At Gandhiji's Ashram - 2009

At Gandhiji’s Ashram in the middle of eastern Maharasthra I filter through it all to try and reach brief moments of clarity, understanding, and salience. I find myself so wrapped up in my own immediate desires, feelings and ego. I am cornered in by my own mind and find it hard to go beyond “I”, “me”. Maybe I am not at peace with everything unresolved inside (Maybe? More like definitely). But there are too many uncontrolled thoughts of myself…

What does it mean to be here? Decades removed from Gandhi one must go beyond the surface of philosophy and the legend of a man who is still worshiped. In the peace, the quiet, and the beauty of dawn glimpses come of what it was all about. Simplicity. Mindfulness. An unbelievable sense of purpose and self. These were the grounds where his experiments with truth were tested. Here is where people gathered to plan and organize, to officially declare that the colonial oppressors of the past few hundred years had to leave, a declaration on the behalf of several hundred million people. It was at Sevagram in July 1942 that the “Quit India” movement was drawn up. Standing in this place invokes a wave of sharp emotion and solidarity. It’s pretty incredible to think about.

There is often the continuous question posed of what is the relevance of Gandhi today. There is plenty we can extract from this man’s message, but at times I struggle with trying to understand this relevance practically, in trying to go beyond the aesthetics of it. At Sevagram one sees the “simple living” philosophy of Gandhiji, embodied in certain action. There is an intentionality of each day focused towards reflection and self-sustainability. Each day includes a few hours of shramdaan, which literally translates to “gift of labor.” As Vinodji one of the acharyas at the ashram explains, Sevagram is meant to be a diya to light the flame within others. It is a good example of a significant part of Gandhiji’s message. And one would like to imagine that maybe one day it could play some role in introducing a modern day application of the idea of swaraj.

Swaraj was Gandhiji’s idea of decentralized, non-hierarchical governance by communities. It is an idea of direct democracy, which encompasses the individual and community levels that emphasizes self-reliance and self-governance. I don’t know what the contemporary adaptation of swaraj is to build self-sustainable, balanced communities, but there is value in thinking about these things in a way that goes beyond simply spinning khadi.

While being here there have been certain questions raised about the role of the ashram. If whether the ashram is really more of a museum? Is it looking backwards too much, without having a clear and active vision for the present? One thought I cannot shake however is that a significant part of Gandhi’s message feels like it is missing in regards to today’s India. What happened we know, but what about now? Gandhiji’s beliefs were certainly of simple living, sustainability, and inner meditation and mindfulness, but it also asked us to go beyond ourselves. Gandhiji believed that your life is your message, and that message includes engaging in our communities, and the larger communities of village, country, and world. When he was killed his vision for India was not realized. The country had just been partitioned, with mass violence ensuing, up to a million killed and over 12 million displaced.

Gandhiji’s vision was of a country that had collectively gone past caste discrimination and oppression, a society that had overcome communalism, and a nation that was clearly addressing issues of poverty, health, and education. Today we can still see the divisive nature of caste through the country, we see ugly displays of religious nationalism and fundamentalism while the state stands impotent, and while we consume magazine articles and 24-hour news channel specials on the development of India, many within the country still struggle with access to the basics.

And at Sevagram the words of Gandhi are posted, “I strive for such a country wherein the poorest of the poor feel that this is his country in building which his voice has its due importance. I strive for such an India wherein there are no differences of high and low and people of all castes live in harmony with one another. In such a country, there will be no place for the evils of untouchability and of alcoholic and intoxicating drinks. Women will have equal rights with men. We shall have peaceful and brotherly relations with the whole world. This is the India of my dreams.”

It seems that if we strive to understand the holistic approach Gandhi took it requires, at the very least, to in some way be prepared to address not only our personal weaknesses, but our societal ones, as well. It’s not about always being “activists”, but actively acknowledging the very same challenges that continue to face this country, just as they did back in Gandhi’s time. And it doesn’t mean simply following Gandhiji’s ideas, or mine, or anyone else’s for that matter, but genuinely engaging in a process that seeks out our own questions and journeys. I suppose I just feel that it’s not simply about looking at Gandhi from the lens of the 1930s and 1940s, but from 2009, and beyond.

