Critical support came when all doors were shut for Pooja
Pooja, 22, lives in Nalapar slum pocket of New Delhi. Her husband, Sanjiv was a daily wage earner whose income was erratic and what he earned, he spent on alcohol. The entire pressure of feeding the family rested on Pooja’s shoulders and on what came from her mother-in-law’s pension. When she became pregnant and developed complications, she was unable to work, putting further pressure on the family’s financial health. The neglect she endured from the family and her own inability to care for herself became a challenge creating a chronic state of weakness.
A kind neighbour saw her deteriorating condition and connected her to Sukarya’s health camp which was nearby. Pooja was having difficulty going to the Government hospital which was at a distance and she could also not afford the bus fare. Fortunately, she found the staff at Sukarya compassionate and caring. They evaluated her health and diagnosed her with anemia. She was immediately put on treatment and counselling so she could take good care of herself during the pregnancy. She was told to assume greater responsibility for herself and the unborn baby and even if other family members were not paying attention to her needs, she must create a system so that she could get her meals, her iron and folic acid supplements and sufficient rest.
She diligently followed every piece of advice given by the senior gynaecologist and nutritionist. “Apart from taking green vegetables, I regularly use an iron pot to cook, as advised and am seeing a marked change in my condition”, says Pooja. Few months later she gave birth to a healthy girl who is benefitting from the advice for new born care.
Ensuring Antenatal & Postnatal Checkups
USHA clinic came to her rescue in her darkest hour of need: Babita’s story
Babita suffered from poor nutrition, anemia, and weakness during her first pregnancy. Due to financial struggles and lack of awareness on antenatal and post natal check-ups, she had no option but to go for a home delivery. Her income as a house maid was a mere Rs 5000 which was not enough to afford private care. Her long and demanding hours of work did not permit her to take leave so she could not go to the government clinic which was quite far and would have taken a full day.
A local community health worker motivated her to register at the USHA clinic. She informed her about Sukarya’s initiatives in Urban Slum Health Action (USHA) and guided her to be regular with her visits especially now that she was pregnant with her second child. From the clinic she got her iron and calcium supplements in addition to regular check-up on haemoglobin, blood pressure and overall health indicators. The doctor and counsellor encouraged her to eat healthy foods such as vegetables, lentils, and fruit. They also guided her on certain food combinations and preparations.
Additionally, the physician and USHA team urged her to deliver her baby in the hospital to avoid any complications. They helped set up a health card for her and gave her periodic reminders so she could be on track with her vaccinations. She was taken to the government hospital and registered. They told her the entire process of what to do when the time for delivery came near. Babita had a healthy baby birth in the hospital. She came back with her second child for postnatal care and her monthly prescription of supplements. Currently both mother and child are regular visitors of the clinic and follow the counselling, prescriptions and guidelines provided by the health team, especially with respect to lactation, immunization, breastfeeding and child health care.
An entire family gets educated on nutrition and hygiene: Peehu’s story
The arrival of a baby girl was a moment of sheer joy for Peehu’s parents who considered her to be the reincarnation of a goddess. Unfortunately, the poor living conditions of the slum in Surya Vihar coupled with constant upheavals had a bearing on all their lives.
Peehu was a fragile child with a delicate constitution. His frequent trips to local doctors got noticed by one of Sukarya's community health worker who decided to make a scheduled home visit to their house. She found Peehu visibly malnourished and covered with dirt. On interacting with her parents, she found that the family was not able to give nutritious food to her daughter and were unaware of hygiene practices in daily life. After observing Peehu’s health condition, Sukarya’s community health worker counselled her parents to visit Sukarya’s monthly health clinic for their daughter’s comprehensive check-up.
When Peehu’s parents brought her to the health clinic, Peehu's weight was only 7.2 kg, which was a poor indicator of health. The doctor advised them that the underweight situation was not good for Peehu’s health and could lead to other complications. The parents were worried. They thought that nutritious food would be expensive and that Peehu’s treatment would be unaffordable. They were proved wrong on both counts. .
They were advised to provide readily available and nutritious food like daliya, seasonal fruits, pulses, mashed potatoes and milk to the child. They also gave them some vitamins and asked them to be regular with their follow-up visits. Within a few weeks things started looking better. On their latest visit Peehu had gained 1.2kg with her weight which is now 8.6kg. She is out of the danger zone and her weight is well aligned with her body-mass-index (BMI). Her parents are happy and thankful for Sukarya’s efforts and timely intervention.
