Tuesday, 25 March 2008

Medics, CHVs and a Frame of Reference (Part 2)

Last night I joined Kiran, some of the staff and the Tearfund team for dinner. The Tearfund team have had a rough time of it as almost the whole crew have been ill and some in bed for 3 - 4 days. In a short trip, that's a chunk of time. Anyway I was talking about teaching children who have so little exposure to the world beyond the slums and one of the directors, who has been involved with Asha for 15 years explained how this also impacted them in those early days. Aditya is a journalist and helped translate the medical terms and terminology into understandable Hindi.

The initial Asha team was primarily made up of medics. This was their primary role, pediatric and pre- and post-natal care. The medics are assisted today by the Community Health Visitors (CHVs) , slum dwellers who show the aptitude and inclination to get involved. Once the CHVs are selected, they are then trained. Once their training is complete, they have a small medical kit and can help on visits in the slums for minor ailments. They help with monitoring pregnant women and observation of all children under 5. That all seems fine, until you get back to this frame of reference concept.

I have said the women initially stay in their homes, they cover their heads, don't speak to strangers, and definitely not to men who are not their husbands. Now change their circumstances. They are encouraged to venture out of their homes and to get involved in the women's group and in community affairs.

To be trained as CHVs they get a little medical training. The medics use everyday terms (to them) like "blood pressure". All this needed to be translated into basic Hindi. How do you begin to explain to someone who has hardly left her home, let alone the village, who has little or no experience of medicine or doctors what blood pressure is and why it is important. Aditya said they'd translate the messages into basic Hindi and be faced with blank faces. Even though everyone involved was Indian, and native Hindi speakers, still it was so hard to find a starting point. Even here the gap between how many live and these slum dwellers is so significant. The task is not insurmountable, it just requires patience and understanding. It is evident by the success Asha has and repeats in the slums where they work.

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