Raat bhar ek khaab ban leti rahi mere sirhaane;
Tamaam tare aasman ka aangan chhod kamre ki chhat se use dekhte rahe;
Chaand naraz tha, dekho kahin muh chuupa baitha hoga, kisi daryia ke kinaare.
Phoolon me ras bhi na pada aaj, uske surkh hoton me ghul rahe the jaane kitne hi rang.
Shabnam ki boondein, uske maathe ke paseene bane hue the, nanhi kopalon ne subeh shikayat ki.
Pahadi ki nadi bhi raat ko taaron ki madham roshni me uske laton ka naksha utara,
'hum bhi aise hi lehrana chahti hain, behna chahti hain, ulajhna chahti hain!'
Par neend ke khulte hi, khaab aur uska na hona bhi lazmi tha!
Tuesday 24 January 2012
Monday 9 January 2012
Janani - The Mother
It is hard to write an article or a post which is based on a true incident and have calculated reactions. It is harder if you know the people involved, both the affected and the effectors. Names and relationship do no matter, as it could be anyone, any woman, any family, in any remove village (there are quite a few of them) in Uttar Pradesh, which is the 7th largest country in the world by population.
The incident is not unique or 'urgent' or 'disturbing' by our Indian and specifically, Indian government standards.
A mother died during child-birth. The reactions are followed by facts which every academician and practitioner quote with immaculate accuracy but disappointing ineffectiveness.
'So many of them (mothers) die'
Around 300 on average out of 100,000 live child births across India and more than 500 in UP.
'Oh! The child is okay but, na?'
60 die per 1000 live births in India and 99 of them do in UP.
'Where was she born?' 'Arre baba, not the mother, the child!'
Only 22 out of 100 child births happen at a medical institution
'Did she receive any medical care?' ' There must be a Sub-Centre with an ANM or at least an Aanganwadi Centre'
26% of women receive proper Antenatal Care (3ANC visits) - % of women who received 3 ANC visits.
'We have Janani Surakhsya Yojana' (thank god it is not called Jawahar, Rajeev, Sanjay or Rahul Yojana, else, I would have had to choose a different title!)
The central and state government under this scheme pay for the expenses of an institutional delivery and pre-and post-check-ups. It is probably largest conditional cash transfer scheme in the world. Many surveys and audits, done by international and local consulting/research companies and NGOs (Hundreds of Thousands of rupees would have been spent by the World Banks and iNGOs (look at the Apple style nomenclature of international NGOs!) claim success.
Now, back to the incident.
The woman was not well for 6-7 days before the date of child birth. The only medical facility in the village is a Sub-Centre. Wait. The building of the Sub-Centre. There is no staff.
There is an Aanganwadi centre with a worker. She gave 'some' medicines to the woman, with no signs of improvement. Nothing else was done as well.
So, on the day of the birth, matters got complicated.
They finally decided to take her to the district hospital at Barailey. This distance of 30 kms takes one and half hours! This is another aspect.
Many state governments have Janani Express Yojana. The mother is reimbursed the cost of transport for institutional delivery. But, what can you do about the roads.
I was advising the state government of UP, not so long back on two such projects.
1. Mobile medical units (to make health care reach remote locations)
2. Emergency Medical Services (to tackle situations such as mentioned)
We were aware of situations where it could take 90 minutes to cover 30 kms. We ideated, planned and recommended many suggestions. Some were implementable, some were not. It has been more than 4 years. Nothing has happened on those projects.
Continuing the narration, the woman died on the road. The child was born healthy, almost healthy. The child was a girl. She would be a mother, if she survives i.e. I do not want to put facts and figures about child mortality, immunisation coverage, nutrition etc. but you get the idea.
A faint hope is that things would have improved by the time this small girl becomes mother.
ps. Incidental to this is the fact that Barielly is the constitution of Sonia Gandhi, The Sonia Gandhi, the single most powerful person in this country.
The incident is not unique or 'urgent' or 'disturbing' by our Indian and specifically, Indian government standards.
