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India’s pink army: Bringing healthcare to doorsteps of deprived

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In a country where quality healthcare remains a privilege of the rich and influential, a silent army of women, clad in pink sarees, work tirelessly and selflessly to make basic healthcare facilities accessible to those who live on the margins of the growing Indian economy, particularly in the country’s vast rural hinterland.

Barely getting time to sleep as calls for help keep coming round the clock, this pink army — as they are popularly known — is the backbone of the primary healthcare in India’s 600,000 villages, providing a connect between the community and the inadequate public health system. These are the trained female community health activists — called Accredited Social Health Activists (ASHA) — under the National Rural Health Mission (NRHM) of the Indian government.

Instrumental in bringing down the infant mortality rate from over 50 deaths per 1,000 live births in 2005 (when ASHA was launched) to 34 deaths in 2016, these women provide information to people in rural areas about health, sanitation and nutrition; conduct ante-natal and post-natal checkups; assist women during their deliveries, deliver polio vaccines and conduct health surveys.

With many of them mothers themselves, they often take along their children to the clinics at unearthly hours because they can’t leave them behind at home.

Clad in the trademark pink saree, her work uniform, state health worker Godavari Anil Rathore, 23, a resident of Kalaburgi, Karnataka, about 623 km north of state capital Bengaluru, is one of the youngest employed as an ASHA.

“When I was a kid, I remember how my aunt had a baby and lost it just within two months. The baby had contracted malaria after she was born, and my aunt couldn’t bear the pain,” Rathore told IANS.

“It’s an unimaginable pain not to be able to save your own baby, which is one of the reasons why I decided I should help women,” she said.

Rathore has helped over 100 women in her district in delivering healthy babies over the last three years that she has been working as an ASHA.

“It makes me extremely happy looking at women living in the remotest parts of the country with not much money to focus on their health giving birth to healthy children.

“Even though it means that we work an average of 12 hours each day, taking health surveys, carrying out polio drives, assisting pregnant women from the district I live in — right from medical checkups during pregnancy, to the delivery, then getting the baby all the vaccinations, and in the end receiving only about Rs 1,500 for a month.”

Rathore said that every woman she works with “becomes family to me, even if they need me at 3 a. m., I’m there.”

For many Indian villages where hospitals aren’t accessible easily, 860,000 ASHAs across the country (according to the Ministry of Health and Family Welfare, 2014) are the only ray of hope in providing medical assistance to thousands of people, and have been working extensively on eliminating polio and malnutrition among infants.

Making sacrifices every day to build a healthier society, these women find it hard to even make ends meet, earning a paltry sum for their services. Over 15,000 ASHAs from Karnataka staged a protest last month at Freedom Park in the heart of the city for a better remuneration from the state so that they could live with dignity.

Rathore, like many other ASHAs, barely sleeps, as calls for help keep coming in from pregnant women round the clock, after a long day of delivering polio vaccines or conducting health surveys. Many a time, she can’t leave her two-year-old girl, Lakshmi, behind at home and takes her along.

“Sometimes, I feel I’m raising my child within clinics with my husband not being at home all the time. But I am glad she’s growing up learning to be empathetic, knowing that as humans we must be able to help one another without any hesitation,” said Rathore with a smile.

ASHAs take pride that they’ve managed to get their communities talking about health and hygiene.

“We are overwhelmed to see people in villages pay attention to sanitation and building their toilets and purifying their water, which they earlier didn’t care much for. These are very important when we talk about health,” Rathore explained.

With every right to quit their difficult job, the women say they continue on because the power to be a part of the birth of a healthy life is unparalleled.

Geetha B, 31, from Ballari district, has been an ASHA for nine years now. A mother of two boys, she takes the responsibility of overseeing the health needs of over 1,500 people in Hariginadone village in Ballari district seriously.

“My vision is always towards making the village a better place. I would have assisted at least 300 women in these nine years in their pregnancies and now I see the kids going to school within the village, children I would have helped while growing up to be healthy. It fills me with happiness each time.”

“Pregnancy comes with a hope for every family. Our job satisfaction comes from seeing their dreams come true, in helping India’s next generation grow up healthy.”

A mother of five children, 35-year-old Nagomi K. from Raichur district, about 400 km to the north of Bengaluru, has seen ASHAs help in transforming the villages in the district over the past 12 years that they have been working.

“In many villages, the women are blamed if something happens to the baby. They have to live with guilt that it was their fault that the baby was born prematurely,” Nagomi told IANS.

With their constant visits to the villagers’ homes for checkups, men also tend to learn from them about their wives’ health, which doesn’t happen in healthcare centres, where the men are just asked to wait in the waiting rooms, she said.

“Even though many don’t recognise the work we do, we are trying to act as bridges involving both man and a woman when it comes to a pregnancy, and having villagers lead better lives in general with better health.”

“A lot of times I assist women who cannot even afford a strip of medicine. That’s when I give them whatever money I have so that the health of the community is never compromised,” Nagomi said.

