanage with Juliet’s baby! In less than two years we witnessed the whole family getting dismantled…Juliet’s baby in orphanage is doing very well, the only consolation we have. This is a story of one Juliet but I’m sure there are many more Juliet’s in our community who need support, guidance and a proper system to address social issues, which is lacking.
Dr Thriveni B S
The 2013 Colloquium Health systems and control of neglected diseases in Asia will be jointly organised by ITM and IPH at Bengaluru Park Plaza Hotel, November 21 through 23. Linking health systems and disease control, as the organisers explicitly do, is no coincidence but a deliberate choice of utmost importance based on “the recognition that stronger health systems can enhance the effectiveness of disease control programmes, and vice versa”. The Colloquium takes the systems-programmes tandem a step further, “investigat(ing) pragmatic ways to maximise the mutual benefits”. It thus offers researchers, policymakers and programme officers a platform to debate common challenges, to update on the state of the art of neglected diseases in terms of knowledge and practice, and to optimise the interface between disease control programmes and national health systems.
The 2013 Colloquium Health systems and control of neglected diseases in Asia is also unique in applying the widest possible – but well grounded – scope to neglected diseases. The organisers welcome all relevant contributions to better understanding and control of infectious diseases of poverty. These include the big three (HIV, TB, malaria), plus the 23 neglected tropical diseases, plus (re)emerging diseases. Indeed, there is today enough evidence to state that “infectious diseases are a proxy for poverty and disadvantage, affect populations with low visibility and little political voice, cause stigma and discrimination, impose a heavy health and economic burden, are low on many research funders’ agendas, have greater impact where health systems are weak, and burden caregivers and families”. Contributions on non-communicable diseases of poverty are also welcomed.
With sessions on the state of the art of neglected diseases in Asia, design and evaluation of disease control programmes, the role of the private sector in disease control, disease control and health systems strengthening, and disease control and social determinants of health, the 2013 Colloquium Health systems and control of neglected diseases in Asia is a firm step towards effective disease control, strengthened health systems and – hopefully – health for all in a better world.
The number of attendees is limited, so please register soon:
IPH is proud to host the colloquium 2013 organised jointly with the Institute of Tropical Medicine (ITM, Belgium). This is the third regional colloquia on Health systems and control of neglected diseases in Asia. To know more, visit our new site!
“Nine Months is like Nine Years”, “why Allah is unfair to me”, these are painful words from the mouth of 19 year old Nazma (name changed). Her agony is related to her pregnancy and marriage. Nazama is nine months pregnant. Generally most of the women enjoy their pregnancy, but in Nazama’s case it is a painful experience for her. Because her husband doubted her fidelity, he always tortured her saying the child is not his, which is a shocking blow to her self esteem.
Her life with this man is not happy either. She is dependent on him for her living. She is neither educated nor skilled person to earn her living. He began to suspect her pregnancy and stopped taking care of her, only then she realized that she has been trapped into second marriage, he is already married with a grownup children. 
According to her there is a background to her marriage. Nazama married a man of her choice, who is much older than her. This marriage was not approved by her family. So, she was thrown out of the house by her mother, saying that she is dead and do not want to see her face.
Before the marriage she was the only breadwinner of her family. Her source of income was through sex work. At the age of sixteen she were trafficked by her neighbor lady (pimp).
*Nazma is one of the thousands of girls who are lured into flesh trade to earn two meals. She has been drugged and house arrested for 24 hours, during this time she was sold for ten thousand rupees. She has had pushed into flesh trade against her wish for three years. When she refuse to entertain clients or refuse to give the pimp her hard earned money, the pimp would emotionally blackmail her saying –“ I will tell your mother about your profession”, due to fear of disturbing her family honor, she had given in to her ( pimp) threat. Her teen age, poverty and broken family made her vulnerable to traffickers, to push her into flesh trade. Nazma is a living example of victim of trafficking. Like her many people are trafficked across national and global*
Nazma’s husband knew about her profession, because he was one of her client. Patriarchy ideology makes women feel marriage is everything in their life. Nazma is also not an exceptional case (whatever may be the profession) When he told her that he wanted to marry her she happily agreed to marry him without trying to learn about his background. Since stigma is attached to flesh trade generally girl like Nazma will feel grateful to a man who marry her.
Only after her marriage she came to know that he is already married with grown up children. After she became pregnant he started moving away from his responsibility saying the child is not his. He stopped coming regularly and also stopped giving her enough money to lead simple life.
Nazma has been feeling helpless that’s where Urban Health Team (UHT) met her and referred her to CHC (Community Health Center) for ANC checkup. After she received moral boost from UHT she decided to visit health facility and felt a ray of hope to deliver health baby.
We do come across pregnant women who do not access health facility for various reasons (related to social determinants of health) in KG Halli in Bangalore. In such cases team address the issues of social determinants of health to improve health seeking behaviour of the community.
