It’s day 4 of GROW 2018 and I already feel at home. The colorful complex of concrete buildings that is the SOVA headquarters has so quickly become familiar to me. Every day here has been filled with such novel and enthralling experiences from conversing candidly with past trainees from the GDA program to partaking in a serious discussion about maternal and child health with Prasantha and ASHA health activists.
When I woke up this morning I took a moment to breathe in the damp air, still heavy with rain from last night. I looked up at the bug-covered ceiling and over at my g fellow GROW team members and was once again hit with the sense of hopefulness and excitement that I had felt the first day. I had to remind myself that I am here on GROW – that today I would get to interview the Chief of the Department of Health for the entire Dhenkanal District and learn about the Indian healthcare system and services, and exactly what role SOVA plays in promoting health equity in the area. Today I would get to learn from primary sources what is really going on in the developing nation of India in terms of their health resources and lack thereof. This excitement for each day to come has frequently accompanied my morning routine – which already consists of lots of chai, white rice, dal, and laughter. It also is carried with me throughout the day and into my nightly routine – which also consists of lots of roti, mosquitoes, humid showers, and more laughter.
On our first night in Dhenkanal, we – Mr. Mishra, Lupin, and us 5 interns, journeyed to the Sri Aurobinda Ashram Temple and Center of Education. At the temple, we spent 30 minutes meditating in front of an image of The Mother, enshrined in red ambient light. After the commotion and welcome ceremony that occurred during the day, this time of peace with ourselves was very much appreciated. During this silent meditation period, I felt that I could belong here. We then walked across the road to the Center of Education where we interviewed the Headmaster of Center of Education where he continually reiterated their school’s “No Discrimination” on the basis of gender, race, or caste policy. It was an amazing experience – to talk to him about the religious values of the school and learn more about the culture in such a first-hand manner. With some difficulty that arose via cultural and language barriers, we discussed the story of the Hero Aurobinda and how to give children a holistic education that prepares them for the outside world. Though there were definitely some highs and lows even on this singular outing, I knew slipping into bed that night that the rest of GROW’s stay would be similarly interesting, surprising, and challenging with a few moments of perfect peace.
The exchange of ideas – culturally, socially, and politically - is an integral part of the GROW trip. On Day 6, we awakened to birds calling, trainees moving about in the rooms next door, their bangles clanging against one another, and the smell of smoky fire wafting from the downstairs kitchen to our window. A 7 AM yoga session was scheduled with Mabhusmita, head of the ASHA program and yoga master. We hopped across the courtyard and into the small room full of other ASHA trainees ready to calm our minds and stretch our bodies in the ancient art of yoga.
Feeling refreshed from such a peaceful exercise, our heads were clear as we dove into conversation with Prasanta, our translator and SOVA trainer, and Mabhusmita about the status of women’s rights in India, the United States, and Portugal. As a women’s rights advocate, Mabhusmita compiled a list of topics she was curious about: “Do women in the U.S. determine the sex of their baby during pregnancy? How does society perceive giving birth to a boy vs. a girl child? What is the status of women in terms of making important decisions for the family? Does the dowry exist in the U.S.? At night, can girls safely walk alone? Does domestic violence occur in the U.S.?”
Each of these questions were pointed toward aspects of Indian society. Through this conversation, we found that though progress is being made, the state of gender equality remains hanging in the balance. Female infanticide is still prevalent which is why it is illegal to determine the sex of one’s baby post-conception prenatally, domestic violence is an extremely large and normalized issue, and dowries still exist despite them being illegal in India. Prasanta and Mabhusmita vehemently conveyed their disapproval for these practices, and told us that things like the Accredited Social Health Activist (ASHA) and Patient Care Assistant (PCA) Program served a dual purpose in combatting both health inequities and gender issues.
