I am organizing children in slum areas in West Bengal to become peer leaders/educators bringing about ‘lifestyle’ changes within their communities. Focusing primarily on preventive health, sanitation and hygiene these children (calling themselves ‘area health minders’) are changing the physical and social environment within which they live.
I have developed a unique model based on children’s right to participation and development wherein the children of slum areas act as change agents themselves by forming groups and spreading awareness on health, hygiene and sanitation within their community. These ‘area health minders’ are supported in their work by me and my organisation Prayasam by providing information, first aid training, developing IEC material that are then used for awareness campaigns as well as in helping these children become real advocates for their cause and approach the local governments for infrastructure needs and requirements.
These children have now tied up with more than 60 schools to help in the formation of more such groups of ‘area health minders’ in the adjacent Municipal area effectively reaching out to more than 5000 students and their families. I believe that the idea of forming ‘area health minders’ from amongst local children have been established as a model this was further strengthened by the recognition received by members of this group when they were chosen as the only representative from India in Unicef’s global publication ‘A Life like Mine’ a book showcasing innovative programmes on of children’s right to participation and the changes it can bring across the world.
Poverty, violence, rapid social and economic changes, lack of education, inadequate or total absence of health services, and a lack of clear policy direction, contribute as much to the increase in cases of cancer, diabetes, or cardiovascular diseases, as they do to AIDS and malaria.
The most pressing concern of any developing country is its health services. India is no exception. Health services available at present fall grossly short of requirement. Therefore the adage, ‘prevention is better than cure’ becomes all the more important. Article 24 of the Convention on the Rights of the Child adopted by the UN General Assembly in 1989 states “Children have the right to the highest possible standard of health, and to access to health and medical services” and state who have signed the Convention (includes India) are bound to honour the statutes enshrined in the Convention. Yet we have ever increasing cases of malarial and diarrheal deaths, deaths that are eminently preventable.
The onus of providing basic health facilities is on the government, which often falls short of the minimum due to lack of finances, resources as well as infrastructure. If the primary health care centres in rural areas are over stretched, the health clinics operated by the municipalities for the urban poor is in a worse state with most of the budget of the urban local government being set aside for infrastructure developments like roads, street lights, water and waste disposal, services such as education and heath are neglected. Exacerbating the problem are the new policy decisions being taken by municipalities based on the dictats of foreign donors who are providing large grants for ‘improvement’ of urban slums. As per the new directives, education and health services are to be eased out of the ambit of local governments since there is very little revenue earning from these free services.
In this context it becomes increasingly important to put systems in place within the poor communities living in urban India to be able to access information and skills to ward off serious diseases to the extent possible. This will not only help them to be healthy but will impact their economic condition since disease rob these daily wage earners their income and then they end up spending large parts of their meager income on medicines.
In 1998 while working with the Lutheran World service (I) I realized that several children are often absent from the school and cultural programmes run by LWS (I). Bent on investigating the reason for the absence I have visited the homes of some of the children and saw that they suffered from chronic ailments some of which are very serious such as diarrhea and malaria. I have also witnessed the dependence on quacks to avoid costs of medicines and the near complete lack of preventive health care in these slums that are in the middle of the ‘mega city’ of Calcutta.
Since I was familiar with most of the children already he decided to bring them together and experiment with them. With the help of a few friends I sat down with the children to develop a questionnaire to collect information on health related issues as well as information on how much money was spent on medicines etc. The children were each given a red bag and armed with the questionnaire they set off to conduct their own home grown survey. The results were startling. It appeared that each family spent a major part of their income of medicines and treatment of illnesses that can be easily prevented through some simple measures. I have decided that I need to concentrate on finding ways to work with the children themselves to improve health standards in their communities. And I wanted to do this on my own way, so I heve resigned from LWSI and with a few friends started Prayasam, a registered NGO with the vision to make ‘health for all’ a reality while ensuring children’s right to participation and development and demonstrating the social mobilisation skills of the children starting in the extremely poor slum of Rishi Aurobindo Colony in the Lake Town region of North East Calcutta.
At the beginning of the year Prayasam members sit down with Ekjot members to develop a plan for the year based on the health need requirements and how special religious and social occasions can be used to organize special events for awareness raising and information sharing. With this annual plan at hand Prayasam staff spend one day every week with the members of ‘Ekjot’ the 25 member team of ‘area health minders’ going over the information collected by them from the community on health and together they develop new campaigns, tools and plans on what issue needs to be taken up (example – if there is a immunization date in the next month then the children concentrate on spreading information on immunization) and how they are going to plan their week. The children give a couple of hours three times a week and most of the day on Sundays for their role as health minders. During this time they wear a tunic and carry a special bag with their ‘kit’ comprising of leaflets, posters, etc.
Ekjot members also discuss whether they need to approach authorities for any of the problems they encounter such as lobbying with the municipality conservancy department to collect garbage and to clear stagnant water and clean the open drains which are the breeding ground for mosquitoes. If there is a need to approach the municipality then Ekjot members request some of the adults from their community to accompany them. The work of Ekjot are often supplemented by the girls group called Alhadi also formed by Prayasam to provide the girl children living in the slum areas the opportunity to perform songs and dances simply as a recreational activity which they miss in their day to day living. Ahlladi members help the area health minders to develop special programmes to mark world health day etc.