Regular antenatal care and institutional delivery a must: Afroz’s story
Afroz is 36 years old and lives in the Israeli camp slum of Rangpuri Pahadi, Delhi with her husband Abid and six children. Five of her children are malnourished due to poor pre-natal care. This was primarily because she had managed all her deliveries at home and never visited a formal doctor for any advice. When Afroz was pregnant for the sixth time, the community health worker from Sukarya visited her and counselled both husband and wife about the need to have regular health check-ups with a qualified doctor in order to ensure a complication-free pregnancy.
Initially both she and her husband were hesitant in accepting the fact that a doctor's help was needed. However, after multiple conversations, they understood the risks and negative impact that could be seen on the mother and newborn’s health/delivery if they did not follow medical advice. Post the sessions, Afroz started visiting a doctor regularly and adhered to all her advice. This led to her having a comfortable and healthy pregnancy without complications like she faced in her previous pregnancies. A healthy young baby boy was born in a hospital.
Afroz is regular with her post natal check-ups and is following all instructions including breastfeeding, immunization and Vitamin supplementation. Her son is healthy and well nourished because of the guidance from Sukarya’s doctors and counsellors. She regrets not having followed the same drill for her previous children. She has resolved to spread the good word and ensure other pregnant women in the family and neighbourhood opt for institutional delivery and ANC check-up soon after getting pregnant.
Migrant women access mobile healthcare as life support
Located along the uphill interior, 7 km from Delhi’s Mahipalpur busy hub, Nalapar slum pocket is deprived of basic health-care services. For pregnant women, it becomes more challenging to travel such a long distance as there is no public transport connectivity. Keeping the dire need into account, Sukarya’s Urban Slum Health Action (USHA) team reaches this slum every month to provide maternal child health-care services with the goal of detecting and treating anemic women and malnourished children. The team comprises of a female gynaecologist and dietician, apart from paramedic personnel.
“Sukarya’s health camp is the only hope for all pregnant women like me, living here. My anemic condition was detected at the camp and subsequently I got treatment and advice”, says Maya. “My husband’s meagre earning does not allow us to hire a cab and access a private hospital.” By participating in Sukarya’s USHA programme, Maya was given a health card that helped her avail the government health facility. This way she got all the necessary tests, medicines and treatment without paying any money.
Maya is extremely grateful for the support that was provided. She knows on her own she would have been at the mercy of private hospitals that would have fleeced her and yet not provided good treatment. Here, no time was lost in assessing her thoroughly, providing her with Iron and Calcium tablets along with nutrition supplements and useful advice like how to cook in iron vessels and the importance of checking her blood pressure and levels of anemia regularly.
For the health workers who work in this area on behalf of Sukarya, their reward comes from the beaming smiles of women and infants that greets them every time they visit. “We have become a part of their extended family and are called bhaiya and didi” says Ramesh, who has been working as a Community Health Worker for the past three years and is grateful for the respect and affection that he has received over the years.
If you are moved by this story and would like to join hands with Sukarya to reach members of these inaccessible slums in and around Nalapar donate to the cause.
Health and wellbeing within their reach now: Raj’s story
Raj, came to Sukarya when she was eight months pregnant. She was suffering from anemia, was underweight at 39 kilograms and had a severe case of low hemoglobin count of 6 grams. She was provided with the required medication and health packets to improve her health. Counsellors too advised her to have her baby delivered at a hospital.
Due to lack of awareness and no support from the family, the child was delivered at home and was malnourished. Constant care and counselling provided by Sukarya to both the mother and child led to improvement in their health. Raj now weighs 55 kilograms and the child is growing up to be a beautiful healthy baby. Both the mother and child attend the health camps regularly and feel that had they not been guided properly they would have remained ignorant, sick and unproductive for a long time.
