I look across the clinic waiting room and watch the young mother. Her face is held in contempt, her eyes stare straight ahead and her lips are curled down and I can’t help but wonder what she’s thinking.
An hour before, while I was walking through the community, I noticed her youngest daughter wobbling after her older brother towards the school, barefoot and filthy, her stomach protruding prominently over her shorts. I stopped the ragged twosome and asked where their house was. Ashley and I went to their home and found out the family had only recently moved to the community in the past few weeks. This family’s story is a familiar one across India and our community. Meager earnings and six children leave the young mother over-burdened and unable to cope with the numerous medical ailments of the children and she has begun to turn a blind eye to the obvious health problems her youngest daughter faces.
I nudge Ashley and whisper to him to look at the mother and ask why he thinks she looks so angry with us? He’s uncertain as well and we think maybe it’s because she’s unsure of us and might be wondering if we are as well meaning as we say we are. A few more minutes go by but I can’t take it. I ask Ashley if he’ll sit beside her and ask her what’s going on and if she is still OK with us taking her children to the doctor?
Ashley gets up and quietly sits beside her and speaks to her. I watch as his face turns from concerned to frustrated and I fear what she has said. He puts his hand up in frustration and sits beside me. He tells me she wants to know why we are causing her trouble and why we can’t just leave her alone? I look down at her daughter who stands below me gently tugging at my leg hairs, her huge unblinking eyes are dark brown, nearly black. She is unaware of her problems and I’m saddened, not by her mother’s comment, but by the situation so many families find themselves in and the lack of knowledge they possess to pull themselves out. This mother, no doubt, came from a family just like her own, starved of nutrients during her early years which stunted her development both physically and mentally, setting in motion her current situation.
It seems everywhere I look since my return to Mumbai I see insatiable greed that is ruining the lives of those at the bottom of India’s economic pyramid. Money drives our world and in India’s boomtown, money means everything, including access to proper education and healthcare.
India’s Healthcare system is divided into two parts, municipal (government) or private. The private healthcare option ranges widely from the mildly affordable to the ridiculously posh with deluxe surgery suites. But the municipal level is even across the board with crumbling buildings, overworked doctors and packed, filthy corridors where the the sick come to get sicker. The cost of care is low for surgery and medicine at the government hospital but the chance of infection and long waits are guaranteed. India’s upper class often speak highly of these government hospitals speaking frankly, saying that these hospitals are there and free so why do the poor patients still want to come to the private hospitals? I have met with countless cases in Mumbai where adults and children have contracted HIV through blood work at municipal hospitals. (Read my blog post about our friend Ganesh’s final hours at Sion Municipal Hospital last year). I have had the opportunity to work helping poor patients in dozens of hospitals both private and municipal across this city and each time I am no less appalled and embarrassed for a city with immense wealth to house patients in crumbling buildings, with rusted bed tables and stained sheets. Two weeks ago, while funding an angiography for a DWP patient at a municipal hospital in Mumbai, I decided to attach my small Go Pro camera to my backpack as I wandered the halls hoping to show a glimpse of what India’s healthcare system looks like from the bottom up. Two hours later as we still struggled to get the appropriate forms filled to even gain admittance for our patient, I suddenly noticed I was surrounded by tan coloured uniforms and one angry hospital supervisor yelling at me in Marathi. The gig was up and I was quickly escorted out of the hospital for illegally filming and taken to the hospital police headquarters to meet the sergeant. Nervous and ever thankful that Ashley was with me to translate for me, we found ourselves sitting on metal chairs in a dimly lit and dank room. Behind the desk sat a young sergeant with a pleasant demeanor. He was told by his officers what I had been up too and gave me the opportunity to explain. Explaining that I only wished to document our patient’s procedure for our records, I apologized profusely while thinking how Ashley was going to break the news to my parents that I was now in jail?! After a few tense moments he looked at me and thanked me for helping his country and people. I was shocked and relieved and finally relaxed. He then went on to say that the healthcare system is terrible and sickly and the government does not want any filming or photos making it out of India or to the media. He was embarrassed for his country…but what to do he said??