While gathering this information, we exchanged our own experiences of these topics in the United States, and together came to the conclusion that these issues exist everywhere on a global scale, if only to a greater or less extent. The conversation was lively and full of personal experience and earnest questions. We felt so empowered by the discourse on this subject, and hopeful that there were such good-hearted and driven individuals taking the charge to create change in India, qualities we hope to bring back to the U.S.
The smell of incense burns our noses as we enter the Self-Help Group site. In the open room, light streams down on the two women sitting on the floor bundling incense and on the woman at the metal machine churning out thin brown stick after thin brown stick. We’re met by a woman by the name of Jangyeoseni who tells us about the incense-making process and how women from many surrounding villages come to this place both in their leisure time to help out, or to garner materials to continue the craft at their homes.
The purpose of these SHG’s is not only to provide another avenue to gain income for these women, but also, and perhaps most importantly, to empower women. We learn later that Jangyeoseni is the woman who founded this model of Self-Help Groups. After being married for one month, her husband, without telling her, sold all of her belongings. Since then, she vowed to become economically independent from him so that she could garner autonomy in her own household, and now advocates for other women to become self-sufficient in the name of empowerment.
These groups are composed of 10 women from the same community who meet twice a month. They are supported and given confidence boosts by talking to each other. Along with having a supportive social outlet, these women are loaned the materials and machinery necessary to create several products that they themselves will sell at locally at festivals and in general shops. Though their families initially disapproved of this surplus activity, since it was considered an added burden to the other housework they had to do, soon enough their earnings were seen as a benefit, and their families accepted the program. Most of this extra money, Jangyeoseni says, goes to enabling their children to reach higher education in better schools. She says that it has led to less quarrels and decreased rates of domestic violence in the surrounding communities in Dhenkanal.
We are, simply put, in awe of this respected woman who took the initiative to not only change her own life, but to change the lives of so many other women in her community. As she and other members of the SHG dress us in traditional Odian attire, draping bell-adorned anklets and flowers into our hair, we are so honored to immerse ourselves in Odian culture, and stand and dance side by side with the strong, intelligent women of Dhenkanal.
The first few days of our visit to SOVA in Odisha, India were filled with meetings, interviews and other interactions with SOVA staff, trainees and general community members. These encounters proved to be valuable to us in our effort to gather information and media regarding health care and culture in Odisha. However, something felt different about our time speaking to adolescent girls in the Srimula community.
We walked into a small community building and were immediately greeted by the curious faces of over 20 young girls. Seeing their expressions, I couldn’t help but think that this was their first time laying their eyes upon people of different ethnicites. We joined them, sitting in a large circle around the room. After administering and collecting a survey on adolescent reproductive health, Prasanta opened up the room for discussion. “Now is the time for any questions you would like to ask.” After moments of silence filling the room, I asked the girls, “Do you play any instruments?”
Laughter filled the room, as the girls seemed taken aback by such a simple question. Soon, our conversation developed as we learned a little about the girls’ personal lives. We talked about what hobbies we share (reading, listening to music, singing) and Emily and one of the girls even had a dance-off in which the girl performed a classical Indian dance to traditional music.
By the end of our time together, the girls’ confused looks had turned into shy but friendly smiles. This was a small change, but meant the most to me as it indicated one thing- we were finally developing real relationships with community members.
One of the greatest aspects of meeting someone from across the globe is being able to learn about their culture. Yesterday, we got the opportunity to interview a 42-year-old SOVA trainee who was willing to answer some questions about family planning in Odisha. At the age of 21, the woman entered an arranged marriage- in Odisha, arranged marriages are more common than ‘love marriages’, as families want to ensure that their children are with someone that they approve of. Common criteria for finding partners for an arranged marriage includes being in a good monetary situation, having a similar family background and social class and not drinking alcohol. The woman mentioned that her father wanted her to marry “as soon as possible” as he wanted her to be in a stable situation- something that she didn’t have in her own family.
