We reflected in the morning what we are taking back as our learning and what we were grateful for. I think what’s been most striking to me was the point Dr. Shoba made about proportions: we are working on improving the lives of people who are already surviving, while neglecting the basic needs of the majority who are dying. That really put things into perspective for me and motivated me to work abroad in the future.

   I’m so grateful for all the little things I have. Indeed, I have so much more than what I’ve witnessed in India. 

   We went to the caves.  It’s really amazing how the temples (Buddhist, Hindu, Jain) were monolithic and done so many years ago- it must have taken so much planning.  It took a few hundred years to complete.  I’d like to learn more about religions. This trip has made me more spiritual, appreciating and being thankful for many things.

We hung out at the resorts afterwards; apparently there was a Bollywood movie in the making, and there was a swarm of people there just trying to see if they could see it. We couldn’t get anywhere close, of course, so we just wandered around. A lot of people asked to take pictures with us, as if we were celebrities.  It was amusing.

^goats!

When we were boarding the plane to Mumbai, we saw the Bollywood stars- it was crazy how people just started swarming and following them at the airport. Even the airport officials were taking pictures of them.  I felt really bad for the actors- people wouldn’t leave them alone!

   I got up, went to yoga, then breakfast. Jamkhed is a pretty big place, I realize.  We watched another video. This lady in the video talked about how she was pregnant at age 12 or 13, gave birth, but since the baby couldn’t get out, they cut the baby into 3 pieces, and her husband left her because of it.  The Jamkhed model of training lower class women seems really effective, empowering, and sustainable.

   We had Dr. Shoba talk to us about Jamkhed. She pointed out how a lot of healthcare research, development,and work is devoted to ailments that only affect a small percentage: 60% of the dying die from starvation, only 2-3% are dying from HIV/AIDS. That’s so preventable! Yet, there’s so much more money given to HIV/AIDS research.  I can’t believe we are spending so much time and money on improving one thing, when so many more are dying from something with a simple solution!  Basically, we already have the cure and we’re just not using it!

   Also in rural India, there is limited access to vaccines. All that is available is: DPT (diphtheria, pertussis, tetanus), polio, and measles. because of financial limitations.  The real solution, Dr. Shoba pointed out, is to change knowledge, attitude, and practices.  And the concept of integration is very important to this; there are 3 components to integration:

1. health should be integrated with other systems (of economics, nutrition, farms, agriculture, women’s development, laws, business)

2. holistic health should be more emphasized rather than specializations. 80% of doctors need to be holistic, only 20% need to be specialists

3. Also, there should be some integration with alternative health systems. 

    Dr. Shoba also made a point that empowerment is important and is executed by increasing access to knowledge. People look to doctors like gods because they have this access while others don’t. One goal of Jamkhed is demystification in order to bring about empowerment. It is important to note here that knowledge and skills do empower, but there is a difference between education and empowerment. Empowerment requires not only knowledge, but also self esteem, money, decision-making skills, etc.

    A problem of the US is that people are given too many rights. The result is selfishness and our country having more mental problems than even developing countries. What we really need to aim for is being,  sharing, and caring.

    After Dr. Shoba’s talk, we met some of the actual village health workers.  They have actually delivered babies! They have an instruction/reference booklet that works well for them. It’s really great that these women were once untouchables (from the lowest caste) and now are looked up to as doctors/nurses.

^ village health workers

   After lunch, we were off to the resorts in Aurangabad. Rebecca and I observed the rural scene outside the window, seeing women in saris out on the fields doing farm work, washing clothes by hand, and remarked again how privileged we really are.  As usual, things ran late. Then we finally go there and it was dark. The place was nice. It’s nice to get (somewhat) away from all the smoke and incessant honking. And it’s cool that there was furniture and a bathroom with plumbing inside! There were monkeys around, so we had to be careful about that. We had a good time talking and some nice appetizers and a late dinner. Then I took a cold shower :( with buckets and slept without getting up for yoga.

^ the rural scene

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DISCUSSION

The state of healthcare in India is not where it should be as proposed by the Indian Constitution.  Unalike the US, the top causes of death and hospitalization are chronic disease states: cardiovascular diseases, diabetes, cancers.  Meanwhile, the Indian healthcare system is struggling to control infectious diseases such as tuberculosis, measles, and whooping cough, all of which are easily preventable.  This is due to the inability to develop a functioning general health system, regulate the private sector, and to address socioeconomic issues that are linked with health.  

