Voices of India - Kimberly Gilmour

Voices of India - Kimberly Gilmour

Dr Rupshri Baxi, Head of Health Unit, Seva Mandir

In response to slow and ineffective government initiatives aimed at tackling rural poverty, NGOs (Non-Governmental Organisations) have emerged as a major player in rural development in Rajasthan, northern India. Founded by Dr Mohan Singh Mehta in 1966, Seva Mandir has grown from a relatively small voluntary organisation which focused initially on tackling adult illiteracy to one of Udaipur's, and indeed, Rajasthan's, largest and most highly regarded NGOs.

Seva Mandir (or "Temple of Service") now works in over 500 villages in the Udaipur and Rajasamand districts of Rajasthan with the aim of bringing about sustainable change through strengthening the capabilities of rural people to become self reliant and take responsibility for their own development. With its headquarters located in Udaipur city, Seva Mandir employs over 300 full time workers and 1100 para-workers, who collectively address the issues of natural resource development, education, health, child development, gender equity, income generation and institution building.

Seva Mandir

Dr Rupshri Baxi is a well-established member of the Seva Mandir team and as the current director of the health unit at the Udaipur HQ, she has dedicated much of her professional life to working towards social change in her native India.

While she currently oversees all four main components of the Seva Mandir health program (Health Awareness, Maternal and Child Health, Research and Home-based Child Care), her primary interest and work area revolves around the training of Seva Mandir TBAs (Traditional Birth Assistants) as a means of reducing maternal and infant mortality throughout the villages in which Seva Mandir works.

Over copious amounts of chai and amid various lengthy interruptions (about what I'm not entirely sure as my Hindi is pretty diabolical at the best of times), I managed to quiz her about life and work at Seva Mandir…

How long have you been working in the health department at Seva Mandir?

Now, it has been 15 years, since 1992. Before coming to Seva Mandir I was a medical doctor. I did clinical work, here and abroad. I was approached by someone from Seva Mandir who told me to visit the organisation and see the work that was being done there. The first time I came, I met the president, he was in a meeting and I did not know how to approach him but when he heard I was here, he immediately came out to speak to me. He was the son of Seva Mandir's founder and, as such, I'd heard much about him. When we finally met I was impressed by his simplicity and devotion to helping the poor and deprived. Despite his own personal wealth he had dedicated his life to helping those rural people less fortunate than himself, and that really inspired me. He told me, if I liked what Seva Mandir was doing I could stay and work for them.

What made you want to work in development?

When I started my private practice in a rural village, before joining Seva Mandir, I used to see a lot of poverty. People were too poor to afford medicine so I used to give it to them, no charge. They would have just one crumpled note and I didn't like to take their money because I knew they couldn’t afford it. Then I saw a program on the television, it was on the voluntary sector, development work in the Udaipur area, I can’t remember if it was on Seva Mandir, it was a long time ago, but the area was the same, it gave me inspiration and I knew that's what I wanted to do.

When I first arrived, my thinking was different. I didn’t really understand what the health department was trying to do. They had this Traditional Birth Assistant (TBA) program, and I remember thinking, what is this TBA thing? I thought maybe it was a midwife or something (laughs). I started working on training these TBAs but back then family planning and such topics were very difficult to discuss. Nobody would speak openly about it. There were lots of challenges, how to change their attitudes and how to put knowledge in their heads.

So, when you started at Seva Mandir you were mostly working with TBAs?

Yes, on the maternal health program, because of my interest in women’s health issues. I gradually moved up to the position of head of health, which is what I am now, and I oversee all programs.

Do you feel the health department has made progress over the last fifteen years?

Yes, but there have also been many challenges. Of course health is such a difficult issue, there will always be problems but the main obstacles remains poverty and illiteracy; they are interconnected. But many things change; we’ve made much progress with the TBAs. When they first come for training sessions at Seva Mandir, someone accompanies them because many of them have never left their village so they find it very hard to come to the city. But, gradually, they become friendly with the other TBAs and after a while, they begin to come alone. It doesn’t sound much but that is a great thing. The training happens quite regularly because these women are illiterate so everything they learn they have to retain in their mind. Currently we have 362 trained TBAs. It has been very difficult to train them, illiteracy is endemic, even now many women do not send their children to school. To change their minds and their knowledge is very difficult.

Have you seen a reduction in maternal and infant mortality?

Of course, I can’t say numbers, but things are changing. The women are beginning to think about family planning, maternal care, contraception etc. The training sessions were dedicated to improving health education to promote safe motherhood and we discussed problems of nutrition, transport, medicine and equipment. As the needs of the people change so the training program must always be altered and adjusted. TBAs have become a big support to women, they are respected members of the community.

What do you personally find most rewarding about your work?

So many mothers die through lack of adequate treatment, for me, my work is worthwhile if someplace, somewhere we are able to save one mother. Of course so many mothers could be saved, just by training somebody in the proper way to care for them.

As a woman working in development, do you feel your gender has been an advantage or a hindrance?

For my work in maternal health, being a woman has obviously been advantageous, as I understand women's issues and can empathise with them. Due to cultural practices many women when they are pregnant are often stopped from eating certain foods, from leaving the house or even from attending various appointments with the TBAs. In my work now though, I see women's attitudes changing – they think of becoming not just birth attendants but nurses, they want to become teachers, they have more ambition. When their daughters become pregnant they do not stop them from leaving the house or other such things, their practices have changed because of what we teach them.

What part has religion played in your development work?

Religion plays an important role in village life and it’s important to believe in god but often, when people get sick they will go to traditional healers. In the areas where Seva Mandir works we tell the people they can believe in god but they can also take the patient to a doctor. We try to make them understand that the two things do not have to be separate.

What are the main problems facing India now?

Poverty, it is always poverty, illiteracy and a lack of services in the rural areas. Of course, there are many problems, especially in the rural villages, and everywhere is different, but these are the main issues which need to be overcome.

What role does the Indian government play in Seva Mandir's work?

With the government, it is all about trying to build a relationship, it is a never-ending task.

What can UK citizens do to help eradicate poverty in India?

Well, in the area in which I work we need skilled volunteers, health professionals who will give their time to us. We need to end the cycle of poverty in India, every issue is interconnected.

You've had lots of volunteers from all over the world come to Seva Mandir to work in the health department, in what ways have you seen them change and adapt during their time in India?

(laughs) They change completely…they become so friendly, just like a permanent member of staff. Of course, we learn a lot from them, they carry out studies and research of our programs, they bring new dimensions to our work, give us a new perspective.

In terms of your work in the health department, what are your hopes for the future?

My main hope, one thing that always comes to mind in reference to my work in particular, is that all over India, TBAs are not considered skilled workers because they have no professional training. But in the villages, medical professionals are not available twenty four hours a day, many of them have practices very far from the villages so it’s the TBAs who provide the long term support and who are always available to help.

They should have some recognition for the work that they do. They may not be professionals but they have a lot of practical experience and for that they should be recognised. It will take a long time to change these attitudes but this is what I hope.

Interview by Kimberly Gilmour

DiA India correspondent

For more information on Seva Mandir and its work, check out www.SevaMandir.org