Soon after marrying, the woman had her first child- a son. In Odisha, couples typically pray for a son for their first birth. A tradition is to eat tea roots in the hopes that they will be blessed with a male child. If the first birth results in a daughter, couples will try one or two more times to get a son.
However, couples don’t usually plan their first pregnancy. The woman mentioned that a common saying in Odisha is “first child is unplanned”; a belief that using birth control before the conception of the first child causes infertility means that many couples avoid birth control and unintentionally get their first pregnancy.
Partaking in conversations in which I am able to be exposed to differences in the lives of those of other cultures is what I have valued most from our stay with SOVA. In particular, it is intriguing to see the varying ways that people treat marriage, children and birth control. Despite advancements in medicine across the globe, it is clear that cultural value and traditions still hold a strong place in people’s minds.
Today, we got the opportunity to visit Bandania Village, a small settlement 55 kilometers away from SOVA. The first thing we saw when we stepped out of our car was a large field of grass and dirt surrounded by a well-constructed fence and with two metal goals on opposing sides: a mini-stadium- the village’s main source of pride. The structure was funded by Oil and Natural Gas Corporation Ltd., a local company, because of India’s Corporate Social Responsibility policy that enforces every corporation to donate a certain amount for social causes on a yearly basis. SOVA contributed to the cause by building the facility.
Every September, 50 football teams are summoned from the surrounding area as dozens of villages train their best men in the hopes of winning the ultimate prize: 8,000 rupees and the tournament cup. Thousands of spectators crowd around the field, anxious to see which team will be crowned champion. The event brings the greater community together in more ways than one; while men and women alike bond over the sport, villages join in a week-long festival of dance, food and culture. The celebrations encourage locals to interact and bond with one another, instilling a sense of community and unifying villages in a way that might not have been possible without the tournament. Visiting the mini-stadium and seeing the passion in the eyes of the villagers when they spoke about the tournament was a true testament to the power of sports.
Wow. The first four days of GROW have been some of the most memorable days of my life so far. Having never traveled to India before, I tried to arrive at SOVA with little to no expectations. I figured that having no expectations about what I was going to be experiencing, seeing, and feeling would be the best way to put aside any preconceived notions I had and allow me to fully immerse myself in the new environment. As of today, I stand by the decision to begin GROW with this mindset. As our plans have been a little wonky these first few days, I have noticed myself beginning every new day with an open mind, something that I often struggle with. I have experienced all sorts of emotions in these first four days, but mostly I have felt welcomed and connected. Throughout the amazing welcome ceremony that the SOVA staff and trainees provided us with, I could not help but look around the room at all the smiling faces that were present. From Mr. Mishra’s subtle smile as he watched our previously prepared “Meet Our Chapter” video, to Dani’s beaming smile as she had paint smeared across her face, to the shy, but genuine, smile of the trainees as they sang us a song of welcome, joy seemed to be present in every corner of the room. From day 1, this has been my favorite part of GROW. The smiles shared between Leo and Lori (Mr. Mishra’s 9 year old daughter), between David and Dani as we recap the day over evening chai, between Antoinette and a local doctor when she shares that she too is interested in medicine, and between the 19 year old trainee and myself that breaks through any sort of language barrier that may exist between us, are the moments that continue to stand out to me.