The healthcare system is ineffective and underdeveloped with insufficient regulation.  For example, most of the costs of the 2001 polio-eradication caompaign went to the campaign and not improving sanitation, which would have yielded better outcomes.  The healthcare system fails to address the difficult to access necessary drugs, which, in the cases of life threatening diseases, was argued as a fundamental human right by the World Trade Organization in 2001.  Furthermore, the costs of the private sector are unaffordably high due to the lack of government regulation.  This forces communities suffering from diseases into worsened poverty.  It is surprising that the lack of a comprehensive health insurance has still not been addressed.  Healthcare facilities should be better established; currently almost 50% of primary healthcare centers in India do not have telephone access!  While childbirth is a common reason for Americans to visit hospitals, some Indian hospitals do not have available obstetricians or gynecologists.  This forces many into home births, which causes a host of other socioeconomic issues. 

The socioeconomic issues associated with healthcare should also be addressed in the regulation by the government.  With the majority (over 77%) of births occurring at home, most children born are not receiving appropriate vaccinations.  This endangers children to easily preventable infectious diseases.  Also, due to women’s low social status and poor access to quality healthcare, the maternal mortality is high at 408 per 100,000 births.  Due to poverty and poor access to quality healthcare, child malnourishment, with 50% of Maharashtran children under 3 being underweight, according to a status report in “Health and Healthcare in Maharashtra.”  

One solution that have been incorporated to address these governmental regulation and socioeconomic issues is to contract out health systems to NGOs (non-governmental organizations), as Jamkhed Comprehensive Rural Health Project and Rural Unit for Health and Social Affairs have.  These organizations have been able to more successfully outreach to rural impoverished communities and provide affordable healthcare by having low expenses and training village health workers.  Although this has been a successful approach, some may argue that this condones the government’s failure to regulate its country’s healthcare. 

Generally, the Indian healthcare system is weak due to lack of government participation and inability to acknowledge the associated socioeconomic issues.  Currently NGOs that manage health systems are more successful in addressing problems, though the future goal is to pass off the regulation to the Indian government. 

REFERENCES

    We left Pune at 7am and went to another university. we discussed women issues, empowerment, sex ratio.  Polygamy is legal in India, depending on the religion. Reshma told us about how in the Amazon, the matriarchal society has women pick their husbands after having sex with a group of men selected by her father. we watched a video about the village, then headed over to the actual village.

    We had to visit all the schools of the village to be polite. They all prepared dance and shows for us. They welcomed us by putting red ink and rice on our foreheads and giving us roses, and wrapping turbans for our trip coordinators. Larry was respected as the oldest male in our group, even though he wasn’t a trip coordinator.  Also, they mentioned a “saint” Gadge Baba and handed us books about him.  What was meant by “saint” was not the same as a Christian/Catholic saint. It’s someone you see God in, but is not a God; they just did a lot for society and the world- ex- Gandhi was a saint. (?)

    I rode a bullock cart, it was quite scary but exhilarating. We had lunch at a village, I think they made everything from scratch and over a fire outside. The only thing that was weird was that we ate off of styrofoam plates… It was especially important that we not waste our food there.

   We got to Jamkhed, ate dinner, and watched an intro video. The apartment we’re staying in is fairly nice, though we are having issues with getting running water now…  The food here is pretty bland compared to in Pune, Sonam said. It’s interesting how different the cuisine is, when we are still in the same state!

——

DISCUSSION

The inferior status of women in India negatively impacts their health, education, and employment status.  Women are associated with lower levels of education, healthcare choice and access, employment, and wages for similar work.  Within the family, women are commonly abused; this violence is unfortunately accepted as the social norm.  Predictors of violence include low education of women, marriage before 18, women not working outside the home, and alcohol abuse of the spouse.  These practices have detrimental consequences on women’s health. The CHAD (Community Health and Development) Program and some government initiatives have been put into place to alleviate these issues and equalize opportunities for both genders. 

Women are very lowly ranked in society, are subject to abuse, and as a result, families favor male births.  Because of the lack of a useful role in society, girls are typically considered burdens in families.  Their expected role is to do housework, gather firewood, fetch water, and take care of children.  Their burden is further exacerbated by the dowry system, requiring families to make payments to the daughter’s husband.  Hospital statistics show that female patients are likely to seek medical treatment later along in disease progression than males.  Because women are often blamed for infertility or not conceiving a boy, the prevalence of post partum depression is higher after giving birth to girls than to boys.  Rarely are women given the decision of their own reproductive health.  The use of contraceptives is normally not under their control.  Furthermore, the most common form of contraception is a high-risk abortion by untrained hands.  These sex-selective abortions contribute to the low female:male sex ratio in India. Ultrasounds and gender-typing technology are abused for these procedures.

