What Not to Expect When You Are Expecting

Posted in Projects on January 18th, 2014 by admin
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January 2014

 

Indu and Agya  (by Cindy Ryan)

 

Indu, our friend and DWP employee, became a mother for the first time on July 2, 2013 in Mumbai, India.  Her beautiful daughter Agya was born prematurely (two months early) weighing just 1.75 kilograms (2.2 lbs.). Indu and I sat down one day and I peppered her with questions about what it was like to be pregnant with little to no pre-natal care and no family to nurture her through her pregnancy or see her though the birth process. Indu lives with her husband, Akhilesh (both in their 20′s) in a room in a chawl* neighbourhood in Marol, a suburb in the northern part of Mumbai, near Saki Naka. Akhilesh is learning to be a carpenter. The following is a Q & A about Indu’s journey to motherhood and the birth of Agya at K.E.M. Municipal Hospital in Mumbai.

When did you know you were pregnant? Did you have a test done? 

Indu: I was not feeling well so I bought a pregnancy test for 50 rupees (just under $1 CAD) to find out. The test said I was pregnant.

Did you go to a doctor after your took the pregnancy test?

Indu: After four months I went to a doctor.

Why did you go to the doctor after 4 months and not before?

Indu: If I want to have my baby in a hospital I have to register before the baby is born so that is why I finally went.

What happens at the hospital when you register? What is the process?

Indu: I registered at Marol Municipal Hospital because it is only 15 minute walk from my house. I lined up with at least a few hundred other pregnant women to register for the birth. They asked for my name and for my husband’s name. They asked if I have a bank account because after birth of a baby the government will give all mothers 600 rupees ($10.34 CAD) when their baby is three months old. I don’t have a bank account so I would have to go back to K.E.M. Hospital (where Agya was finally born) with photo ID and the baby’s birth papers to collect the money. The rickshaw money to go back to K.E.M. Hospital would be more than 600 rupees back and forth and I would have to line-up all day in very long lines while holding Agya to collect the 600 rupees. I have not gone.

How was your pregnancy? Did you feel healthy or were there problems?

Indu: Everything was normal. At four months pregnant I started going to Marol Hospital where I registered for a check-up. They weighed me and checked my blood pressure every time and felt my stomach and asked if I was having problems. It takes a whole day to wait in line-ups. Up to 70 women wait in line every day for a check-up. They gave me an injection and didn’t tell me what it was for. They didn’t give me any information about blood pressure or other issues to watch out for. The whole appointment takes about 5 minutes. They gave me pills the first time I went for my check-up. I didn’t know what they were for. After that I had to buy the pills for 425 rupees ($7.32 CAD) a month. They gave me a type of protein powder that I had to mix with milk and then drink.

Did they ever measure your stomach to see if the baby was growing?

Indu: No, they just felt my stomach each time.

What happened when you were in your seventh month of pregnancy?

Indu: I went to the hospital for my monthly check-up. The doctor looked at my file quickly, didn’t examine me physically and said everything was fine and I could go. Two days later I was getting ready to go to my job (Indu worked at an office job at the time) and I realized the baby hadn’t been moving. I waited for an hour and still felt no movement. I walked to Marol Hospital and told them. The nurse said it was normal, that babies sleep in the womb. I told them this not normal for me, that my baby moves all the time. A doctor gave me an internal physical check-up and said everything was fine, but if I was worried I should go to a clinic and have a sonogram. I left the hospital and walked about 40 minutes to Saki Naka to get a sonogram. I waited two hours for the results and was in some pain after the physical exam at the hospital. Then I walked back (40 minutes) to show my sonogram to the doctor at Marol Hospital. The doctor said the sonogram was fine. I still hadn’t felt the baby move. They said I could be admitted to hospital if I wanted. I said no because the doctor told me everything was fine so I went back to work. (My husband was not working at this time because he had a broken his hand, so we needed the money). I walked home after work to tried to relax and I started having pains about every 5 minutes. My back started to have pain. I ate some food and tried to sleep.