Varsha successfully beats her low haemoglobin score
Weakness, lethargy, mild fainting spells and irritability marked Varsha’s early stages of pregnancy. Little did she know that all this was due to anemia and malnutrition. She lived in the slums of Sector 53 Gurgaon. It needed a visit by Sanjeev Kumar, Programme Coordinator at Sukarya who was visiting her for a follow-up visit, to identify her condition. “I found Varsha was not taking iron and folic acid supplements. She was hesitant to talk about her anemic state. Her husband too seemed oblivious of his wife’s condition. As a family, anemia was not a priority issue for them, even if hunger and poverty were.”
She was requested to visit the health centre where a Community Health Worker counselled her and make her go through a comprehensive health assessment. A rapport was struck and follow-up visits and attendance at several health camps helped bring about a perceptible shift in her approach towards diet, nutrition, anemia and overall health.
She began to make the connection between being anemic and demonstrating lower productivity, concentration, energy levels and morale. She realised that living in a slum had made her more vulnerable and that she had to make a very strong and conscious effort to monitor her condition. Regular intake of nutrition supplements further improved her condition. She could complete her household chores easily and was in a more cheerful frame of mind.
Dr Kriti Mathur, a women's counsellor at Sukarya’s health camp says, “it is difficult to convince women to recognise anemia as a disease and even more challenging to change their perception towards the need for treatment. The intergenerational neglect of women’s health has made it hard for them to acknowledge their own deficiencies. However, this situation can be reversed. All it needs is guidance, consistent handholding and appropriate referrals.
If you want to extend a helping hand to other anemic girls like Varsha, donate to Sukarya.
Couple counselling works miracles on multiple counts: Sudha’s story
Sudha, mother of two came to Sukarya when she was seven months pregnant with her third child. Her husband Gopal worked as a mason and the financial condition of the family was very fragile. Sudha was a beneficiary under the mMitra Urban Poor Programme. She received a recorded call every week, in alignment with her stage of pregnancy and health condition. The call provided her details on medication, immunization, food and dietary habits, nutrition and care of mother and child. Her husband was apprehensive in the beginning due to the sharing of her mobile phone number which he considered to be sensitive information.
But over the weeks he was reassured seeing the nature of the engagement and how it was benefitting Sudha. When the health worker proposed couple counselling, Sudha and Gopal were curious as to what it entailed. This again was a novel concept and it enhanced not just the care that she could get during pregnancy but also the quality of their marital relationship. “My husband became a lot more caring and supportive. Earlier he would have dismissed many things attributing them to women’s issues expecting me to seek advice from older women in the neighbourhood but now he assumes responsibility.” Sudha gave birth to a healthy baby and the couple thanks Sukarya for reaching out to them through this programme.
Change begins at home, in this case with the mother-in-law
The Inder Camp slum habitation in Rangpuri Pahadi in Delhi has seen a rise in footfall. Several senior women are trooping in to the dispensary, counselling and examination room with young daughters, daughters-in-law and nieces. This is a new trend and a result of the advocacy done by Sukarya, that has renewed focus on engaging with older women since they exert a great deal of influence in the domestic arena.
“I feel privileged when my mother-in-law accompanies me to Sukarya’s health Clinic every month for health checkups and listens to the advice given by the doctor. It shows that she cares and this gives me so much confidence,” says Simla, a young mother who lives close-by and has been regular with her postnatal check-ups.
With a great deal of pride, she informs that her mother-in-law is a role model for her. She has been instrumental in mobilising the local community and exerting influence on other mothers-in-law who otherwise would sit and bicker and complain about their daughters-in-law. The transformational change has not only contributed in improving the health of the young women but also reduced the incidence of domestic abuse and improved the bonding within households and neighbourhoods.
The older women have started congregating and organising demos to show their 'nutritional way of cooking'. These health awareness sessions are facilitated by Sukarya and are very well accepted. The integrated approach adopted by Sukarya’s Urban Slum Health Action (USHA) programme ensures clinical services are provided and all efforts made to bring about behavioural change among community members. According to Suman, a Community Health Worker, “translating plans into action needs effort and dedication. Team Sukarya goes the extra mile to build rapport with each family member and stands by them in their hour of need. Regular home visits help understand problems of the household and timely referrals go a long way in establishing trust.
63-year old Rajni Devi, who is now a local champion for nutrition and sexual and reproductive health reaffirms by saying, “if we don’t become agents of change, who will. We must lead by example.”
Would you like to be a part of this social change? Extend your support to girls like Simla who deserve to be healthy and happy. Donate to Sukarya.