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12. July 2005

Archana Kapoor, ©Xenia Hausner

Archana Kapoor, editor of Hardnews, a Delhi based political magazine.

India - "We are still Fighting for Basics"

Archana Kapoor, editor of the Hardnews magazine in New Delhi and general secretary of the NGO SMART in a talk with Women without Borders

Archana Kapoor, editor of the Hardnews magazine in Delhi/India and general secretary of SMART, a NGO which is working in India’s minority regions, was in Vienna at the end of May.
Women without Borders talked the women´s activist about the situation of women in India – about health, poverty and HIV/Aids.
Archana Kapoor is currently establishing a Women without Borders office in New Delhi. She is supporting us in the realization of our projects in the country and in an important Women without Borders partner.

Poverty has the face of a woman

Archana Kapoor: India is a country of large population. We are 1 billion people and no matter how much the government and the non-governmental organisations (NGOs) do, it becomes very difficult to provide facilities for such a huge population. In this situation, women suffer the most. This is due to the problem of water shortage, poor health and sanitation, and low literacy level among women in India. For me, literacy and education is a kind of solution for everything. Because in my view, the worst face of poverty is reflected through a woman. Or if you want to put it the other way, poverty has the face of a woman. Women of the poor families suffer the most, because they are the ones who have to run the family with the limited resources at their disposal. If there is a water problem, then the women have to travel a long distance to fetch water. The topography of India varies from mountainous regions to deserts to planes. So, in the planes there is a major problem because maybe in some areas three to four villages would be having one hand pump. So, if there is a population of about 500 people in a village, which is a minimum I‚m taking, all the people will take water >from that one hand pump that is available for the whole village. So water has a direct relation with health and sanitation. Now at least the basic minimum is provided, every village should have one hand pump. We are still fighting for basics.

In this kind of a society, the woman gets neglected the most because she is so busy looking after her family that she has very little time for herself. She thinks that she has enough stamina to look after her children and the husband, so she doesn’t give any attention to her health. In the process, at the end they suffer the most. They die very early, especially in the hilly regions, all over the country. The problem is that we have child marriages, especially in the rural areas. In the urban areas it’s getting better. By law you cannot marry before you’re 18, a boy cannot marry before he’s 21. But in the rural areas, and I have visited those areas myself, when a girl gets married at the age of 13 or 14, she is not even major enough to look after herself and bear children. And by the time she is twenty, she already has 3 to 4 children. So where is the time for her to look after the health? And in the process, she is also travelling miles to collect water. In the hilly regions where I

Education is the Key

I strongly hold the view that education can provide solutions. Because if someone is illiterate, they don‚t know what facilities are available for them. The person does not have access to information; hence they are unable to use it for themselves.

Another problem is that the woman has to create a need for good health. The need is not there, because she‚s just surviving somehow and pulling along. Since morning 5 o’clock till 7 o’clock in the evening she is working all through. And she cooks, looks after the children, goes to the field and does everything. So the whole thing is that we have to create a need for good health in the mind of the women. And we have to tell them that if they are healthy, they can nurture a healthy family in return. But if they are unhealthy, then they don’t have healthy children, they would have a healthy environment around them, and they are not able to do justice to themselves and the family.

WwB: Are you trying to reach this aim by talking to women? Is there awareness training for men as well?

AK: The effort is to reach the women because they are easier to reach. They are easy to access. If a woman goes to counsel the female folks of the village, she would open up very soon with them. The counsellor gets an easy access to their homes, where she could sit and talk to them. But to include the men in this is a problem. I just give you one little example: In this village where I work, just about fifteen miles from the capital of India, even today there are no hospitals for women when they are giving birth to their children. They don’t go to a hospital. There are old women in the village who help the pregnant woman give birth. The expecting mother is made to lie on the bricks. It is prepared in a way that she is on a little height and the child is supposed to be brought into the world and she‚s literally held when the mother is giving birth to the child. And she doesn’t even have the comfort of a bed. It is a tradition that nobody has been able to break. That is the extent of misery of the women, if you ask me, since I have not seen anything better. But now what is happening is that gradually people are reaching out to them. The nurses are reaching out to them and making them aware of the facilities that are there. We had a very high mortality rate amongst the women and the children. And a lot of women died during childbirth.

