The Anaemia Project: Phase One

Information Collection | FOUR

Visit with Lakshmi Murthy of Vikalp Design, an expert in Social Communication

I traveled to Udaipur to meet with Lakshmi after hearing about her from my guide. She was a great hostess and an even better designer. Her work in the field was extraordinary, one of the very few who has devoted her life to educating rural populaces about health issues. Her insights on how they interpret visuals is groundbreaking and especially for urban designers who deal with a different vocabulary. It is not as if these communities don't read images, it's just that they read them differently. We had a look at several of her pieces that made use of flaps and pockets so that pictures on sensitive topics like sex can be viewed in a glimpse and covered again, and how she develops her material from a visual vocabulary developed by the very audience it communicates to. The language is simple and easy to understand. She then field tests her visual matter over and over again so that it is made perfect.

More at www.vikalpdesign.com

Information Collection | THREE

Reports and publications dealing with similar target audience / Case Studies

I selectively compiled a list of relevant resources in the form of reports, either from the web or from organizations like Sanchetana. I also purchased a few from some NGOs. I have gone through most of them. Below is a list. (Please contact me if you would like to read them):

Angst: Theirs and Ours; Domestic Violence: an epidemic on the upsurge. Research report published by Sanchetna. January 2001.
Why Some Men Beat their Wives? Research Report on perpetrators of Domestic Violence published by Sanchetna. 2003.
At a New Threshold Annual Review published by Sanchetna. 2003.
Reproductive Health Program, Review published by Sanchetna. 2005-2007.
Surakshit Prasav Set of two instructional manuals published by Chetna. Date of publishing not mentioned. Language: Hindi.
Swaasthay Dekhbhaal aur Sevaaen Praapt Karna.... Instructional booklet published by Chetna. October 2008. Language: Hindi.
Set of brochures on Women's Health including Gender & Women's Health, Anaemia, Health of Women in Indian Families, Women & HIV/AIDS, Violence and Health, Breast Cancer, Training for Women's Health & Empowerment, Panchayati Raj and Women's Health, Indigenous Health & Healing practices, Mahilaon ka Manasik evam Bhavnatmak Swaasthay (Hindi).

[A detailed analysis of the case studies later]

Web Resources

VikalpDesign: www.vikalpdesign.com
Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia by Rebecca J. Stoltzfus & Michele L. Dreyfuss (International Nutritional Anemia Consultative Group or INACG): PDF
Prevention & Control of Nutritional Anaemia, (UNICEF): PDF
National Family Health Survey, India: www.nfhsindia.org

Information Collection | TWO

Interview with medical practitioners and social workers

I had the good fortune of being able to spend a good half hour or forty five minutes with two doctors who owned private clinics in the slums who were giving medicines at a very low cost. They spoke to me at length about the nature of the slum-dwellers. I gleaned a lot of information about the women here. They told me that almost all the women work, and 80% are anaemic. Despite being the ones who cook they are often fed leftovers and hence are very weak. Their children are often born with low-birth weight and have a high mortality rate. Most women have 5-7 children each and the families are unplanned. They do not realise until space runs out in their homes that reproducing at this rate is not healthy. While I myself saw the great care the women took in the cleaning of their homes, utensils etc., and how the slums are generally clean (No lack of good toilets, no open drains) it became apparent that they had low personal hygiene and that they were therefore victims to infections. Doctors complained that the people here did not like to take medicines and bought medicines but usually forgot to consume them.

I also spoke to some social workers who worked in Gramshree a sister concern of Manav Sadhna. She told me that most women in the area were ignorant of health issues and bore the pain, as part of being a woman. She spoke at length about the many problems of these women she encountered as a social worker. From the general consensus I could see women had a lot of issues with reproduction, sex and nutrition. I also understood a great deal of what the NGO does here, to educate these women, street plays, charts, small booklets/brochures, teaching etc. as well as providing food for to-be mothers and schooling for children at the Anganwadis.

Information Collection | ONE

PHASE ONE: INFORMATION COLLECTION

Right now I am wrapping up my information collection and starting to analyse my data, so I thought I would share my sources and all that I have understood. My information has come from a variety of sources, namely:

Visit to site and interaction with target audience

A visit to the the largest slum in Ahmedabad, Ramapir-No-Tekro, (Near Vaadaj Bus Station) also known as the Tekro, home to a population of 1.5 lakh. This huge slum is not a new settlement, it has been around for around fifty years. However, it has been growing at an alarming rate with migrants coming in great numbers. Most of these consist of people from Gujarat and Rajasthan. People of many religions live together here and surprisingly they do not have clashes. Hindus are in the majority but I also had a chance to see Christians. Muslims are a minority but have a presence in the Tekro. Initially the slum lacked basic amenities, but the government has now provided most of the basic necessities like electricity, water and sanitation etc. However, due to the ignorance of the people, much of their problems remained to be solved.

On the visit, I observed each woman having an average of 5-7 children. I also spotted some of their small industries, a rag-picking 'kaarkhaana' as they called it, firewood sheds, houses of potters, etc. I also spoke to social workers around the area and doctors who had set up small clinics. The nearest government hospital, clinic and pharmacy is quite far off at Usmanpura.

An organization called Manav Sadhna is trying to reform the area. More can be read on this here: Manav Sadhna / Ramapir-No-Tekro. I also visited the Manav Sadhna community centre and one of the Anganwadis, where I interacted with a few women and children.

A girl of 18 chopping firewood in her Father's shed. The firewood is later sold to the households in the slum.

A slum-dwelling woman with some of her many children.

A glimpse of the Tekro at around 8 in the morning.

[EDIT]

At a later phase of my project I zeroed in on Anaemia being a problem I recognised that needed focus. I had the opportunity to meet slum-dwelling women (Bombay Hotel, Behrampura) through an organization called Sanchetana set up by Dr. Haneef Lakdawala. A few days were spent with a number of CHWs (Community Health Workers) and women from the slums who came to speak with me and this was far more rewarding as a certain comfort level was already achieved. On the first day I spoke to members of a Muslim community and the next day member of a Hindu community. We talked at length about their pregnancies, experience with IFA (Iron & Folic acid tablets) and the improvements they've seen. They also briefed me about the foods they ate, and how they tried to incorporate iron into their diet. Most of them were unaware about Anaemia until Sanchetana came into the picture. I was well-informed by the CHWs about their iron intake, why it is so low in women, what side-effects are seen with tablets, why the government's IFA distribution programme is not efficient enough and what foods aid/ hamper the absorption of iron in the body.