We woke up at the crack of dawn this morning to start our 1.5 hour journey for today’s site visit. The smell of Ramesh’s fresh omelets made waking up early more bearable and as we ate our breakfast, we discussed our plans for the day. We were thrilled to be visiting the tribal village of Bandania and were eager to see what it would entail. Mr. Mishra explained to us that SOVA had facilitated the construction of a mini sports stadium in the village and asked us if we were interested in seeing it. “Of course!” we replied. When we pulled up to the stadium there was a large group of men waiting to talk with us. We exchanged smiles and shared a bottle of “Thums Up” soda as we sat in a circle and began asking questions about the new stadium. We learned that the its main use is for an annual football tournament in which 50-60 teams from different Munda Santhala villages in the area come together and played for 4-5 days. The tournament is sort of a festival in the way that it includes not only football matches but music, dancing, and food, as well as acts as a coming together for all of these different villages. We asked various questions about both the stadium and its impact on the community and we learned that it has become a source of pride for the people of Bandania, as they are able to host this tournament and bring people together. The various men we spoke to at the stadium explained to us that its construction had provided not only a space for football tournaments, but for entertainment and social gathering as well. After learning that the majority of teams that play in the stadium are for ages 14-29, it was clear that SOVA’s facilitation of the construction of the stadium goes along with their goal of empowering Dhenkanal’s adolescent population. It was really cool to see first-hand how SOVA is working to empower adolescents and I was again shocked to hear about yet another SOVA program I had heard nothing about in the past.
Today was only our 6th day of GROW, but I feel like I have been here for months! I have learned so much more about SOVA in this first week than I could have possibly imagined. Seeing as we primarily focus on learning about the GDA program during the year, I was completely unaware of the number of impactful and crucial communal programs overseen by SOVA. In between learning about SOVA’s wide variety of projects, my absolute favorite part of this first week has been getting to know Prasanta, one of SOVA’s head staff members. We have spent our long car-rides and evening chai times this week talking with Prasanta and getting to know each other on a more personal level. If you ask any GROW team member after this week, they would likely describe Prasanta as one of the most wholesome, driven, and progressive people we have ever met. We talked with him about his desire to be an advocate for the often overlooked adolescent population that makes up over 20% of India’s population, about the different forms of birth control available in India versus the U.S., and about various other topics that we had expected to be off limits with someone we had just met. I think we are all a little bit jealous of Prasanta’s drive to promote change and challenge social norms in his community.
Today was the first time we got to see Prasanta in action and we became even more impressed with the impact he is having on the Dhenkanal community. We accompanied him and Mr. Mishra to SOVA’s fifth sensitivity training on the PC&PNDT Act at Anchalika Junior College. The Preconception and Prenatal Diagnostic Techniques (PC&PNDT) Act was put in place to combat the rapidly decreasing sex ratio in Dhenkanal. The decrease is stemming from the deeply rooted preference for male children over female children. The act prohibits the use of diagnostic techniques that allow parents to find out the sex of their child before it is born. The goal is to prevent the termination of pregnancies solely due to the child being female, as this is the major contributor to the decreasing sex ratio in the area. SOVA’s project, led my Prasanta, is working to educate adolescents about the current situation and make them aware of the PC&PNDT Act.
The training began with a room full of rowdy 15 and 16 year old boys and girls. Prasanta quickly captured their attention with his energy and the room quickly went silent. He began his presentation with a series of facts and pictures that reminded the students how proud they were to be from Dhenkanal. This slowly transitioned to addressing the decreasing sex ratio and its posing threat to the existence of their community. Prasanta concluded the training by asking everyone to close their eyes and try to picture a world without women. The look of realization that swept across their faces revealed that they had indeed learned something valuable from Prasanta. After spending thirty minutes or so interacting with students, we left the college, beyond impressed by how Prasanta had so gracefully delivered such an important training.
Today we took a trip to a Dhenkanal village about 2 hours away from SOVA’s headquarters to visit the local high school. The purpose of the visit was to learn about SOVA’s involvement in the World Food Program’s implementation of the Mid-Day Meal at schools in Dhenkanal. We learned about SOVA’s partnership with the World Food Program and were impressed, yet again, by the number of thriving programs SOVA is involved in. We met with the local head of the World Food Program (WFP) as well as the village’s head of education and asked questions about their Mid-Day Meal program. We learned that the WFP is providing fortified rice as a meal for students in school everyday. The idea for fortified rice came from the need to combat the rising anemia crisis in Dhenkanal. Basically, the rice is fortified with iron supplements as well as vitamins such as B1 and D12 that are lacking in the everyday diet of working class individuals. We learned that the rice is fortified right here in Dhenkanal with the help of a local rice mill and we were invited to take a trip later this week to see the process ourselves. We also got to ask students and teachers how the intake of fortified rice had affected their daily lives. Students in class 8 told us that it had significantly increased their “memory power” which allowed them to perform better in school. Alongside this, the physical education teacher told us that he had seen a dramatic increase in the energy levels of his students and in their ability to play. It was great to see first-hand yet another successful SOVA program in action.