Although the women’s issues are deeply rooted in Indian culture, programs designed to improve this issue (sex ratio) must confront the problem directly and assertively in order to be successful.  The CHAD program aims to equalize opportunities, health, and social outcomes between women and men.  One strategy it has implemented is to educate children in schools of gender equality and women’s issues.  It also provides family counseling for families that deal with problems due to gender inequality.  An intervention by the government of Tamil Nadu is financial assistance for low caste women to pursue their education.  There is also a police force made up of women specially put together to handle crimes against women.  

REFERENCES

    Yoga was really great this morning! I learned about the benefits of so many poses and started feeling like yoga is really important- just to have some ways of controlling stress and for restoring balance in the body. She told us about how the left nostril reflected the parasympathetic nervous system’s activity, and the right was sympathetic. Also, forced expiration, auto inhalation helps satiate the body with oxygen, makes you less hungry, so it’s good for dieting. And forward folds have the most benefits out of all the yoga poses.

    We went to MIT again for some more lectures. First we saw a professor’s office- it was huge, with a lot of seating, where people would be served with drinks and snacks. It looked more like a huge living room to me than a professor’s office.

   We later went to a blind girls’ school. There, they learned massage, stitching, weaving, sewing, making towels, and chairs, writing Braille (they have Braille for Marati too), using the computer, and playing musical instruments. It was pretty amazing. They also had their own vegetable garden so they could teach what a good sustainable garden should be like. There were some interns from Germany there who helped teach.

^ Braille typewriter

   Then we went shopping and then fine-dining. It was all you can eat style, but they served appetizers on a grill to you, which was famous for filling you up before you could even eat the entrees.

    The street shops really remind me of Taiwan.

———-

DISCUSSION 

The observation of blind children’s school raises the question if social behavior is governed by perception and communication abilities.   It is logical to believe that the blind may have a different perception and judgement of future occupation possibilities for a variety of reasons.  Most blind people are at a disadvantage to learning about occupations through visual observation through the community or television.  Also, the blind are often discriminated by employers, and this along with parental attitudes can contribute to their career aspirations.  A 1973 study surveyed completely blind children and their families to assess how blind children viewed their aspirations for occupations. Another aim of this study was to investigate the blind children’s views as correlated with their family’s status and roles in society. 

In the US, the federal government and private agencies set up a variety of aids to help the blind find employment; one example is specialized vocational schools.  The issue with this is that even “special” blind schools may be reinforcing the children’s difference by having an isolated, separate school.  Another issue is that these schools tend to emphasize certain occupations, such as weaving, broom-making, chair-caning, basket work, newsstand, piano tuning.  These may contribute to constraining options for the blind.  While this makes a point for improvement for certain agencies, any agency’s existence is more helpful than the absence of resources altogether for this population.  

Upon survey of the children and their parents, it was found that the quality of being blind lowered expectations for their own future occupations as well as for other blind people’s future occupations. On the other hand, the blind children’s aspirations for education was viewed as equally essential as for non-blind, some even affirming that education is increasingly important for the blind than for the non-blind.  While the investigators’ hypothesis was that the blind may have unrealistic fantasies due to being disconnected from the society, these findings suggest that the blind are aware of their aspirations being constrained and their need to work harder to achieve.  

It is interesting to note the effect of blindness on social class perception.  Blind children’s aspirations were not affected by the family’s class while non-blind were.  This is attributed to the non-blind being more aware of their surroundings and therefore of their social classes.  However, it can be argued that social class is irrelevant to the blind because their handicap classification is an overriding status.  The blind are set aside from the rest of society due with certain expectations for behavior and role.  In the context of the caste system, blind children may also be less aware of their social caste constraints due to their impairment.  Despite this, due to the lack of government involvement and abundance for resources for the blind, the blind are unlikely to achieve their aspirations. 

REFERENCES

^ an auto rickshaw. They’re like little cabs. they remind me of golf carts.

We took rickshaws to MIT (Maharastra Institute of Technology). It was a really nice campus and is known for feeding its guests really well. 

   The most interesting lecture to me was about women empowerment in India. Patriarchy is practiced throughout populations independent of level of education. There are enactments for women, but they have loopholes and are not percolated into society. Even the school’s curricula reinforce gender roles.

    We also learned about how reproductive health has not been taught or accessible enough. Anemia among pregnant women is 52%. Using contraception is not even the woman’s decision. and sex ed is banned from being taught in schools!

   Girls are generally burdens because of dowry- so that increases sex-selective abortions.

   The electoral role of women has increased, but this is not reflected in the decision-making.

   I realize that this lecture was kind of sexist, because it was accusing, saying many men would admonish women or rape women if she refused sex. Because some men argued it’d be the same if the survey was flipped (asking women what they’d do if men refused sex). At first, I was annoyed, but now I guess I can see that they were kind of annoyed the lecture was sexist, providing statistics on how some men do terrible things.