I certainly do not doubt the inspiration that places like Sevagram can provide, even while it may not always be easy to translate that inspiration into today’s many proverbial languages. Sevagram is only one diya to draw light from. Spending some time at Anandwan and Somnath, two projects of the Maharogi Sewa Samiti displayed the incredible potential of people working together, reminiscent of many of Gandhiji’s ideas, under the motto of “Work Builds, Charity Destroys.” People who are shunned by society proudly living, with dignity, alternatives to the status quo. Visiting Vinoba Bhave’s ashram (a contemporary of Gandhi and active in the swaraj movement) also shed some light on collectives living alternatives to the status quo.

Amongst other things Vinoba Bhave is known for his leadership in the ­bhudaan movement, a campaign of voluntary land reform that aimed to redistribute land from zamindar (landlords) to landless farmers. And there are so many others I have encountered over this year in communities and organizations all over this country that are working for change, against what many would say unfavorable odds. Where the passion doesn’t overtly strike claim to your heart, it’s quite clear it’s right there beneath the surface being kindled. And that list of those who are also sparking the flames of social change includes my fellow fellows at Indicorps.

When intimately engaging with India it’s possible to easily get discouraged and depressed with being faced with the massive contradictions, stratifications, and inequalities in Indian society. But at the same time it’s exciting and uplifting to see what so many dedicated people are doing. From providing livelihoods to women’s groups, to working with youth towards empowerment, to struggling towards a more peaceful, secular and democratic society there are many fascinating activities being undertaken by amazing people committed to a better tomorrow. And I feel like in a lot of ways, wherever we are, it’s a question of how we choose to engage with what is around us.

The idea of Gandhiji’s teachings, this idea of “living with purpose,” it’s about not only what we do, but how we go about doing it. Which are the paths we will have courage to take? How strong are our own limitations, the ones we place upon ourselves within our minds? How will we react in the face of distraction? The sunlit sky creeping golden, overhead blue. The peepul trees are huge, magnificent. The huts remain, and retain peace. If there are images to try and capture these are them. Green and stillness. A disturbed mind colliding with what it cannot fully grasp and digest at Gandhiji’s Ashram.

Journey(s)

Journeys. Much is made of the word and its’ associated meanings by the Indicorps brigade. At this point, any further attempt by me is certainly certified clichéd. And as I sit on this train and journey on, this time towards Nagpur, it all seems fittingly framed through the horizontal metal blue bars across the window.

Some of the paint is chipped, some of the dust is still settling, but it all keeps moving. I see the traffic of the city flowing by, kinda insane, but at the same time normal. The city lights pass, as do the slums. The heaps of garbage, the congregations of rag pickers next to the pristine walled-in green, green lawns. Soon the urban landscape fades and it is back to the khet – and rural India. This time in the plains, far away from the villages I know in that corner of Himalaya.

And so the recurrent conversation of this year (or is it this lifetime?) returns – of journeys, and understanding, or rather struggling to make sense of it all. Of wealth and privilege, and urban and rural, and where I’m coming from, and truly where I’m going. Not simply Anandwan or Sewagram, but where will it all lead? When do the answers come? And where do we go to find them when questions only become a little sharper? Cut a little deeper?

The moon is full. It shines light down on the setting below bearing witness to the journey. The singular and the plural – weaving in and out of one another, like the strands of a double helix. Connecting and disengaging. And I told you so. Totally, certified clichéd.

National Rural Health Missing?

National Rural Health Missing?

“This is activism."
“This is what I know how to do.”