This picture features Mukti Prasad Das, the pharmacist on site, who is handing out prescriptions to the patients as the GROW team was interviewing him
A happy love marriage. A thriving local grocery store. A soft side for sweet romantic music. These are just a few examples of the many stories and thoughts that were shared when we interacted with the community members over the past four days. These stories had completely eradicated my preconceptions about life, and more importantly, the people in Dhenkanal leaving me mind-blown1. We will be sharing these personal stories throughout the school year, so for now I will be focusing on the action behind the scenes.
On Day 2 of our internship, one of the tasks we were given was to prepare questions to ask the medical staff and patients of Srimula Primary Health Center. As soon as we could, we sat around a table and crafted sets of questions that would give us more insight of their practices (i.e. for staff: do you think you have adequate staffing to best provide care for patients?) and opinions (i.e. for patients: are you treated well at this hospital) as well as questions that would help us piece together their story (i.e. what is your favorite memory at this hospital.). When we finally decided that we had no more questions to add, we all headed to our bedrooms to clear our minds and mentally prepare ourselves for tomorrow (spoiler alert: we weren’t ready for day 3).
8:00 a.m. came and we all had to get up and get ready for the day. At 8:30 a.m. we scurried downstairs for some rice, dahl, and coffee before we hopped in the mobile unit to drive to Srimula. As we ventured deeper into Dhenkanal, were in awe of the lush green nature that surrounded us while singing along to Taylor Swift, and occasionally getting stopped by a casual cow or a herd of goats. When we arrived at Srimula, we were greeted happily by the staff and met our first interviewee: the allopathic doctor on site. We all got into our positions: Leo and David ready to ask questions, Emily and Antoinette ready to take notes, and me ready to collect the media of the interview. He expressed what most staff on site expressed as well: there are adequate resources and staff at the hospital. Also, they have successful methods of reaching the people, for example, vaccinations get delivered at everyone’s doorstep free of cost and there is an ambulance for emergencies. Although, what really stood out to me was his hearty laugh.
The generous homeopathic doctor presented a rose to each of us before the interview and showed us the medicine he prescribes that the government provides free of cost to all of those who are in need of it. We saw the young pharmacist, who we saw interact with the community carefully tending to their needs throughout the interview and said that we must take a selfie once the interview was over (and tracked us all down until he got it!) When we went outside of the office to interview patients, they started gathering around us, curious to see what we were doing and eager to participate in our interviews. They all were very satisfied with the services and resources that are provided, and had opened up to all of us very quickly. All the patients at the hospital came outside to smile for a quick group picture.
The last person we spoke to was the on-site midwife. I could tell she was very passionate about her job because she was so eager to show us the birthing room which consisted of a baby warmer, bed, stool, and various tools to assist with delivery. Before we left, I spotted a painting of a woman holding an T shaped device on the wall of the building that had the birthing room nested inside. I immediately recognized it as an IUD and Prasanta informed us that it was a copper IUD! Although they are not the most popular form of contraceptive, we found out that women who have had at least one child have the option of getting an IUD inserted within 24 hours after the birth by the midwife or doctor.
We gained a lot of knowledge and a better understanding of the health center and public health on day 3 and it only made us more curious and eager to dig deeper. Learn more. Make more connections.