Prayasam members are always present to provide the support needed and resource persons are invited on a regular basis to the weekly meetings as well as to specially organized workshops to enhance the skills of these children. In the last 3 years the 25 member team of Ekjot have grown into mature health workers with training in first aid and orientation in ways to combat superstitions – these were in collaboration with other organisations such as St. Johns Ambulance, West Bengal Science Communicators Forum etc. For the immunization drive Ekjot members have worked steadfastly with Unicef and are a shining example of the power of children in mobilizing community support and participation so much so that these children were the only representatives featured in ‘A Life like Mine’ a worldwide Unicef publication celebrating examples of innovative programmes of children’s participation for social change.
Rishi Aurobindo Colony is now a model slum with clean alleys, hardly any incidence of malaria and diarrhoea and the children are proud to be neatly turned out as described in one of the rhymes (translated from Bengali) penned by Ekjot members “we bathe daily and try to be neat, or else we will fall sick and our fun will be beat”.
Based on the success of the Ekjot model I am now taking the idea to other urban areas of the state through the local government system. Using the municipalities as the base I have developed a strategy to reach the municipal schools starting with three municipalities of South Dum Dum, Kamarhati and Bidhhannagar. 2 Ekjot members along with two staff from Prayasam visit the municipal schools (average of 50 –60 in each municipal area) two times a week initially and then once a week and finally once a month over a period of six months. These visits are made during school hours to ensure that the school authorities also slowly gain ownership of the idea. This was made possible by the support of the municipality. During these sessions Ekjot members explain their work through role plays, songs and simple narration of their experience. Based on the response from the individual schools they return, the usually have to return to most schools. Some of the children from the municipal schools who are most interested are then trained by Ekjot members and are even taken on visits to Ekjot residential areas to make them see the change in the slum environment there. For them to be able to compare their own slums and community living conditions with that of Rishi Aurobindo Colony.
Ekjot members have so far approached 60 schools in these three municipalities and the children have formed already more than 30 Parent Teacher Associations – which is a necessary first step for the larger community to ‘buy into’ the ideas being implementd.
I estimate that from the initial 60 schools approximately 7900 children will be exposed to Ekjot’s model and about 3500 children are expected to join as ‘area health minders’.
I am leveraging several new programmes being undertaken by the municipalities in West Bengal using funds from the British DFID to spread this model to 40 other municipalities in South Bengal. At the same time, through another programme targeting child labourers and their families in brick kiln industries in central Bengal (Purulia and Bankura districts) Prayasam has started introducing Ekjot’s model in these very poor and remote areas. The model has to be appropriately altered for the brick kiln children since their situation differs from that in urban slums. Having presented his model in a nation wide workshop on ‘children’s right to participation at work’ organized by Unicef and attended by several national level NGOs and government agencies I have been requested to take his model to North Eastern states.
In developing the ‘Ekjot’ model I have partnered with many private organisations. Managed to raise resources from the citizen sector and managed to garner support form the media. Prayasam’s activities are always in the news and its public programmes are attended by famous personalities from all sections of society, which is one way to spread awareness about its work as well as generate resources.
A qualified lawyer I began my career as an apprentice to the most reputed criminal lawyer in Calcutta. He was soon disillusioned with the legal process that allowed little justice for the poor who could not pay lawyer’s fees and have the patience to withstand the long drawn legal process. I have decided to make a complete switch and joined an International Implementing Agecy in 1996. In 1999 I have registered Prayasam together with a few friends with the intention to actually find ways for children to participate in the decisions and factors that affect their lives. I am the organizer behind Prayasam, which focuses on the development of children and the promotion of their rights. To raise money for the first activities I approached my past employer and also set up a boutique that would sell clothes to raise funds. Personally I continues to raise money for Prayasam through consultancies, imparting Life Skill trainings, conceptualizing, planning and manning events for the national / overseas Agencies (UNICEF, UNDP, World Vision India, LWS(I), Vikramshila Education and Research Society), Corporates (Exide, Eveready, Amul India, TATA Steel) and Government organizations and hosting radio and television programmes. Amlan is the Meena Resource Person of UNICEF, Kolkata. Ashoka, a global association of the world’s leading social entrepreneurs, has recognized me as an individual whose innovative solutions to social problems have the potential to change patterns across society, and has awarded him the title of Ashoka Fellow in 2006. In July 2007, I was invited by the Rockefeller Foundation to attend the Global Summit on Urban Population Health in Ballagio, Italy.
Prayasam’s award-winning Area Health Minders were subsequently cited as a successful local solution to public health in Century of the City: No Time to Lose, a Rockefeller Foundation publication. This past year, I have been selected as one of eight public health leaders to be profiled in Revolutionary Optimists, a documentary film project headed by Stanford University’s Center for Biomedical Ethics, Program in Bioethics and Film. In the year 2010 I have been awarded Indian Achievers’ Award for Social Service from Indian Achievers Forum, New Delhi.
Prayasam continues to introduce its peer education and child empowerment concepts to impoverished sectors of society. Notably, Prayasam is working with the West Bengal government to uplift brick kiln migrant worker communities – the first such collaboration between government and NGO in India – through its signature “Multiple Activity Centres.” In addition to my work in West Bengal, I facilitates leadership, soft skills and gender trainings across India, most recently with World Vision India and the Xavier Institute of Social Sciences in Bangalore, India.
In the year 2011 I have been awarded the Ford Fellowship by the Ford Motor Company Fund and the Picker Center for Executive Education at Columbia University’s School of International and Public Affairs.
last year myself and my two Child Area Health Minders, Salim Shekh and Sikha Patra, were invited to Skoll World Forum, Oxford as speakers to share their field experiences with a global audience.