    Then a music therapist played for us.

We then went to Darshan’s parents’ house. Apparently guests usually head to the bedroom first, when visiting a home, make themselves comfortable, then join in the living room. very different form the US.  We had our henna done in a sitting room. It was amazing how fast they did it.  And we saw Darshan and Sonam’s wedding pictures! Apparently Sonam changed 7 times during her wedding. Also a lot of people get really intricate henna done on hands, arms, and feet.

   We went to a bar where we smoked hookah, drank some, danced some, and ate some bad pasta and “ecstasy balls”  (????)

—-

DISCUSSION

The inferior status of women in India negatively impacts their health, education, and employment status.  Women are associated with lower levels of education, healthcare choice and access, employment, and wages for similar work.  Within the family, women are commonly abused; this violence is unfortunately accepted as the social norm.  Predictors of violence include low education of women, marriage before 18, women not working outside the home, and alcohol abuse of the spouse.  These practices have detrimental consequences on women’s health. The CHAD (Community Health and Development) Program and some government initiatives have been put into place to alleviate these issues and equalize opportunities for both genders.

Women are very lowly ranked in society, are subject to abuse, and as a result, families favor male births.  Because of the lack of a useful role in society, girls are typically considered burdens in families.  Their expected role is to do housework, gather firewood, fetch water, and take care of children.  Their burden is further exacerbated by the dowry system, requiring families to make payments to the daughter’s husband.  Hospital statistics show that female patients are likely to seek medical treatment later along in disease progression than males.  Because women are often blamed for infertility or not conceiving a boy, the prevalence of post partum depression is higher after giving birth to girls than to boys.  Rarely are women given the decision of their own reproductive health.  The use of contraceptives is normally not under their control.  Furthermore, the most common form of contraception is a high-risk abortion by untrained hands.  These sex-selective abortions contribute to the low female:male sex ratio in India. Ultrasounds and gender-typing technology are abused for these procedures.

Although the women’s issues are deeply rooted in Indian culture, programs designed to improve this issue (sex ratio) must confront the problem directly and assertively in order to be successful.  The CHAD program aims to equalize opportunities, health, and social outcomes between women and men.  One strategy it has implemented is to educate children in schools of gender equality and women’s issues.  It also provides family counseling for families that deal with problems due to gender inequality.  An intervention by the government of Tamil Nadu is financial assistance for low caste women to pursue their education.  There is also a police force made up of women specially put together to handle crimes against women. 

REFERENCES

   We went back to the hotel and I shopped around the street shops with Ashley. We didn’t do very well with bargaining! :( Later, we went to shop at some nice stores. Some were kind of expensive.

   I had this “Indian burger” on the bus, it was nice. The patty in it actually contained some potato in it. It looked like it could have been friend before I bit into it.

   Then we went to Maher. We first went to the facility that housed the mentally ill women. Sister Hira led us around and showed us the medication room, where they pray, but for any god/religion.  The children sang us a really nice welcome song when they met us.  They gave us cards and hugged us, and we got red and yellow dots on our heads and garlands. As I said, the kids in these shelter are extremely well-behaved. We also saw their garden, which was so beautiful. and sustainable! the water and fertilizer came from the building. And they plant their own food. I love the place. 

   We then got on the bus to go to the central/original Maher. But traffic got very congested.  Apparently today was one of 3 days in the year where the lowest caste can get on the government buses and ride for free. It’s a day where they rally for the political leaders who stand for them. It was quite chaotic. We took several hours to drive when it should only have taken 1.

   Sister Lucy came on the bus during this bad traffic. She is so motherly and divine and always smiling. When we finally got to Maher*, it was quite dark. but we got to meet the kids with the similar welcome song and ritual, and we shopped a bit for Maher items that the women made.  We ate a really nice dinner and Sister Lucy told us more about Maher. I really felt like I saw god in her. For some reason I expected her to be all-knowing like God. Also, we met this girl from Vermont who was volunteering. She’s the niece of one of the authors of the Maher book. I may consider doing that for a bit if I have time. She told us about how Maher made societal changes on different levels: grassroots and societal fundamental (by support groups in the community).

 *Maher is a shelter for destitute women and children. Many women run into marital issues, concerning not being able to fully pay dowry to her husband’s family, resulting in abuse and sometimes murder (being burned alive).  A catholic nun, Sister Lucy, founded Maher as an interfaith haven for these women to go to; the children also stay here too.  Women and children are eventually returned to society, some stay to be “mothers” in Maher, and are assigned 10-20 children to cook and care for.  :)

   I heard I had missed going to the slums. They’d also bought these sari bags from the slums, which apparently were a project that was hijacked from Darshan.  I’m not sure how it happened, but some company/organization he used to work for took his idea of having women make sari bags to recycle saris. Though they stamped their won name on them and then packaged them in plastic, which defeats the purpose of recycling. It’s unfortunate, and we shouldn’t have bought them.