Since my arrival last September in Kumaon, at the foothills of Himalaya, the focus of my efforts has been working to address issues of public health with local communities. This has mainly involved organizing alongside Gram Panchayats. Gram Panchayats are elected local village councils that deal with social, economic, and developmental issues of the community. The Panchayati Raj system is backed by the Indian Constitution, which gives certain responsibilities and authority to panchayats to address issues of social justice and development. Since September I have seen my work slowly moving along, progress and small victories here and there, but it certainly hasn’t been easy. It’s involved a lot of patience, waiting for people to get on board, both in the communities and NGO, for meetings to start and action to be taken. It’s involved a lot of walking, up and down hills, across streams and through villages, at times for eight, ten, twelve kilometers a day. And it has included an immense amount of learning – about rural India, development, public health, village governance, and myself. It’s the type of work where the results don’t necessarily show in any sort of immediate timeframe and the questions only increase as time goes on. And honestly, every so often I have found myself questioning what impact I am having. In the long run, are these efforts I am undertaking enough to make a difference? Sometimes I wonder. But enough about me, what about rural health?

In brief, over the past eight months the process I have been helping with has involved forming health committees through village panchayats, providing trainings and workshops to these committees on their roles, responsibilities and rights, identifying main health issues and problems, writing out yearlong action plans to address the major health issues identified, and beginning the implementation of these plans. The issues range from anemia to waterborne illnesses (diarrhea, jaundice, typhoid, worms) to women’s health problems such as leucorrhoea. Importance is placed on antenatal care and on child health, specifically, ensuring that children are receiving the proper vaccinations. Health committees also address basic hygiene, cleanliness, and sanitation. This type of organizing has also included ASHAs (Accredited Social Health Activist) and ANMs (Auxiliary Nursing Midwife), in short government health workers that in different capacities work to address various health-related issues in villages. And in recent months implementation of the action plans drafted by health committees has begun. De-worming tablets have been requested by health committees and distributed, hemoglobin tests to check for anemia have been done, and springs and water tanks have been cleaned to help combat waterborne illnesses. Health camps on leucorrhoea have been planned and letters to the block and district levels have been sent.

Here’s one really quick anecdotal example of something that’s been achieved. For up to two years in many villages Iron Folic Acid (IFA) tablets have not been available through local government health supplies. It is strongly recommended that pregnant women take 100 tablets while they are pregnant (200 if they are anemic as well). In an attempt to get IFA tablets restored I spearheaded a campaign where Gram Pradhans and health committees sent multiple letters to both block and district health departments inquiring over the lack of IFA supply. Gram Pradhans even took up the issue at Block Development Committee meetings, a place where issues of health are never raised. Four months after the initial letter was sent word came from the Chief Medical Officer of the entire district that IFA supply would be restored for the entire Ramgarh block, and has now reached the majority of villages. A similar campaign was initiated to restore the supply of Vitamin A dose for children, which has been absent for almost three years. A couple days ago a letter from the CMO arrived informing CHIRAG (the NGO) and Gram Panchayats that Vitamin A is also being fully restored to the entire block. Chalk two up in our column.

All of these efforts have been within the larger context and framework of the National Rural Health Mission (get it? Mission, Missing. I thought it was kinda clever…), an Indian central government program initiated in 2005 to better attend to health in rural parts of the country through a number of different programs. While the NRHM covers the entire country, there is special concentration on 18 high-focus states (including Uttarakhand) “where the challenge is the greatest.” The NRHM specifically focuses on a decentralized approach that gives much decision-making and planning power to the grassroots level through village panchayats. In theory, action plans made at the village level are supposed to help determine the block’s, and in turn, the district’s health agenda. The idea is to empower communities to take ownership over public health in their villages. Another portion of the NRHM is the realization of Indian Public Health Standards, which aim to improve the level of government health service delivery. While on paper the NRHM may seem quite solid in its approach, the reality on the ground is much different and in remote areas there are still many challenges to be faced.

