![Juliet: We met, we supported and we lost…….& witnessed family getting dismantled?]()
by iphindia | Aug 11, 2013 | Blog, Latest Updates
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? http://www.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 http://www.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
http://www.iphindia.org/urban-health-project/
by iphindia | Jul 23, 2013 | Latest Updates
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:
![Juliet: We met, we supported and we lost…….& witnessed family getting dismantled?]()
by iphindia | Jul 5, 2013 | Latest Updates
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!
![Juliet: We met, we supported and we lost…….& witnessed family getting dismantled?]()
by iphindia | Jun 21, 2013 | Latest Updates
“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.
![Juliet: We met, we supported and we lost…….& witnessed family getting dismantled?]()
by iphindia | Jun 21, 2013 | Latest Updates
Women and tobacco is there a connection? Definitely yes!
The bond between women and tobacco goes way beyond the cultivation and manufacture, and is now creeping into consumption as well. As more and more tactics are used by the industry to tap into this vast less explored area of women and tobacco use studies have shown a rapid rise in female tobacco users. In general 6 million people worldwide die due to direct or indirect effects of tobacco usage. By 2030 tobacco is estimated to kill more than 8 million people worldwide each year, with 80% of these premature deaths among people living in low- and middle-income countries.
In India till recently tobacco use among women was not very common. Though rural women do consume tobacco, in various parts of India, generally tobacco use by women is not a socially acceptable norm. Smoking habits, often seen as an act of rebellion usually becomes linked with freedom and equality. In urban India with the increasing number of working and educated women, smoking is picking up among this group as a way to break away from the social constraints and express their freedom. Such circumstances are cleverly exploited by the tobacco industry to gain customers among new target groups such as women and children. Marketing, portrayal in the media, and movies can influence the progression to regular use and addiction. While smoking among women has declined in many developed countries, it is predicted that as women achieve greater spending power, and socio cultural and religious constraints decrease an increase in smoking rates in developing regions is emerging; such is the scenario currently in urban India. Overall, 2.9% of women smoke and 18.4% chew tobacco in India. The prevalence of smoking among women is low in most parts of India, but is somewhat common in parts of the north, east, northeast and Andhra Pradesh.
Smoking by men is somehow considered normal and does not evoke much of a response, but smoking by women does turn heads; more so in India and other neighbouring countries. Hence usage of smokeless and other forms of tobacco such as hookah, tobacco water etc is quite common among women of this region. Smokeless tobacco usage is convenient for women as it can be concealed quite easily and does not attract the same social attention as smoking would. The major concern with this is, smokeless tobacco is shown to contain 3095 chemicals of which 28 are potential carcinogens (cancer causing agents). India presently has the largest number of oral cancers in the world and smokeless tobacco users have a high risk of developing oral precancer and cancer. In the case of smoked tobacco there are more than 4000 chemicals, of which at least 250 are known to be harmful and more than 50 are known to cause cancer. Second hand smoke(SHS) is also equally harmful as the mainstream smoke. SHS causes lung cancer and coronary heart disease. In children, SHS causes sudden infant death syndrome (SIDS) and many other diseases, primarily related to the respiratory tract. Other than tobacco consumption in smoked or smokeless forms even the chemicals used in tobacco farming have hazardous effects on maternal and fetal health.
Few of the reasons for the unique relationship between smoking and the female gender are as follows. Research findings reveal that female smokers derive greater subjective pleasurable effects from nicotine than their male counterparts. Also weight control and reduction of appetite are important aspects of the appeal of smoking for many women and girls. Studies do suggest that cessation may be more difficult for women than for men; one of the reasons could be weight gain and fear of weight gain particularly among women.
Other than the gender neutral effects of smoking such as lung and heart diseases, strokes, cancers etc., women are at an increased risk for female specific reproductive issues, including painful, irregular periods; earlier menopause; increased risk for cervical cancers among women who smoke and have human papilloma virus (HPV) and increased risks among those who use certain birth-control methods.
As tobacco industries are targeting gender specific promotion, increasing efforts should be made to develop gender-specific prevention strategies as well. Women who are very conscious of their looks should not fall prey to such lame excuses of reduction in appetite for weight control as they could end up with much more disfiguring consequences. A change in perspectives is required to consider tobacco use as ‘uncool’ and not a normal behaviour especially among young boys and girls. Women do not need to use tobacco to depict that they are independent and smart. Gender specific tobacco control activities should also take into consideration the millions of women involved in the tobacco farming and production industry that tirelessly roll lakhs of beedis to earn meagre amounts. Such activities should also focus on young girls to help them make well informed choices about their health and life.
![Juliet: We met, we supported and we lost…….& witnessed family getting dismantled?]()
by iphindia | Jun 5, 2013 | Latest Updates
“He is a caterer, he needs that place to cook and park his vehicle. Therefore he is creating a problem”, it is the opinion of youths from BM layout in KGhalli ward no.30, Bangalore.
KG Halli ward No.30 is located in Bangalore North, with the population of 45000. Findings of baseline survey says 73% of the family do not have tap at home, they depend on other water sources like bore well street tap and tanker etc. To improve water source in this area UHT (Urban Health Team) have planned to strengthen water facility. In consultation with community and local counselor we decided to install 5 Ciston tank each in five areas of KGHalli (AKcolony-1, BM Slum-2, BM layout-1 and Venkateshpura-1). Although we had planned five Ciston, we were able to construct only three Ciston tank.
Construction of water tanks are in progress in identified places. There has been no objection in three places. But team faced problem in two places, we have been asked to stop construction work in both the places namely AK colony and BM layout. Thus any program becomes failure if community does not take lead or if local rowdy element is controlling the community.
Construction of water tank is failure in AK colony
In AK colony the place identified is almost an adjacent to the wall of a house. The house owner objected the construction of water tank. People did not come to our aid or tried to identify another place to install the tank. The point here is how can community let go a basic facility (water) when it has been taken to their door step?
In BM layout we found individual V/S community.
A team of construction workers had already started construction (basement of two feet height) in an identified area in BM layout. When construction is on Nazeer picked up quarrel with the construction workers and did not allow them to continue their work. Nazeer (Caterer) is not an owner of the house but he is a tenant residing in that house. Community member have taken permission from the owner to construct water tank in front of his house.
Despite consultation with community, counselor and permission from the owner, in a public place we could not construct water tank. The reason behind the failure of water tank construction is a local politics. He is being a caterer he wanted to utilize the space for cooking and parking his vehicle. It is hard to fight when the fight is ending on injustice note, few community member especially youths came forward to support the construction of water tank. Their effort became fruitless when Nazeer brought the local rowdies to hush up youths by manhandling them.
We called counselor and BBMP official, everything became futile. None of them want to side the community for an issue of basic amenity.
UHT witnessed the fight between Nazeer and youths, we felt we were helpless when youths were beaten up and construction was stopped. This incidence kept on haunting me for several days, because community has been deprived from basic facility. Is community gullible or do not want to take any effort to protest against injustice happening to them? Is community scared of local rowdies? Is that particular area ruled by local rowdies/unofficial elected leaders? When construction of tank happened in other three areas successfully why not here?
As an outsider we cannot protest on behalf of community, our role is only to facilitate the program. May be the lesson for us is we must have mapped who control’s that area other than counselor or political leader, what is the strength and weakness of the community before the construction of water tank.
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.
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”!