Walking anywhere in Mumbai is a test of agility and nerves. Chaotic traffic, no footpaths, crumbling pavement, open sewers, food vendors, chunks of cement to step over, muck and mud, buses belching purple exhaust and motorcyclists driving the wrong way make walking anywhere a test of agility and nerves. Crossing the roadways puts faith into perspective.

Did you think you were in labour even though the doctor said everything was fine?

Indu: I wasn’t sure but I was worried. After about an hour (at around 2 am) my water broke and I told my husband to get up. I tried calling a taxi to take me to the hospital. I knew I was in labour. No one answered my calls so my husband and I walked to the hospital. There was no doctor at the hospital. The nurses checked me and my water was still coming out. They said they didn’t have an incubator and because I was only seven months pregnant they wouldn’t admit me because they knew there might be complications with the baby.

You were having labour pains, your water had broke and they turned you away without a way to get to another hospital. What did you do next?

Indu: The nurse gave me the names of three different hospitals to try. I left Marol Hospital with my water still coming out and my husband and I walked home and then called a taxi which took twenty minutes to arrive. My husband, a neighbour and one of the people I worked with came with us and we went to Sion Hospital, the first hospital on the list the nurse gave me. The trip took one hour. When I got there I was directed to different buildings by different people and we wandered between them to find someone to help me. When I found someone to finally help me, I was told the maternity ward was full. Then I went to J.J. Hospital by taxi (another half-hour). I am in labour and in much pain. At J.J. Hospital, two doctors were there. They had to consult with a surgeon. They called the surgeon and waited for a return call. There was no call back. I had waited another hour at this hospital and then they said I couldn’t give birth there because they also didn’t have an incubator. Then we got back in the taxi (who waited for us) and went to K.E.M. Hospital. When we arrived there we searched many buildings to find where to go. A nurse finally checked me and said the baby’s birth would be very soon. I waited about half-an-hour until they admitted me and my husband had to sign paperwork before they would do anything. Three or four other women were also giving birth in a large room with 5 or 6 doctors in attendance. The air-conditioning was on and I was very cold. They gave me two pills without telling me what the pills were for. I was shivering. I couldn’t straighten my leg for some reason. I had five or six labour pains and finally the doctors snipped me and my baby girl was finally delivered at 7 am. They showed me my baby. They stitched me up without anesthetic which took about fifteen minutes. A half-hour later I was taken to a ward. They asked if I could walk to the ward. When I said no, they gave me a wheel chair. They took my baby to PICU (paediatric intensive care unit) in an incubator. We were both labelled. I slept until 10 am until someone woke me to tell me my baby was crying. I went to PICU and she was in the incubator. She weighed 1.75 kg. They checked her over and gave her a whole body x-ray, took blood samples and told me she was healthy. They gave her an injection when she was born, but didn’t tell me what it was for. For the next five days I slept in a chair beside Agya’s incubator, afraid that no one would call me if she cried. The doctor gave me some milk and I spoon-fed her. After two days I extracted milk from my breast and spoon-fed her that. Everyday they checked her weight.  Once she could suck properly I breast-fed her. After five days the doctor declared Agya was fine to leave the PICU and she came to the ward with me. The doctors gave me pills twice a day for blood pressure. I was told my blood pressure was very high and that’s why I gave birth early. The doctors are so busy with hundreds of patients that each patient gets very little time and attention. The doctor who looked after me was very nice and caring. Her name was Tejhashree.

When you were in labour how did your husband react. 

Indu: He was very scared for me and also worried that the neighbours and our relatives would blame him for any problems if the baby died. He always took good care of me. My husband spent four days coming and going to the hospital and made me food to eat.

How many beds were in your room on the ward? 

Indu: About 100 beds full with new mothers.

We have spent time with patients at BMC hospitals and noticed the beds are rusted and the sheets are stained and often ripped, sometimes actually in shreds. Was this what the ward was like at Kem Hospital?

Indu: Yes, my bed had stained, dirty sheets.

How many babies were in ICU when Agya was there?

Indu: About 30.

When you are a patient in a BMC hospital do they feed you?

