ASHA means HOPE

Hello again! Sorry this is a few days late, from August 9. We've been having a lot of trouble with the internet here at the hotel. Yesterday when we finished up at Stanford-India Biodesign (SIB), we headed off with Tor Garvik from Laerdal to the Qutab Complex, a bunch of beautiful buildings and ruins from one of the Mughal kings of the area a few hundred years ago. The pictures here are from the short trip there and the site itself. You can see in the last picture 6 of our 7-person team: Hector, Anmol (not present - he took off to visit home for the evening), Michelle, and me from JHU, and Namrata, Sharon, and Sowmya from NID (National Institute of Design).

Earlier today we kinda took it easy because the SIB people didn’t really have anything arranged for us to do. I had been planning on talking with the team there that worked on addressing birth asphyxia, since I also had done a design team project on that last year and wanted to collaborate. However, all the fellows who were working on the birth asphyxia project graduated out, so there wasn’t too much reason to meet up today, and I’ll talk with whoever takes it over sometime once they are settled into working on it.

So, instead we headed over to Jhpiego at 11am and met with Dr. Sood, the country director, and Dr. Somesh Kumar, the programs director for Jhpiego India. Both of them were really enthusiastic that we were there and so generous with their time. They did an overview of statistics for India, ongoing programs, new public health policy in India, and what has and hasn’t worked/progressed. That led into more detail on the programs going on, especially family planning. That’s a huge emphasis now for a couple of reasons: 1) maternal mortality is extremely closely tied to total fertility rate, as is infant mortality; 2) around 25% of women in India desire but do not receive contraception (e.g. IUCDs) or improved child spacing; 3) development of family planning can lead to improving women’s education (it’s hard to finish an education once you’re married and have a kid when you’re a teen) and empowerment; 4) the exponential growth in some states makes public health programs less effective, and education, infrastructure, and development to catch up.

Another important thing we went over was characterizing an ANM (auxiliary nurse midwife) and ASHA worker. For those who were like us a couple days ago and don’t know how the rural Indian public health system works, ASHA workers are Accredited Social Health Activists, and ASHA means “hope” in Hindi, which we all thought was so cool. ASHA workers have contributed tremendously to public health by being the bridge between government healthcare and villagers. They are local women who council and encourage women to receive services, especially maternal and child healthcare, such as vaccinations, give birth at facilities, contraception, etc. and get paid when women receive these services. They only do counseling at the moment, though. Evidently, they’ve had a huge effect on health statistics for India so far.

After Jhpiego, we headed to our flight to Kolkatta. So that’s where we are now. Today was probably the most exciting for us so far and really got us prepped for the immersion. In Kolkatta we’ll be in a good government hospital here for several days, at neonatal care and Ob/Gyn. Excited for the clinical immersion to begin!

Stephen