A mother died during child-birth. The reactions are followed by facts which every academician and practitioner quote with immaculate accuracy but disappointing ineffectiveness.
'So many of them (mothers) die'
Around 300 on average out of 100,000 live child births across India and more than 500 in UP.
'Oh! The child is okay but, na?'
60 die per 1000 live births in India and 99 of them do in UP.
'Where was she born?' 'Arre baba, not the mother, the child!'
Only 22 out of 100 child births happen at a medical institution
'Did she receive any medical care?' ' There must be a Sub-Centre with an ANM or at least an Aanganwadi Centre'
26% of women receive proper Antenatal Care (3ANC visits) - % of women who received 3 ANC visits.
'We have Janani Surakhsya Yojana' (thank god it is not called Jawahar, Rajeev, Sanjay or Rahul Yojana, else, I would have had to choose a different title!)
The central and state government under this scheme pay for the expenses of an institutional delivery and pre-and post-check-ups. It is probably largest conditional cash transfer scheme in the world. Many surveys and audits, done by international and local consulting/research companies and NGOs (Hundreds of Thousands of rupees would have been spent by the World Banks and iNGOs (look at the Apple style nomenclature of international NGOs!) claim success.
Now, back to the incident.
The woman was not well for 6-7 days before the date of child birth. The only medical facility in the village is a Sub-Centre. Wait. The building of the Sub-Centre. There is no staff.
There is an Aanganwadi centre with a worker. She gave 'some' medicines to the woman, with no signs of improvement. Nothing else was done as well.
So, on the day of the birth, matters got complicated.
They finally decided to take her to the district hospital at Barailey. This distance of 30 kms takes one and half hours! This is another aspect.
Many state governments have Janani Express Yojana. The mother is reimbursed the cost of transport for institutional delivery. But, what can you do about the roads.
I was advising the state government of UP, not so long back on two such projects.
1. Mobile medical units (to make health care reach remote locations)
2. Emergency Medical Services (to tackle situations such as mentioned)
We were aware of situations where it could take 90 minutes to cover 30 kms. We ideated, planned and recommended many suggestions. Some were implementable, some were not. It has been more than 4 years. Nothing has happened on those projects.
Continuing the narration, the woman died on the road. The child was born healthy, almost healthy. The child was a girl. She would be a mother, if she survives i.e. I do not want to put facts and figures about child mortality, immunisation coverage, nutrition etc. but you get the idea.
A faint hope is that things would have improved by the time this small girl becomes mother.
ps. Incidental to this is the fact that Barielly is the constitution of Sonia Gandhi, The Sonia Gandhi, the single most powerful person in this country.
Thursday 5 January 2012
weekend
dedicated to the inverted ratio of 2:5
-------
friday ke 4 baj te hi,
hoton se hafte bhar gayab
haasi ka wapas aana,
doston ke numbers
jo 'last dialled calls'
se gayab se hone lage the,
unhe phir se dial karna.
newspaper ke safhe palat palat kar
stock prices aur headlines ke badle
theatre, music aur art galleries
ke events check karna,
chun ke kapde almari se bahar nikaal na,
long walks pe jana,
early mornings uth na, (early can be swapped with late!!)
jam ke khana and wine peena,
tera weekend ki tarah aana,
aur aakar chale jaana.
kya bura hota agar
tu aur weekend, dono reh jaate!
.
-------
friday ke 4 baj te hi,
hoton se hafte bhar gayab
haasi ka wapas aana,
doston ke numbers
jo 'last dialled calls'
se gayab se hone lage the,
unhe phir se dial karna.
newspaper ke safhe palat palat kar
stock prices aur headlines ke badle
theatre, music aur art galleries
ke events check karna,
chun ke kapde almari se bahar nikaal na,
long walks pe jana,
early mornings uth na, (early can be swapped with late!!)
jam ke khana and wine peena,
tera weekend ki tarah aana,
aur aakar chale jaana.
kya bura hota agar
tu aur weekend, dono reh jaate!
.
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