   I learned that at Maher, there is no power on Thursdays, and this is part of a nation-wide power-sharing plan.  In other places, they may have power for 6 hours per day. I think it’s a good thing; it forces people to plan when to use the internet, when to do other things, which probably increases efficiency and productivity. 

———

DISCUSSION

Women in India suffer adverse consequences from the practice of the well-established dowry system.  Dowry is a payment agreement from the women’s family to her husband’s family upon marriage.  While originally were well-intentioned gifts, these payments have now become a burdensome tradition and have proven to have adverse consequences on women in Indian society. 

One consequence is the increased abortion of female fetuses.  Because a daughter’s only future is to be married, which carries with it a financial burden in the form of dowry, a family is discouraged from having female children.  Especially for a family with few financial assets, the woman is often abused by her husband for insufficient dowry.  To avoid this situation of violence and turmoil, the best option seems to terminate any pregnancy of a girl.  Also, sons in the family are more likely to benefit from the dowry system when they marry. Simply put, daughters are expenses, and sons are sources of income.

The situation may be exacerbated by a phenomenon known as hypergamy, where women of lower status marry men of higher status.  The incentive is that the woman is secured a better future, having been accepted by a family of high status.   However, these women are expected to pay greater dowry payments for this arrangement to be accepted by the higher status groom’s family.  Another strain caused by hypergamy is a higher number of lower class women competing for few high status men.  This competition further strengthens the importance of dowry by allowing it to play a role in mediating the competition. 

A study conducted in 1992-1993 from the National Family Health Survey in the province Bihar aimed to examine women’s approval of the dowry system. It was found that approval was not different among different castes. The amount of modernization (exposure to media and other cultures) women were exposed to correlated with decreased approval of dowry.  Surprisingly, the number of sons a woman has does not significantly increase her approval of dowry; however, the number of daughters a daughter has did decrease approval.  This suggests that dowry is more of a burden than an asset. 

Although dowry is deeply rooted in Indian culture, the high level of women’s disapproval of the system may be a foundation for change.  It is a possible role for the social worker to be the catalyst of this change, as society may be reasonably accepting of it.  However it is still important to maintain a level of and equanimity and perspective when approaching an intervention.

REFERENCES

http://www.jstor.org/stable/3600328

   I decided to take it easy this day and just stay in for the morning. After getting in the hotel past midnight after a 5-6 hour long drive (that was only supposed to take 3), I didn’t feel like doing anything.  I went to lunch with Sidd and someone who helps with some of his projects. He’s a professional deep sea diver!  We went to a nice restaurant and had thali, an assortment of with roti so you could dip it into different sauces/broths.  I still can’t bring myself to eat rice with my hands…

    I did a little shopping on the street markets around the hotel. I got 2 shirts. I barely bargained down any, though they weren’t that expensive.  

this is what it looks like outside the hotel

Later, I joined the group at Apala Ghar, an orphanage. It was really nice playing with the kids. The kids at these agencies are so well-behaved! I think American kids are a bit spoiled… The man took much difficulty in accepting our funds before we left! He was so humble.  We served dinner for the kids; it was the same style as we ate at lunch. The different parts of the dinner had to be served in a certain order.  It was nice to watch the kids eat. They said a prayer before that was saying thanks and praying for those who couldn’t have food.  We played games with the kids, then sat around the campfire until midnight and shook hands/hugged each other happy new year!!  It was really nice.  Ashley and I missed yoga the next morning accidentally.  We had poha (rice flakes) the next morning, which a lot of people haven’t really enjoyed much elsewhere, but it was great here.

———-

DISCUSSION

The 1974 National Policy for Children states that the nation’s children should grow up to be strong, healthy, and skilled in society.  The reality is that many children are unwanted and neglected.  Many children are left to wander the streets.

Over 100 million children live below the poverty line, over 1 million under 4 years of age die each year, and 90% of children suffer from malnutrition.  While Maharashtra is a more progressive state in India, it suffers the same issues. 

Most destitute children are found to be unwanted because of illegitimacy.  Unwanted children are mostly illegitimate children resulting from adultery or pregnancy outside of marriage (which oftentimes is a result of rape).  These mothers are often deserted by their husbands and families.  The government of Maharashtra offers some assistance to these women by providing shelter and support.  Most times, the mother files an affidavit, giving up rights over the child when the children are admitted to institutions.  Children who are not admitted to these institutions are often left on the streets; sometimes married life is resumed after an unwanted child is given to institutions or abandonned in public locations. 