As the opening steps of implementation of these action plans unfold and village communities and health committees slowly become more familiar with health issues and use to the idea of taking action on these issues, there’s another idea I have had. The reality is that when illnesses or health problems strike, the majority of people make the several hour trips to the nearest towns of Haldwani, Bhowali, Almora, or Nainital. While more local facilities exist they are often underused and under-stocked. For smaller illnesses and injuries these local sub-centres can play an important role. As I see it, along with implementation of action plans, health committees could visit sub-centres to see what supplies and facilities are and are not available. Equipped with a list of what should be present, according to Indian Public Health Standards, such a visit would firstly familiarize committees and villages with what is available at their local centers, and secondly provide a platform for these committees to place pressure in order to ensure that the facilities and supplies that they are due will arrive. At this point I’d like to note that this is not to put all the blame on local government facilities or on the staff that work there. Nor is this is to say that the state is doing nothing. While health issues have not received the urgency they deserve, and there has been a slow response, some efforts have been made to address health. One example is 108, an emergency ambulance (and fire/police) service that has been introduced as part of the NRHM, is functioning fully in this area, and is used frequently (especially for deliveries). Even the name of this piece is posing a question. And the response is clear that things are gradually happening to address health and clear that there is plenty more to be done.

In my very-much-so imperfect Hindi what I have been pushing for with my colleagues and with committee members alike is for a more pro-active stance in seeing that health facilities provide what is needed. “­Dekho, apne aap kuch nahin hota. Thora sa dabana, thora sa hilana, phir kuch ho jayega. Agar log awaaz nahin uthayenge toh sarkar sochegi ki subkuch thik hai. Koi dikkhet nahin hai. Aur ye jhagara ke baath nahin hai. Ye apka adhikar hai. Aur ye main nahin bol raha hun, CHIRAG nahin bol raha hai, sarkar bol rahi hai ye sare subidha hona. Humen sirif dekhna kya hai or kya nahin hai. Phir is jankari ke saath hum kuch kar sakhate hai” (“Look, nothing happens on it’s own. You have to put a little pressure then things will happen. If people don’t raise their voice the government will think everything is fine. There’s no problem. And this isn’t about fighting. These are your rights. And I am not saying these facilities should be there, CHIRAG isn’t saying it, the government is saying all these facilities should be there. We’re just seeing what’s there and what’s not. Then with this information we can do something”). And so these visits have been planned. At this point it’s not entirely clear if it all will go as planned (but rarely is it ever). What happens from here and how successful this campaign will be are still to be determined – both in the short term and in the long run. Stay tuned though, and I’ll try and keep you posted.

So when my friend and colleague Manish points out that this approach I am encouraging is “activism”, I don’t know what to think. Maybe he’s right. But what are we talking about here? We’re talking about people following up on what is guaranteed to them. We’re talking about be able to have your blood pressure or hemoglobin count checked. We’re talking about pregnant women having access to Iron Folic Acid tablets, and communities being able to purify water with chlorine tablets. The ability to perform a safe delivery outside of a hospital, in an area where the majority of deliveries still happen at home. We’re talking about access to the basics. What I do know is that the background I am coming from is one of student organizing and social justice activism (in Washington DC and more so the surrounding suburbs, a context that is completely different from where I find myself now). And Manish is right when he goes on to say that it’s not necessarily the approach people are use to, but lets not forget that this is also the land of the Chipko movement and of Mahila Mangal Dal.

In any case, it’s been one way I have found myself engaging in my project and trying to build something here. Aside from being slow, and frustrating at times, there are moments where these ideas can also be exciting. Amongst communities and committees interest has been sparked and that spark has led to a little excitement from time to time of my own. It’s exciting to feel the potential of panchayats organizing around issues they haven’t normally done so in the past. Traditionally in this region panchayats have focused on physical development –building roads, sidewalks, and water tanks. Soft-development areas like health or education are relatively new, uncharted territory. This is the first time in this region that panchayats and communities are coming together in this way to address health. It’s been reassuring to see the priority women’s health has taken in this process, as issues of leucorrhoea, anemia, and maternal health, have been recognized as issues that must be addressed. What is more encouraging is that men have been active in identifying women’s health issues and pushing for them to be tackled in what remains a rather patriarchical society. And the moments I am able to see my work and time here through this lens, it’s pretty cool. To be a part of this course, though still in the opening steps, in a process that will take years and years. And it’s meaningful to me to be doing it here, however small my contribution in the larger picture, in rural India. In this corner of the world, in this place, which over the past so many months has become familiar. And if I may remind you, it is health we’re addressing, a fundamental human right, and a fundamental human need.