Maternal and Child Health

My Attempts at Facilitating Change in Rural India

In my final year of medical school, as I was reading a chapter on Maternal and Child Health, I came across a table of mortality rates elaborating the health status of mothers and children of my country. They were dismal and though I could see that progress had been made, to my 20 year old brain, it seemed insufficient and too slow to be accepted. After all, these were lives and not just numbers! The rural-urban difference made the figures look worse. I was restless. How could I bridge this gap? I reasoned – a woman was the base of the society’s pyramid and if I could do something to strengthen her I could attempt to address this gap.

I was also convinced that since most of India’s population lived in rural areas, in order to make a significant impact, I should focus on rural areas. Though I had been reared in a city and had never seen what a village looked like, I was ready to learn along the way. Itching to materialise this dream, the month I passed my MD in Obstetrics and Gynecology, I moved to Bihar; a state with one of the worst reproductive and child health indicators.

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My first project there was to strengthen the quality of maternity services in the government hospitals through hands-on training of doctors and nurses. I knew things were in a bad shape, but nothing had prepared me for what I witnessed there.
I saw up close all the things that affected service delivery to mothers coming there from far-flung villages. They ranged from attitudinal apathy to infrastructural gaps to skill deficiencies, often leading to serious health consequences for women and their babies. Working on them was overwhelming and frustrating to start with, but we eventually succeeded in transforming the hospital dynamics. Significant gains were achieved in infrastructure, hygiene and skills. Our District Hospital later received the Prime Minister’s recognition for its radical transformation. It convinced my young heart that no matter how flawed, every system was capable of change.

My next project involved setting up a health center for women and children in a village which housed some of the poorest communities, was hard to reach and had poor means of transport. It is here that I witnessed firsthand the fate of women who never reached a government facility.

It was immensely humbling for me as a woman and as a doctor to see what happened to their childbirths, to their family planning needs and to their children battling with malnutrition and pneumonia. Maternal and Childhood malnutrition was rampant and with the nearby government health centre non-functional, most deliveries were aided at home by unskilled birth attendants. Women of the village had no access to contraception and one could easily find women with up to ten deliveries. Prenatal checkups were not considered important as pregnancy was seen as a natural event, not a ‘disease’ that needed a doctor.

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I saw how quackery quickly proliferated in such places to fill the void created by a struggling government health system and how unscientific beliefs and taboos easily gripped such rural societies, vulnerable by poverty and ignorance. I also saw how the deep seated caste and gender divisions led to disempowerment of women and their children. A range of psychological issues and non-specific aches and pains in these women revealed to me their deeper emotional turmoil, isolation and loneliness, as a result of living most of their lives alone. The child bearing and the child rearing shared just with other women, while their husbands were away at better paying jobs in cities. I had to pinch myself when I saw young women being restricted to the confines of their homes due to fear of being seen by other men. With such ground realities, I had to reorient myself to move beyond providing safe childbirth and contraception to using healthcare as a tool, as a medium towards initiating deeper discussions with women, urging them to find their individuality.

I am glad I followed up on my dreams of medical school early enough. I feel happy that I am spending the most productive years of my life doing something that I find meaningful and worthwhile. Working for rural areas, its women and children, has given me my most precious moments as a doctor and as a woman.

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Category: Maternal and Child Health
Tagged with: Child health    India    inequality    Maternal Health    maternity services    rural women

Dr Taru Jindal, MD (Obst. and Gyn)

I work as a consultant in Reproductive and Child Health for DOCTORS FOR YOU, India. My key focus of work is to strengthen government hospitals in delivering quality maternity services. Training health care workers and mothers in appropriate Breastfeeding/ Complementary feeding practices, managing Childhood Malnutrition in communities and working with adolescents to increase their reproductive self-awareness are other areas I have been working on and feel deeply for. I am from Mumbai,India and enjoy reading and writing in my free time.

See more posts from Dr TARU
  • Pingback: Reblog: My Attempts at Facilitating Change in Rural India – Girl’s Globe – Inspire For A Better Life()

  • Dr.Divyal D Gala

    Congrats to Dr. Taru, ur ideas of strengthening government health systems & ur efforts to the powerful execution will definitely bring fruits in near future.
    I believe there are Four basic components of powerful nation- Roti Kapda Makan & Health.

    • Dr Taru Jindal, MD (Obst. and Gyn)

      Dear Divyal, Thanks for your comment! I agree with you that working with the govt health systems is the way forward. Its reach and scale is huge and if we can influence even a small part of it, the impact is far-raching. India I believe has moved on from hunger and clothing issues. The real issues are education, health and livelihood.

  • Congratulations on what you’ve achieved so far and best of luck with your future efforts : )

    • Dr Taru Jindal, MD (Obst. and Gyn)

      Dear Phil…I thankyou for your wishes. I have just started the journey and all that has been achieved has been a team effort. I am nothing without my team 🙂

  • Dr Ravichandra Karkal

    Inspiring work. I am sure that you would have given them transformative experiences. Would love to read more. Keep writing.

    • Dr Taru Jindal, MD (Obst. and Gyn)

      Dear Dr Ravichandra…thanks for reading and commenting! Transformation is the dream for which we all work in the NGO sector. And to see it happening is the greatest reward. I have been lucky enough to see change happening soon enough 🙂

  • Its phenomenal Dr.Taru madam, I am fortunate that I had a chance to work with you in Bihar.Will never ever forget those day’s.

    • Dr Taru Jindal, MD (Obst. and Gyn)

      Bhikshu ji…we all have been a team and we have learnt from each other and with each other. Thanks for supporting me always!

  • Hat’s off to you Dr Taru for the work you are doing in a state like Bihar in rural area. My best wishes for your future work and keep on writing.

    • Dr Taru Jindal, MD (Obst. and Gyn)

      Dear Swati Maam, you have seen me from my residency days and I am indebted to you for introducing me to the significance and impact of breastfeeding on newborn health…Thanks for the wishes!

  • KEWAL DHONE

    Respected Dr Taru mam big salute to your dedication & hard work towards upliftment of Rural community.
    Health care facility in India is mostly concentrated in cities..Rural ppl do not hv proper asses to Health care specialist doctors.
    High cost of medical services is also major deterent factor for villagers.
    So as a specialist Doctor your work is commendable, educating& treating most vulnerable population i.e. Women& Children of Rural India at affordable cost is great work.
    My best wishes are always with you Mam.
    You are real change maker!!!

    • Dr Taru Jindal, MD (Obst. and Gyn)

      Dear Kewal ji…Thanks for the generous applause! I agree with you that healthcare is majorly maldistributed. That is exactly why I moved to Bihar. 60% of healthcare personnel works in urban areas where only 28 % of our population lives. It is important to think about these things. If all of us as doctors thought about such issues, situation wont be so challenging

  • Dr Sushma Malik, Professor, Incharge Neonatology

    An amazing story of the impact that one dedicated soul like Dr Taru can have to address the deep rooted socio-medical problems in rural India. This can really inspire all of us to make a difference and to improve maternal and infant mortality.

    • Dr Taru Jindal, MD (Obst. and Gyn)

      Thanks Madam for your kind words. Women and children are the foundations of any society but remain neglected, ignored and vulnerable to exploitation. If we don’t give them the centre stage, the society as a whole suffers. However even with the disadvantages with which they live, I have seen them to be the most resilient of the lot. Their patience, endurance and ability to absorb negative experiences have always inspired me to keep working with them 🙂