Other times children are institutionalized as a result of a parent dying or deserting the family.  Most times, the one parent (typically the father) deserts the family, or abuses the family, driving them away.  The single parent is left to support the child with limited income and manpower. 

Unfortunately, Infant survival rates are estimated to be lower at institutions than in the general public.  Predictors of survival rates include medical problems, prematurity, and infection; also the biological and economic factors of the mother.  The high mortality rate for institutionalized infants may be a sign that institutional care cannot be an adequate substitute for maternal care. Findings also show that poor mental health correlates with parental deprivation. 

In India, adoption is not applicable to all; the Hindu Adoptions and Maintenance Act of 1956 alllows Hindus to adopt if he/she is mentally sound a, is over 18, and does not already have a Hindu child.  However, adoption is not socially acceptable in India and therefore is uncommon. 

The issue of destitute children is closely tied to the lower social status of women.  Their vulnerability and injustice ultimately leads to the institutionalization and poor outcomes of children.

    We did yoga in the morning before breakfast. Then we checked out of our hotel and got on the bus to Apne Aap Women’s Collective, where they housed children who were daughters of prostitutes. The manager told us that their original approach was to stop prostitution completely, which isn’t realistic enough to work. Then they offered things like condoms, healthcare, and bank accounts. and they take care of their children. I like the concept that being realistic would accomplish more. especially since they explained that condoms are important to avoid HIV, which would cause bad business. We played with the kids afterwards, which was nice.

   A lot of these agencies get funding from donations, no government funding. This may contribute to the development of the very important sense of community in India: The government is unlikely to support, so people rely on community.

   We learned that you can tell caste from surname and skin color, lighter being higher.

   We went to lunch at a pretty fancy restaurant (called “The Flute”)before heading to Mani Bhawan (Gandhi Memorial). WE met Gandhi’s great-grandson. He mentioned how corruption is two-sided — it takes 2 palms to clap — the citizen paying the police a bribe is just as corrupt as the police accepting the bribe. We got copies of Gandhi’s autobiography.

   Then, most people headed for the train to Pune, while a group of us went to Shraddha, a mental health institution. It was set up very differently from the US. They had patients behind gates, which opened into a courtyard. They had a live-in social worker for each quarter. People were rescued from the streets, rehabilitated, then brought back to their homes several years later. It’s too bad I was too tired to absorb most of it. Our driver who brought us there and then to our Pune hotel got REALLY lost and we had a huge language barrier, so there was much confusion and several hours’ delay. I’m glad we got to our hotel finally.

—

DISCUSSION

Despite the fact that India’s constitution prohibits discrimination, women’s rights are still unprotected.  The many Indian women in poverty who resort prostitution, are especially vulnerable to violence, high HIV infection, and poor access to health care.  Two common approaches exist to alleviate these issues have put legislation in place, though enforcement has yet to be developed. 

Women’s rights are unprotected despite the promises of the constitution, laws, and international agreements, because the country lacks sanctions against violations.  In fact, some violations are made by the police themselves, as confirmed by a report by Amnesty International in 1992.  This gives a glimpse of the corruption of the Indian legal system.  A major issue with the federal law enforcement is that India has a ratio of 10 judges per 1 million population, one of the lowest ratios in the world.  Illegal but unenforced practices creates the environment that encourages these practices to go underground, leading to the lack of access to health care, education, and other services.  It is therefore not surprising that women have significantly lower literacy rates and wages than men. 

While child prostitution is illegal in India, the business thrives and makes this population especially vulnerable to harassment and punishment by police.  An estimated 1/3 of all sex workers in India are child workers.  About half of brothel sex workers in Sangli district starting before 16, and an estimated 40% in Mumbai were abducted or sold by their families.  Unfortunately, many arrested women are later returned for payments.

Issues sex workers face include lack of access to health care, financial services, education.  HIV testing is recommended for sex workers; although women who are tested usually are not given choices of their health care or counseling on preventative methods.  This is an increasing issue with the AIDS/HIV epidemic.  The earnings of sex workers are normally returned to brothel owners sometimes at rates that are similar to slavery.  This perpetuates the poverty of the women’s households, many of whom entered the profession because of their impoverished status. 

The underdevelopment of human rights protection is ultimately responsible for the perpetual issue of sex trafficking.  This introduces a need for a social worker to intervene and offer the protection that the government is not able to offer.  Several challenges face the intervening party.  One approach is to remove the workers from their professions and offer alternative employment, marriage, or skill development.  This is based on the ethical perspective that sex trafficking is wrong; however, the partner issue is that efforts to stop sex trafficking are not likely to address the poor health situation of existing sex workers.  Based on the ethical standpoint that sex work is wrong, as the name suggests, the Immoral Trafficking (Prevention) Act of 1986 aims to use this method to rescue sex workers.  Another approach is altering or restricting the sex work by the brothels to legalize the process.  This method is less common but may be more realistic, as it offers some protection to the already existing workers.  The Contagious Diseases Act of 1864 mandated testing for STD’s and restricted the geographic locations of their work. 

