Another day of immense learning and many unanswered questions in mind!!!
My brief today in KG Halli as part of the urban health team was to help one of my colleagues, unravel the tangle she found herself in……this time thanks to our training and interventions in the area.
Domestic Violence and women’s right – who’s responsibility?
When the gentlest and youngest of our community health trainees (she married at 16 and at twenty two, is the mother of three children) came in for our training programme four months ago, it appeared her husband was not enthusiastic. However, in an attempt to learn a skill and add mite to the family income, she joined the group and has been our quietest but brightest trainee. In her own words, “speaking with confidence” has been a huge hurdle but she has been working on it. Two weeks ago, she had to go to Tamil Nadu with her husband for a family wedding…..and her ensuing absence started interfering with the group’s training schedules. The team started getting antsy and our co-ordinator, Antu called her out of concern. We were told that her mother’s illness was the cause of her absence.
A series of miscommunications, falsehoods, old family skeletons in the cupboard……and the ensuing fear, resulted in her being beaten by her husband over the weekend. Our team members went to try and sort things out, and came away quickly from the tiny home on Saturday – close to midnight, with issues still unresolved but with an aim to prevent her from being hit any further The immediate reply from other team members who witnessed this was “ we felt so helpless and sad to see her get hit”.
Has the society accepted violence/abuse on women as part of life not questioning out of fear or due to financial dependence on husband?
After a break of two days, hoping things had cooled down, we went today with an open mind, to see what the next steps might be……..and the meeting was an eye opener. In the small 10 foot square space, where the saree cradle “oonjal” holding a baby took centre stage, we perched around the room while the young husband, Shankar, challenged us and our paradigms. “You may believe in all this freedom” he said, “but I retain the right to send or not send my wife for work”.
Does that mean she lost her right to freedom after marriage? Or does he believe it is his right to decide for his wife? As we struggled to explain the role we undertake as community change agents (difficult because there are neither words or role models!), one could see the others – more experienced, more confident, yet sensitive to the family and gender issues at stake – take on the discussion.
Finally we left, asking the young couple to think about the questions we had raised, explaining we would respect whatever decision they came to ………….but we all had grown thoughtful and quieter, faced with issues close to home. The burning question here is how many women know that there is Act (The protection of women from domestic violence act 2005) to protect women form domestic violence and under this act they have the right to avail free legal services, ect?? Will the laws on paper make any difference to the women who is constantly under pressure and abused? I did not get any answer to these questions!!!
Expecting Quality of health care and drug regulation – is it not a right of the community?
The next challenge came not too far along, as another team member came sailing down the road with her infant who had full blown measles! Her three older children had been immunized but the youngest had missed all his shots except for the BCG. Very sheepish, with her childlike exuberance , she explained the fever was not subsiding, so she took the baby to two private doctors, one of whom gave the baby an injection, the other gave bottles of chloramphenicol syrup ( did not know they even manufactured these any more!) and phenergan syrup. Strangely, paracetamol was missing from the prescription so the poor little fellow was burning up with fever. Also, thanks to measles coverage over the years, it is rarer and rarer, and our trainees could not recognize the clinical picture…….so an on the spot class in the street. Is it possible to regulate drug manufacturing? Is there any regulation which monitors doctors performance or can doctors get away prescribing harmful medicine, when the community trusts his competence with closed eyes?
Can the urban health centre in the area catering for 80,000 population with 5 link workers follow up all children for immunization?? Is the immunization coverage as good as it is projected? Who has to be blamed for this? The system or ignorance from mother side who failed to vaccinate this child?
Failure of health system for early diagnosis of Tuberculosis?
Which left only the last follow up home visit in the area. When we started out in K.G.Halli two years ago, a young woman, helping in the local child-care centre (the Anganwadi) was diagnosed as having sputum positive tuberculosis. We saw her complete her treatment and were yet, shocked to hear that about three – four months ago that she has had a relapse. After an admission in the “Isolation TB sanatorium” on Old Madras Road, she is now taking her medicines
from the dispensary on Tannery road. Equally important, her 10 year old daughter – who had a swelling in the neck – went to the local hospital where an FNAB was done, and the diagnosis of an acute abscess was made. Given a course of antibiotics, to which she did not respond, now she has a swelling the size of a big lemon under her jaw and makes a textbook picture of caseating “ TB lymphadenitis” This entire circus has made the family borrow to the tune of Rs 3000/-, which is a huge amount for them. I am beginning to see why self help groups running microfinance schemes are a thriving business on Tannery road!
When the tertiary centre and medical college has failed to diagnose TB on first visit, are we somewhere failing to give quality medical education to the students which the community deserves? How competent are they when they graduate to practice with no supervision?
Dr. Roopa Devadasan and Dr Thriveni from the Urban health team.