If you allow me to cite an example of my own office attendant who stays in suburbs of Delhi: his wife, who has come from a hilly area to Delhi, had conceived after six years of marriage. As soon as she got her labour pains, she was rushed to a government hospital where her husband did not have to pay much. And there was so much rush in the hospital that she could not be admitted immediately. She had to wait to get operated until the next day. It was only after 24 hours when we went and spoke to the doctors, she was admitted at 9 o‚clock in the morning and next morning at 7 o‚clock she was operated upon. And she gave birth to a son. We were all very happy because all night I was wondering whether she would be able to survive this or not. When I spoke to the nurses they said, „for us the child is not important. We have a number of cases where the mother‚s life is in danger, so we will save her first.” There were several floors in this government hospital and there were about 40 patients in the queue. It was like in an emergency situation and it was night, so there was no team of doctors available. Later, the son was born and we all celebrated. He was very weak. On the third day hospital discharged the mother and the son. That very day she reached home at around 5 o’clock in the evening. At around 10 o’clock at night, the child started turning blue. At three o’clock in the morning again this man and his wife went to the hospital and there was no doctor on duty in this government hospital. The doctor came only at 8 o’clock in the morning. We spoke with the doctor at around 10 in the morning, and he told us that the child came in so late and the condition was very poor. So we said „why did you discharge the child if he was not in the best condition?” He said that the mother and the child were discharged from the maternity section, thus this doctor from the paediatric department was in no position to comment. He declared the condition of the child as critical and hopeless. We asked „can we take the child to a private hospital?” The doctor said, „you can do what you want, but we would not advice.” At four o’clock in the evening the child was dead.

This has just happened last week. So, when it can happen in the capital, and it is not only one person’s story - this is the story of so many women and children. I have seen with my own eyes: on one bed you have two mothers feeding their two children. And these are mothers who have just given birth to the child. They need care, need to be looked after, to be kept away from different kinds of infection. The kind of food, which is served to them in the hospitals, is pathetic. I just don’t know. Sometimes we believe in god and I think that it’s god’s will that so many people are still being born and they survive. And it was so difficult to convince my office boy that it was the fault of the hospital and not god’s will.

So when we talk about health situation, we have extremes. The minority of the population has the best facilities that you can compare to anywhere in the world. But the majority of the population in the rural areas, which has migrated to the cities, cannot afford good health facilities. Despite that they come with a very fat packet of fees to pay to the doctors, because they are severely suffering. Even today we have deaths of mothers while giving birth to a child. On one side the government is talking about health tourism. They are getting people from Pakistan, saying that we are the best where health facilities are concerned. But if you just travel a little away from these posh areas, you realise that the condition is pathetic. If you don’t have good water, can you have good health? When you don’t have immunisation, when you don’t get a tetanus injection, can you have hope of having a healthy child? And coming to nutrition: when you have still deaths due to starvation in so many districts, when most of the people are just eating onions and the seeds of mangoes in so many districts, can we talk about nutrition there?

“…because giving birth to a girl child is the worst possible thing that can happen.”

And there is so much of discrimination even now. Everybody wants a male child, like many other societies. In India it’s more so. The proportion has come down in some districts to 782 women for 1000 men. That is the kind of discrimination which is happening. We are having a lot of infanticide. They are just killing their foetus if they get to know that it is a girl. So three, four, five months, as soon as the family members get to know „oh, another girl”, they force the expecting mother to go in for an abortion. Though it is not safe for her to have an abortion done after three months. But we have so many cases of women going and taking this kind of risk because giving birth to a girl child is the worst possible thing that can happen. And there are so many areas, especially in the central and the western part of India, where we have women giving birth to a child and later allowing the child to die a natural death by not feeding her. Because they don’t want the child. And we’ve had several films and several papers written on all these kinds of things.

Talking about health in my country is a very sensitive issue. Especially for those who have seen what health is all about and what it is to live in a village. Because if there is any crisis, you won’t have a road infrastructure, you won’t have a vehicle. So how do you take the mother or her child to such a place?

And they’re so many superstitions. Like my house held, they would never go to a doctor. They would do all this kind of old traditional methods of medicine and would believe that somebody has done something so that is why the child is ill and that is why he has a running temperature. But it will never strike them that it is a medical problem and it can be treated and there is medicine for this. They don’t have faith in the medical facilities or doctors. They just can’t think of going to the hospital. They would always think that it is some divine thing which is happening or some kind of voodoo.

This is all over the rural area. It‚s not only in one ore two districts.