The current corrupt status of the Indian government leaves women unprotected, with especially vulnerable populations being child sex workers.  Although legislation has been put in place for improvement of the situation, law enforcement is weak and an intervention is needed. 

   After breakfast, we went by bus to TISS (Tata Institute of Social Work). We had 3 lectures and lunch with some Social Work students. University classes are taught in English in India. Lectures were on social work issues, mental health, and women’s issues.

   Someone mentioned the issue of karma belief and their social standing: people may believe they deserve to be where they are, and it can be hard as social workers to intervene.

   *** I learned that in India, there is a strong sense of community. Friends eat off of each other’s plates freely without asking permission. Also, people are usually very connected with their families.

  *** We are constantly being served Chai tea and biscuits! I wish we had chai breaks between classes in the US!

   Mental illness was an interesting lecture for me. Many issues impede people from receiving mental health care. First there’ a stigma associated with people with mental illnesses (causing unwillingness to get diagnosed). Another issue is that some mental disorders are viewed as being possessed, and that is seen as a privilege, which discourages people from getting treatment.  Thirdly, treatment is usually delayed because people are not referred to mental health specialists until they’ve gone through many general practitioners.

    Health care is divided into: primary healthcare (reaches 50% of people), block healthcare, district healthcare, and tertiary healthcare. Only a few percent make it to tertiary healthcare. The issue exists that healthcare is not accessible to all, and there should be more integration between mental and primary healthcare. Interventions made should improve the living, learning, and working lives of people.

   Poverty and mental health perpetuate a vicious cycle. Also, the patriarchal society. A man living with his daughter to help take care of her sons is looked down upon. Oppression also may play a role in causing mental disorders.

   Many seek faith healers for treatment- along with conventional healthcare. Its goal is to change thinking patterns; however, in practice, that doesn’t always happen.

    One issue is that pharmacological intervention is costly, especially for the more effective drugs.

    Then we talked about women’s issues in India. in 1950, India was the first country to have a family planning program. Some issues are that new drug clinical trials are conducted in India (these aren’t necessarily safe), or that not enough trials have been done before people start using them.

   *she mentioned a movement called Pink Chaddi.

   Later, we bussed to Mewsic, Brett Lee foundation, founded by a cricket player. It’s a shelter for children from harmful homes or orphans.  They learn to sing, dance, and to play an instrument. They were pretty good; their voices projected really well. We interacted with them a little bit, but they don’t speak much English. It was such a cute place.

    After dinner, we met a Bollywood actress involved with social work, Gul Panag.  At first she asked us what social work in the US involved because it seems like we don’t have as many social issues from the Indian’s perspective. She told us about a networking site she helped set up that organizes events/fundraisers for people who want to do projects and people who want to volunteer.

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DISCUSSION

There are several elements of Indian culture and history that have contributed to the development of mass poverty and low social standing.  From an American perspective, the living conditions are unjust and filled with suffering.  It raises the question, how could this have developed and been sustained for so long?  Justification may be provided by the beliefs of Hindu society and the caste system, which are widely accepted and practiced in India’s diverse culture.

India’s history and development has been much influenced by the dominant Hindu religion.  While the country has undergone many changes since, many beliefs are still practiced.  The concept of karma, which suggests that the current situation of a life is a result of past lives and actions.  Not only can this justify a person’s poor social standing, but also deems it unalterable.  These beliefs allows for the sustenance of mass poverty.  Another Hindu belief is the goal to strive to be detached from other beings or materials.  This belief also also reinforces the inflexibility of socioeconomic stratification, as the more privileged citizens are less likely to reach out to the lower population.

The problem can be traced deeper than the religious or cultural beliefs.  The belief of karma justifies the caste system, an organized social stratification in India, which is deeply rooted in the Indian government and history.  Castes were groups that determined status and marriage.  People are assigned to castes by birth and not by achievement.  Certain interactions between castes are forbidden, such as sharing meals or marrying members of different castes. Despite the system being outlawed in 1950, many of its practices have remained, partially explained by the common beliefs.  Being born into a certain caste is explained by previous lives, and the dharma, or duty, of life is to accept this role.

While an American visitor will most likely be struck by such a phenomenon, it is important to be cognizant of its reasoning and origins while planning any interventions.

