Monday, December 26, 2011

Karnataka, from the ground up

For the past month and a half, I have been getting to know my neighbouring state a little bit better. With some of my colleagues from the University of Hyderabad's Department of Communication, I've had the opportunity to visit different parts of Karnataka and speak with some of those who are trying to bring public health care to the poorest communities in both rural and urban areas. As part of the wide-ranging public health initiative known as the National Rural Health Mission, the Karnataka State Department of Health and Family Welfare has been attempting to scale up the intensity and range of its activities. The specific project that drew us in was the strengthening of the Department's IEC activities (Information-Education-Communication), particularly, building the capacity of its frontrunners (the block level health education officers) in social and behaviour change communication (known in the profession as SBCC). Supported by UNICEF, this effort involves training the 170 or so BHEOs from the state's 30 districts in new ways of approaching health communication, focusing more on interpersonal communication and participatory methods of engaging communities.

It's been a challenge, to say the least. The diversity of issues across the districts, representing relatively affluent and high literacy areas like Udipi and Shimoga to extremely disadvantaged regions like Raichur and Bidar, the structural hurdles and entrenched corruption in the system, all serve to create a very dubious foundation upon which to build the dream of equitable, accessible, good quality health care. The NRHM is a beginning, and in its seventh year of implementation, it seems, a very small beginning. The BHEOs--many of them in their 25th or 26th year of service, sometimes more--are doing what they can, travelling among the villages they serve, talking to mothers and panchayati raj institutions, persuading medical professionals and para professionals, mobilizing self help groups to pitch in...and somehow keeping their heads above the water.

I have no idea whether or not our feeble efforts to provide some new ideas and new ways of doing will have any impact. But for us (and I know I speak for the whole team here) it's been a learning experience. Now when I travel to Mysore I will look beyond the perimeter of the royal city to see the infant mortality rates that continue to pose a challenge to the villages in Mandya, or when I decide to take that holiday in Coorg, at the back of my mind will dance the awareness of the hill communities in Kodagu that have little or no access to a doctor's healing hands in an emergency. When I trek through the fort in Bidar, a part of me will be thinking of the young women who are not sure they will get to a hospital in time to have their babies there.

There is still a lot to understand, about health care in Karnataka, about how communities can become more active and informed participants in decisions about their own health, and about how the system can be truly strengthened on all fronts.

But there's been another side to the travels as well. There's been the incredible hospitality and warmth of the health workers we've met. The varied landscape of the state, from the rocks and boulders along the Mysore highway to the thickly forested tracts of Uttara Kannada to the deep valleys of Hospet and dramatic ruins of Hampi. In the pauses between workshop sessions, and at the end of long interactive days, we have managed to see a little more of the other side of the places we've visited. Stopping to sample the sugarcane straight from the fields in Mandya, or taking a walk in Brindavan gardens with not a single tourist in sight, walking along Malpe Beach after a long day of talking about communicable diseases, or stepping on the very rock from which Rama is said to have shot at Vali in the area now known as Anegundi near Hampi, the state has unfolded, bit by bit.

Tuesday, December 13, 2011

Rediscovering Sunday morning on Abid Road

After months of wanting to get out there on a Sunday morning and scrounge around the street bazaar for more books to stuff into my already bursting-at-the-margins shelves, we finally made it! Three regulars and one newcomer from our three-month old Book Club met on a Sunday morning, bright and early (well...tennish) near St George's Grammar School (remember those grey school tunics?) and set off to stare at the books on the footpath. The first few displays we came across, just past the Taj Mahal hotel (we could already smell the dosas we had promised ourselves), were not very inspiring, despite snazzy titles and lurid pictures of women in sixties' hairdos on the cover. One title in particular caught my eye: "The curse of the singles table: A true story of 1001 nights without sex" by Suzanne Schlossberg. Intriguing, that, and perhaps nothing like Sheherezade's tales spanning a similar period!

Gouri was the first to spot something she liked, and before we knew it, she was on a mission, to pick up books that had been adapted into movies. Emboldened by Gouri's purposive acquisitions, Binit began looking in earnest for titles that would justify purchase--something that would fall under the broad rubric of "academic"! I had no such qualms, and half an hour later I was about five hundred rupees poorer and had three volumes in my bag: including a nice fat Calvin and Hobbes collection. But the film adaptations far surpassed my collection in number...and beat me in terms of price! Amit too had his share of fun looking at a dozen different editions of classics in translation and sundry coffee table books (which, by the way, Binit had loads of fun looking at!). Old bestsellers at ten rupees each and slightly better reading at forty rupees, and the very real chance of finding that rare edition...doesn't really get better than that for a bibliophile.

Two hours later we began to feel the heat of the midday sun and retired gracefully to the Taj to savour our dosas. I had my Calvin and Hobbes; Binit her visions of Scandinavian villas; and Gauri her collection of movie inspirations. Satisfaction!

The last time I went to the Abids Sunday book market was over 30 years ago (sobering thought), with my friend Suroor and her sister in law Gina, and a five-year-old Imran. We rounded off that morning with dosas too, but at Sarovar, which now no longer exists, the building having been turned into a multi-specialty hospital. The Abids second-hand book bazaar is a Hyderabadi institution. It's a great place to find cheap text books, rummy novels you wouldn't pay full price for, and those colourful Archie spectaculars that bring back a yearning for a comic-filled childhood. And the best part? Crisp masala dosas--or button idlis and wadas--at the Abids Taj!

Friday, December 02, 2011

Always on

It's close to midnight on the second full day of my winter vacation--or what is supposed to be one. I find that I am sitting here at my laptop catching up on email, listening to rough cuts of the upcoming shows on Bol Hyderabad (the campus community radio station of the University of Hyderabad), reading student work that needs to be commented upon, preparing for a series of workshops I have committed to... in short, it doesn't look like a promising beginning for a vacation! And I thought University life was going to be a picnic compared to the corporate or NGO sectors! Whatever happened to the life of quiet reflection peppered with the occasional ruminative lecture that academics are supposed to be privileged to have? When I switched jobs last year, I thought I was entering a space where there would be time for some amount of purposeless reading, for writing (things other than reports and promotional materials), and for stimulating intellectual debate (unlike the heated arguments over paper texture or background colour that I had grown used to having periodically). It's been twelve months now, and those three things have remained mirages.

I'm not complaining, really. I love the work. I absolutely love the highs that come from being in a classroom full of young people who believe in you and what you have to say (for the most part--and I try to ignore the texting that is happening in one corner, or the surreptitious surfing in another). I enjoy the conversations I have with students who walk into my open office and talk about their confusions and their hopes. And I enjoy being able to work with my own deadlines, the independence with which I can organize what and how I will teach. I have no one but myself to blame for the add-ons...the papers I choose to write, the chapters I agree to contribute, the workshops I get involved in, etc. And of course the love affair with radio that has resumed after three long decades of being out of touch with the medium.

Not to forget, there's also another thing that keeps me busy even when the University is closed. Teacher Plus. I've just downloaded 16 articles to be given an editorial once-over for the coming month's issue. There are papers to look at and deal with. There is the next issue of Edu-Care that needs to be planned.

There's a pile of novels by my bed that I'm hoping to get to this month, and tonight, I just might get to the crossword. But for now, I guess I had better get back to work. Yes, it is vacation time. But some of us can't bear to turn ourselves off.