It’s a very difficult situation. A lot needs to be done and we need the attention of a lot of foreign agencies and people who are funding. I think there is a lot of money trickling in, but it has to be put together. What happens is that we get funds or the help from NGOs, but we need a more consolidated program or strategy to provide medical facilities to the women in our rural regions and in the peripheral areas.

WwB: Do you see that happening or is it still a dream?

AK: I think it will happen. According to me it should have happened by now. It’s not easy because, as I told you, women if you give them facilities, sometimes they refuse them. But the fact of the matter is to make them understand that the world has come a long way, that there has been a lot of development and of advancement in health care and basic facilities. It’s going to take time to reach an attitudinal change that is required.

In my country the people are still dying of malaria, cholera, and diarrhoea. At times, they fall prey to some expired immunisation drug. In addition, people die of hunger and starvation. So in this kind of scenario, of course, it’s going to take a long time. But I think there is hope and one has to keep working. We have to work in-groups to convince a smaller group, and than move to a larger group and use these women to convince the others. Since, the outsiders can only be facilitators, so it has to come from the local people, as they would place more trust in the local people. That is what we will have to do. There is a little hope because we have decentralised governance. Local is important. We are investing a lot in the local self-government. And we have a 33% reservation for women in the local self-government. Ten villages would have one leader and at least in 33 villages out of hundred you will have a woman as a leader. Sensitising these women is very important. Sensitising them towards the need for good health, water, sanitation, and education. They will be women who can understand the plight of women. And if we can sensitise them I think the work would become, the task becomes simpler and there can be change in the near future - very near future.

The problem of HIV/Aids

I want to share another thing with you: The problem of HIV/AIDS. Women are suffering the most because of this. I was in Manipur, one of the Indian states where the HIV incidence rate is very high. The health facilities there shocked me and mind you, this was in the very capital of the state. What shocks you is that about 2500 kilometres away in the northeast, in a district there are just two hospitals. I will forward the pictures that I have taken: As soon as you enter the hospital, you have patients lined up in the entire corridor. The whole entrance and the corridors are full. You can’t even walk through. There are drips hanging from the doors and the windows, families feeding them on the floor and the doctor is checking the patients at the entrance of the hospital because there are no beds. That is the kind of infrastructure facilities we have.

The state of the hospitals is terrible. The doctors aren’t enough. And every institute has its limitation. The population is very large and so we have a lot of patients but there are no facilities for them. I think that the government has to look into this and do something with a special focus on women and children.

WwB: You talked about this high incidence area. Why is the rate so high?

AK: There are a number of factors. In the north we have high incidence of HIV/AIDS because of sexual relationships. In the north-east, where I went, it‚s more because of drug use. It’s the area which connects Myanmar to the rest of this part. Through Myanmar the drugs come to India, from where they go to Vietnam, Afghanistan, Pakistan, Bangladesh. So there’s a lot of drug trafficking going on which is obviously linked to drug use and HIV/AIDS. This district is very sensitive. It’s a highly militarised area, and you have a really high population that is using drugs. Initially, when AIDS was not such a big problem and nobody knew about it, people would share needles. The first case in Manipur was reported in 1990. Today in a population of 2.4 million, they have an incidence of about 15%. Through vertical transfer that is through pregnancy and mother to child transmission the incidence is about 40.000 in just this state. What has happened is that it has now reached the homes. For e.g. there is an unsuspecting woman whose husband was or still is a drug user. And then she’ll obviously have a sexual relationship and have a child. It’s only later that she comes to know that this man is suffering from HIV/AIDS. And by that time even she has become a carrier of the virus and it has been transferred to her child. And here, I‚m talking only about those who have been tested. Most of the population has not been tested.

I also visited some sex workers, who are also drug users and I asked them - although the government is running an intensive program of distributing syringes and condoms - if they used a condom. And they said very categorically, „If men are willing to pay more, we won‚t use it”. They have given up on life. That’s what I was trying to tell you. The woman has to be made conscious that she also has a right to a healthy life. But they have given up. They are not thinking about the future at all.

HIV/AIDS is a major problem now. The official figures are about 5.1 million. And this is a very conservative figure. I think it has to be much more than this. There is an increasing feminisation of the epidemic. They are not even aware of this disease. They are unsuspecting and presume that their husbands are honest and normal people. The problem is very, very huge.

During their stay in Vienna, Archana and Sanjay Kapoor interviewed Austrian politicians – click here to read the interviews with the Austrian President Heinz Fischer and Andreas Khol, president of the Nationalrat, in the current online issue of Hardnews.


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