In a way, the caste system is comparable to racism in the United States.  Recognition in a caste is shaped by race and they are both systems of oppression.  Some time before Indian Independence, castes were being defined as Forward Castes (higher status and propertied communities) and Backward castes.  Eventually, the terminology “untouchability” was evolved to describe the depressed classes, when the castes were listed by the British for “special electoral representation in the Government of India Act, 1935.”  This shift in nomenclature caused some turbulence to the definitions, and some effort was put forth to define classes.  These discussions carried into post-Independence India, and the First Backward Classes Commissoin was assigned to further define “backwardness.”  In 1961, lists of backward communities were listed and state quotas were established. 

In the next few decades, several movements were made to rebel the caste system and untouchability.  Marxist and Communist parties were uprising, and a Marxist group called Dalit Panthers (inspired by the Black Panther movement in the US) formed to speak for the misrepresented lower classes.  About a decade later, The Bahujan Samaj Party was established with the objective of taking down the Brahmin hegemony that existed despite the quotas of various castes. In 1976, the Second Backward Classes Commission (“Mandal Commission”) reinforced the reservations for the misrepresented classes, raising the total percentage to almost 50%; this spurred a furious debate over the country over the reservations policies. 

It can be argued that the Hindu identity strengthens the caste system, and that the strengthening of Dalit identity is also an additive effect.

REFERENCES

Parth J. Shah. The Freeman. Ideas On Liberty. The Persistence of Poverty in India: Culture or System?  March 1998 • Vol. 48/Issue 3.  Accessed from: http://www.thefreemanonline.org/featured/the-persistence-of-poverty-in-india-culture-or-system/

     It’s 7:35am now according to my calculations; there’s no clock in this hotel. I just got to Mumbai last night. I was greeted cordially and got a red dot on my forehead and a garland of flowers with some snacks (pistachios) and water.  On our way to the hotel, I felt like everything I was seeing was very surreal. Run down buildings, abandoned construction, … basically the urban planning was just very haphazard. also, there weren’t lanes in the road, I noticed. We were just weaving through traffic and honking to communicate.

     Looking out the window with Ashley this morning, I saw a half-finished tall building beside some small dirty stores or homes. We noticed some people coming downstairs from the tall unfinished office building- did they live in there?! They were dressed pretty normally…

     It was such a sight to see!  We watched the people go about their normal life routines, gathering water from the well with some abandoned buckets, collecting firewood, cleansing the body with a rag, and using the bathroom in the corner of the room.  This was their lifestyle, and it seemed pretty comfortable to them!  We should be ashamed for having toilet paper!

     Our hotel is pretty nice and even has a TV in it (though turning it off was difficult to figure out). There is a shower and Western style toilet. I wasn’t sure if we had to just pour water on ourselves to bathe, like in Taiwan. The water doesn’t get very warm and there’s no internet. but it was fine, I don’t really need much, especially after reading all that happens to some people from that book: Women Healing Women.  My whole life is a blessing, I never really stopped to think about it.

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     We took a very crowded local train, separated by gender. Getting on the train involved a lot of pushing. We ate quickly at this cafe. Then we went to wait for the ferry to the Elephanta Caves. Meanwhile, some people took pictures of us; I suppose they were fascinated by how different we looked.  They were friendly.  The ferry was delayed (which is common for transportation in India) and took a really long time when we actually got on.

     As we were hiking on the Island, a monkey started chasing me- he was after my paper bag of garbage. He seemed disappointed to find that out. I had my first encounter in India with an Eastern toilet as we left the caves.

     I was so ridiculously tired. I fell asleep on the ferry a bit, and at the restaurant after eating (!) and in the cab back.  The restaurant was good - I got paneer tikka masala on Sidd’s recommendation, with rice and roti.

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DISCUSSION

    The most striking observation about this trip was the pronounced poverty.  The phenomenon of people living in abandoned buildings spoke for (1) the government’s lack of organization in urban planning (2) the impoverished conditions of the citizens (3) the natural way citizens organized their lives and adapted to the environment. 

     Clearly, the construction of the building abandoned for an extended amount of time to allow for the organized living system of its inhabitants. This fascinating initial observation introduces some key questions:

-How did this issue of widespread poverty develop?

-To what extent is this an issue in India?

-What kind of interventions can be made to address this problem?

     I want pause to comment on the issue of world view when it comes to social work and making interventions: It is always important as an international worker to keep a worldly perspective.  Many models of social intervention fail because they attempt to impose certain rules on a community to “fix” problems without first understanding the culture.  It may be natural for Americans to view a culture as wrong or dysfunctional simply because it does not match American standards. While familiarity with different countries can be an asset to an international worker, it also introduces the difficulty of maintaining a neutral perspective.