The state of the healthcare system does not stop at the hospitals, but spreads deep into each community across the city in small decaying clinics and pharmacies. India’s drug market is also split in two, selling prescription drugs by “branded” (quality) or “generic” (low quality and sometimes completely fake). Prescriptions from government hospitals are often given using the generic names which sell for a fraction of the cost. A branded pack of pills will sell for 100 INR($2 CAD) where their generic counterpart will sell for 20 INR (.40 cents). This is great in theory because generic medicines are somewhat affordable for all sectors of society but…nothing is ever as it sounds. I have filled hundreds of prescriptions over the last few years and finding these generic drugs can sometimes be next to impossible. As a business pharmacies are not interested in selling drugs which are one quarter of the price, as they stand to make less money.
The next major problem in the system comes in the systemic abuse of antibiotics across the city. Small shops turned into “clinics” and “hospitals” hand out cheap antibiotics like candy to nearly every patient through their door. Just yesterday, an article in the Times of India wrote about all the new viruses including a new strain of drug resistant TB which antibiotics and the rampant abuse of them has surely caused. Every slum community has a small clinic nearby where the majority of people go because the cost of drugs is cheap. The clinic near our community is a ten minute walk away and deals with any type of case. Patients complaining of upset stomachs, diarrhea or with open wounds are all given the same generic blue or white pills which sit in the clinic’s only drawer in two separate containers, wrapped loosely in newspaper and cost 50 INR – $1 CAD. The antibiotics clear up the problem quickly, but not forever, and both patient and doctor are happy.
Malnutrition is so rampant throughout India (1 in every 3 malnourished children worldwide live in India) that it is believed to be double that of sub Saharan Africa where massive droughts and food shortages are abundant and pandemic. Yet, 48% of India’s children are malnourished, underweight, under height and developmentally challenged due to poor nutrition and hygiene habits where food is available and within reach for nearly all urban slum dwellers in the city. Perhaps the way to help this next generation of India’s poor is to educate their mothers about nutrition and hygiene, to ensure, despite their economic standing, the improvement of their children’s health and well-being as well as the need for birth control. With no money for birth control and no control over their own bodies, women must endure multiple pregnancies, miscarriages and the premature deaths of their children because of illness and abnormalities.
Eight months ago I briefly came into contact with relatively new NGO in India called the Foundation for Mother and Child Health (FMCH). FMCH has done extensive work through South East Asia and has expanded their field of help to Mumbai, India. I became immediately interested in their work and visited their clinic a few months ago and followed up, bringing several malnutrition cases from our community across the city to see their doctor (Dr. Rupal) and the team of health care providers. The thing that struck me is the care and passion they have to truly bring about change in these young families by nurturing the babies and teaching the mothers practical and useful knowledge. FMCH concentrates their efforts on children 0 – 6 yrs. old, holding daily clinics, cooking demos and awareness campaigns all geared towards the developing child and their mother.
Two days ago I sat in front of our school during our monthly health camp and watched as mother after mother with swinging babies on their hips and children in tow lined up to see a doctor and I realized that these young mothers need help and access to the knowledge to help their children, and not just another blue pill. A few hours later, I travelled across the city to FMCH’s offices in South Mumbai and met with their committee. In our meeting, we took turns discussing our work and what we both had to offer one another all in the hope of fighting the same battle. FMCH is currently looking to expand to other communities and I have pitched for that next community to be ours. This will be a big project and partnership, but one that can truly have a lasting and meaningful impact on hundreds of families and India’s next generation.
FMCH will be visiting our community in a few days to view first hand our centre and projects and with any luck to set in motion a health commitment to an entire community.
charity, child, children, Dirty Wall Project, donate, DWP, education, health, health camp, India, janvi trust, Kane Ryan, Malnutrition, mother, Mumbai, non-profit, Photography, saki naka, slum, travel, woman, women