The following is a small selection of images from HOPE foundation’s work on maternal and child health in New Delhi, accompanied by commentary that features quotes from my time with the individuals photographed. For this assignment, I was asked to tell the stories of Chotton ki Asha (meaning ‘hope for little ones’), a programme established in Sonia Vihar in 2006, one of Delhi’s most deprived slums at that time, and also Sanjha Pahel (which translates as ‘combined initiative’), now being implemented in Seemapuri building on the lessons learned from Chotton ki Asha.
This is Mark Templer, who is American-born but has lived India for more than twenty years. He is the former CEO of HOPE foundation, and was at the helm of the organisation during the time that Chotton ki Asha was conceived and implemented. He told me that in approaching this programme, HOPE’s vision was twofold: “one part of it was to actually make a difference and save lives; the other was to create a model that could to some degree influence the government, in a sustainable fashion, to do things that would help people everywhere”. Mark told me that HOPE and its partners learned how to do the former by teaching people. “We really mobilised a lot of volunteers”, he said, proudly. You’ll hear about the programme’s ‘anganwadi workers’ below, for example. So what was the impact? “When we evaluated Chotton ki Asha, the data told us that thousands of lives really were saved”, Mark explained. “In an area that had no healthcare facilities, multiple facilities were established. In every location, they’re still running. This community of 200,000 now has more healthcare and a real understanding of what it means to be healthy. These women are telling their children they need to wash their hands, etc. And that’s how middle class society developed! We’ve made a sustainable impact, and we see the government’s approach evolving elsewhere based on what it’s learned from working with us. And around the world, our NGO knows better as a result of this”.
On the left is Dr [name removed], who is Medical Officer-in-Charge at POC Sonia Vihar Zero Pusta. I grabbed a few minutes of his time before he needed to attend to Shiv Kumari, pictured on the right. He was able to give me an on-the-ground view of what the programme looked like. “Our main aims were to implement 100% hospital delivery and to ensure that immunisations for children under five became routine”, he explained. “At that time, I would see more than 300 patients every day. Yet the basic difficulty I faced wasn’t this”, he told me with a smile. “It was that the lanes in the area were so terribly muddy. Vehicles were not able to pass inside, including ambulances. After my first day in the job, I thought I’d be handing in my resignation the very next day! However, once I was inside HOPE foundation‘s building, I found that everything was well maintained. The patients were lined up and the Community Health Promoters were counselling them. Further help was given to them by posters, TV and leaflets. When I got inside my cabin, I felt that I was safe and everything was alright”.
This is one of the men that Dr [name removed] has to thank for the improvements to Sonia Vihar’s roads. His name is Sanjay Sharma, and he’s the Vice President of a Local Area Committee. “Before HOPE foundation came here, we were not confident in approaching government officials”, he said. “They guided us in taking our proposals to the right people and our work got done. For example, the road I’m standing on here used to be mud and potholes”. Confirming what Dr [name removed] told me, he said that “this meant that women in labour found it very difficult to get to hospital. Road work was essential. HOPE foundation worked with our committee to draw up a compelling application, and I then followed up with councillors repeatedly until our application was accepted”.
Mark Templer spoke of the volunteers that HOPE foundation and its partners managed to recruit. Here are some of them, known as ‘anganwadi workers’ (‘anganwadi’ means ‘courtyard shelter’ in Hindi), in action. On the left, two of them are checking a child’s weight. When Chotton ki Asha commenced, almost 32% of children were undernourished. HOPE successfully instilled a wide understanding of the importance of growth monitoring over the years that followed. On the right, another anganwadi worker is demonstrating hand washing to children. Important in the control of diarrhoeal disease, HOPE’s research showed this increased from 0% to 15% over the project period.
Now meet microentrepreneur Pradeep, a beneficiary of HOPE’s microcredit scheme that provides loans at 0% interest for those who want to start up small businesses. He told me, “I want to give a message of thanks to HOPE foundation’s donors. Because of them, I was able to borrow Rs. 6,000 to start a business selling ladies’ and kids’ undergarments. Now, thanks to this, my family and I are doing well. And I’m proud to say that I’ve been able to return all the money”.
Pictured here is a young lady named Rajni. She attended a computing course that HOPE helped to establish in her area. She is so grateful for the support provided that she even penned a message of thanks on the model release she gave me for this image! “There are several institutes offering tuition in the basics of computing here in our area, but they all charge too much”, she told me. “HOPE foundation‘s course is far more affordable: it costs Rs. 200 per month. Outside, it costs Rs. 400 per month and there’s no guarantee on whether or not the student will get taught”. Now that Rajni has been able to complete this course, she has gone far. “The knowledge I gained has given me the confidence to do all my work (presentations, etc.) by myself. I’m studying Geography Honours from Miranda House, Delhi University, and within this I’m able to pursue a special interest in Geographic Information Systems (GIS) thanks to my computing skills”.
Much was learned from the success story of Chotton ki Asha that could be used in designing and implementing HOPE foundation‘s project ‘Sanjha Pahel’, in Seemapuri. The maternity home in the above image plays a crucial role in Sanjha Pahel’s referral system. Under this, primary urban health centres have been linked to maternity homes like this one, and then to secondary and tertiary hospitals, and healthcare workers help to distribute patients to under-utilised but well-equipped centres. “All around us are slum areas, and the people who come here are from poor families”, Staff Nurse Madhu Bala (pictured here) told me. “They have virtually no money. The majority of the community prefer to deliver at home with the help of a dhai, the traditional form of health worker. Their lack of sound medical knowledge makes this very risky. HOPE foundation‘s arrival has meant that community facilitators are now going out and explaining the need to give birth somewhere that has the right facilities. We offer this for around a third of what a dhai charges, and while the demand’s risen, HOPE has also helped us to start offering a 24-hour emergency service”.
And here is one of the beneficiaries of this programme. Now aged 24, Poonam delivered her first three children with a dhai’s assistance at home, before getting convinced that she should go to the hospital for her fourth delivery. “The experience in the hospital was good, better than at home”, Poonam recounted to me while sitting on the single bed her growing family shares in a space no wider than the width of the bed itself. “It gets messy when done at home, but in hospital I got rest and it was clean and hygienic. It was also peaceful for my child. Doctors visited me and kept a watch on my baby. When I got a sudden pain, they gave me medicines which eased it. At home, the dhai just leaves after taking the money. She doesn’t give any medicines, we have to purchase our own”.