As Karnataka State ASHA Workers’ Association Secretary D. Nagalakshmi puts it, “These women are the lifelines for our country in letting those who cannot access medical help get every kind of support. They must be credited with raising a majority of India’s next generation.”

Each of the 37,000 ASHAs in Karnataka are working despite severe hardships and have some moving stories to tell, but they don’t hesitate to make any sacrifice in building a healthier country, she said.

India ranks 131 among 188 countries on the Human Development Index (HDI) 2016 released by the United Nations Development Programme (UNDP). India was placed behind countries like Gabon (109), Egypt (111), Indonesia (113), South Africa (119) and Iraq (121) among others. The government is working towards improving this rating by creating competition between states to perform better on key social indicators like infant mortality rate, maternal mortality rate and life expectancy.

(This feature is part of a special series that seeks to bring unique and extraordinary stories of ordinary people, groups and communities from across a diverse, plural and inclusive India and has been made possible by a collaboration between IANS and the Frank Islam Foundation. (IANS) Bhavana Akella can be contacted at bhavana.a@ians.in) By Bhavana Akella

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The Cost of Living: You Can’t Afford to Die and You Can’t Afford to Live

Even those with health insurance still have limited access to the care they need

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Cost of Living
The Cost of Living is referring to what it actually costs you to stay alive and well on this Earth, as far as your health is concerned. Pixabay

When you hear the phrase “cost of living,” you typically think about the normal thing like salary ranges in your field, price ranges of homes and apartments, and gas prices… but in this particular scenario, the cost of living is referring to what it actually costs you to stay alive and well on this Earth, as far as your health is concerned.

According to ABC News, over 40 million Americans either don’t have access to the health care that they need or they just simply can’t afford it. The report discussed a study conducted by the CDC and revealed that one-fifth of Americans couldn’t afford the services of: 

  • Eyeglasses
  • Prescription drugs
  • Dental care
  • Medical services and treatments

Even those with health insurance still have limited access to the care they need. People tend to think that just because a person has health insurance, that they are automatically secured in health care coverage, and that’s not the case at all. People who have health insurance still face health care access due to:

  • Not having transportation to get to doctor appointments
  • Not having the money for copays
  • Deductibles
  • Services that aren’t covered

There is a commercial out now for the prescription price tracker called GoodRX. The commercial showed a woman with her sick son walking into a pharmacy and all she could think was “I hope I can afford this medicine for my son… he really needs it.” As she approaches the pharmacy counter, the pharmacist informs her of the price and the mother says thank you and proceeds to walk away because she can’t afford the medication. 

Cost of Living
You have to take every necessary step to do your part in maintaining your health to pay your Cost of Living. Pixabay

The next thing you know, the pharmacist informs her about GoodRX. The mother downloaded the app and was able to afford her son’s medication. The sad part about that commercial is that so many people face that same scenario everyday but instead go without medicine altogether.

The Cost of Living and Dying

Living

Everything is so expensive that you can barely afford to live and you’re lucky if you can afford to die. In order to live a good, healthy quality of life, you have to eat right, exercise, take care of your skin, take care of your teeth, etc… and that’s if you don’t have any preconceived conditions! If you have diabetes and require insulin to live, one vial of Humalog insulin costs $435. If you’re like most people, you don’t just have $435 laying around.

For those living with cancer and need chemo treatments, it can cost hundreds of thousands of dollars. A common Leukemia medication called Gleevec will cost a patient $146,000 a year. That is a life-saving drug and failure to get the medication could have life-threatening results. The number one cause of death among Americans is heart disease and just like cancer patients or people living with diabetes, they can’t always afford the medications they need to survive. Some of the most common conditions are hard to treat due to costs… asthma medication is getting too expensive now.

So as you can see, it’s hard enough to live and be healthy but to live and be healthy with medical conditions, is even harder. You have to take every necessary step to do your part in maintaining your health, whether it means you exercise and eat vegetables or even if you have to find another job that’s not as stressful, making those types of changes is a lot easier then having to pay for hospital bills and new medications you didn’t have to take before. You have to take care of yourself by making healthier choices.

Cost of Living
When you hear the phrase “Cost of Living,” you typically think about the normal thing like salary ranges in your field, price ranges of homes and apartments, and gas prices… but in this particular scenario, it is much more than that. Pixabay

Dying

If you thought it was expensive to live, it can be just as expensive to die. The only difference in living and dying is who is paying for the end of life arrangements. In most cases, people don’t make proper end of life arrangements ahead of time, leaving their family members to not only grieve but to also take on the stress of planning and paying for a funeral.

The average cost of a funeral can be anywhere from $7,000 to $12,000 and more. To leave your family having to pay for those kinds of costs during such a difficult time can be very stressful for the family. Some people will be proactive about their end of life arrangements and handle everything in advance. They’ll find the right power of attorney (POA), create their living will and testament, and speak to family members about their last wishes.

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The only thing about that is, a lot of people don’t have that mindset and feel like they need to wait until they get old to do that but the reality is that you’re never too young to make those types of arrangements because life is so unpredictable. You honestly need to make these types of arrangements when major life events happen like marriage and children and just continue to update things as you grow older. (IANS)