1When I wrote mind-blown in my end of the day evaluation Prasanta asked if I was okay because he thought something was wrong with my head J
After three packed days of interviewing and interacting with the community, I was honestly a little relieved that on day four we were given some time to relax before we had to tend to business. We learned so much and experienced a significant amount of change, from conversing with adolescent girls in the community to figuring out how to hand wash and dry our clothes, in such a short period of time. I used this time to recollect my thoughts to make sense of what I was feeling before because in the moment all I could think was “wow”. A couple of hours later, we got a knock on our door from Prasanta who informed us that we had a visitor here to interview but I didn’t catch the name. We made our way down to the main meeting area to find a table full of well-dressed men. When we sat down, Mr. Mishra introduced our guest at the head of the table, Dr. Bhihera. And by the way, he isn’t just a doctor…he’s the chief of the district health office. He explained to us the general health structure of the health system involving community health centers, private health centers, and smaller subsectors (like Srimula primary health center) and answered all the questions we could think of in the moment. His answers included a lot of information that we learned at Srimula, however, he spoke about something that was surprisingly not mentioned once yesterday: incentivizing patients. To incentivize women to give birth in hospitals, due to safety and sanitary reasons, the government pays for the transportation to the hospital, maternity leave (500 rupees per month for six months), and even just giving birth in the hospital (1400 rupees). There is also an incentive for regular patients to travel to the hospital (500 rupees) when in need of care. I was floored because the government provides all these benefits on top of universal health care. In addition to these incentives, the government also pays each village 10,000 rupees a month to use for whatever they decided was necessary for the health of the community. I expected India to be a conservative society due to culture and traditions, but these incentives are extremely progressive and socialistic. He soon had to go to another meeting, but assured us that he will schedule to meet again before we leave. And of course, I was back at square one attempting making sense of the “wow” I was experiencing.
“Our guests are our gods”. As we are officially welcomed to Odisha and the SOVA headquarters, past trainees sing us these words. Earlier that day, Niharika knocks on our room with a delightful voice and infectious curiosity to know our names. We all make an effort to pronounce each other’s names correctly and I attempt to use my very little Hindi skills to ask her how she’s doing. Ramesh, the cook, prepares us dal every day as we get ready to learn more and more about SOVA and the community. They have been the familiar faces we see every morning before joining Mr. Mishra, Prasantha and Lipun on the jeep heading to the healthcare centres, schools and surrounding villages that SOVA works with. Every day is a new opportunity to learn more about their work and fight for social justice and health equity in the Dhenkanal district.
A day later, the same song returns in a different setting: a temple in Bhojadeipur, Mr. Mishra’s home village, the same village where SOVA had been founded. As we were later explained, this Odian expression is rooted from an attempt of the community to nurture and strengthen the bonds with those who have come from afar. This warm reception of guests is symbolic of the deep spiritual harmony that Odisha has preserved for centuries. Think of it as an extremely spiritual "respect thy neighbor".
This has been clear from the start; that we are more than just guests, more than the students from an American university, more than one of many of SOVA’s partners: we are here to be friends, as Prasantha had emphasised on and the girls we had talked to about Reproductive Healthcare in Odisha had so strongly agreed on. Friends who learn from each other, are ever-curious, grow together and challenge each other to constantly look into new perspectives. And as days keep passing by, I have never felt more intellectually challenged and curious. I am constantly reminded that there is always more to learn, more to see and more to question. Questioning my own biases, my own expectations and assumptions have made introspection almost second nature to me, as each day brings something new to ponder over. This is precisely what has happened in the past 4 days here. From learning about SOVA’s different projects and partnerships, the several awards they have won for their work on youth training and development, the impact of the Srimula primary healthcare center on the 8000 people that benefit from free healthcare, the favorite memories of the workers employed in SOVA’s initiatives and the bonds I have made with the staff, they all add to this rich tapestry to learn from.
As I continue on this internship, I am shaken profoundly by what I have already experienced and eagerly await the next few weeks as they unfold. There will certainly be more rich experiences for me to dissect and sate my curiosity with, and more lessons to bring back to our chapter.