Indu: They do give some food. Not tasty or nutritious, but it was food. The dal was very watery. They did give milk. My husband brought me food to eat.

What were the total hospital fees to have your baby?

Indu: 700 rupees ($12 CAD) for blood tests. 500 rupees ($8.62 CAD) charged for a woman to clean up the afterbirth. I had to buy pampers and medicine during the hospital stay. The total cost for the birth was about 4000 rupees ($69 CAD).  We also donated a small amount of rupees for a kit (baby socks, pampers and a bowl and spoon for feeding babies milk) for mother’s who can’t afford to buy their babies basic items.  We took a taxi home from the hospital after the birth which cost 450 rupees ($7.75 CAD).

When you got home were you confident about how to care for the baby?

Indu: No, I was worried because she was so small. The nurses at the hospital gave me some instructions about how to care for the babyI didn’t sleep for the first three months because she cried so much.

What are normal baby care rituals each day for mothers in your community?

Indu: Some people have a bai who comes every day to massage the baby with mustard oil and then bathe the baby. After the massage and the bath, the husk of a coconut is burned and then garlic husk and some kind of seed is sprinkled onto the smoking coconut husk. The naked baby is flipped and turned upside down over the smoke for about ten minutes. Then the baby is wrapped tightly in a blanket and sleeps for about 3 hours. The reason to put the baby into the smoke is it is believed to keep the baby from getting colds and from getting ill. This massage, bath and burning coconut ritual happens every day for at least one month or whatever the mother can afford. The bai charges 1500 rupees ($26 CAD) per month. The bai will also give the mother a complete body massage/coconut smoke ritual and bath. For that service she charges 2000 rupees ($35 CAD). Black bracelets or white plastic bracelets are put on the baby’s wrists for protection. Metal bracelets woven with seven strands of different metal (copper, silver, brass) are also worn by the baby for protection. Agya is wearing one thin white plastic bracelet on each arm. I put a disposable diaper on Agya when I go out for all day, but usually only use one a day. When we are at home she doesn’t wear diapers.

Children in slum communities defecate on the street or in lane ways and are often unclothed from the waste down until they are old enough to make the trek to the public toilet (shared among hundreds) themselves.

What rituals do you perform on Agya every day?

Indu: Everyday I dip my finger in kajal (black powder mixed with mustard oil) and press my finger in the space just above her her nose between her eyes (giving her a third eye) for protection against bad spirits and evil people. I also line Agya’s eyes in kajal. This keeps the dust out of her eyes and helps her eyes grow bigger. I dot the bottom of each foot as well.  After I bathe her I put baby powder on her body and face and mustard oil on her head. At night I give Agya a massage with mustard oil. Mustard oil rubbed on the baby’s skin is good for bones.

Do you take Agya for regular check-ups?

Indu: Municipal (BMC) hospitals ask mothers to bring their babies for monthly check-ups but I can’t afford to go because of the cost of transportation (250 rupees ($4.30 CAD). I take her back to K.E.M. Hospital for immunizations and I can also take her to immunization clinics in my neighbourhood.

I accompanied Indu to K.E.M Hospital for Agya’s first immunization shots. We waited a very long time in a very long line-up. We were finally shown into a room. There were numerous medical staff sitting around a broken wooden table. One man was removing pills with his bare hands out of large white plastic container and wrapping two pills in small packets made out of scrap paper. Agya was laid on a gurney covered in grimy vinyl with no barrier between her and the vinyl. A nurse (without gloves) injected her with the immunization and Agya was picked up by Indu and another baby took her place on the vinyl gurney. The vinyl was never cleaned between babies. Indu was handed a packet of pills and instructed to give them to Agya for pain. No instructions were given about how one would give a tiny baby a pill. As for Agya’s monthly check-ups, DWP pays the transportation cost (1000 rupees ($17 CAD)) for Indu to go to take Agya to The Foundation for Mother/Child Health clinic. We try to have up to two other mothers and children join us for the monthly trip (which takes almost two hours by taxi to get there in Mumbai traffic) provided the mothers agree to continue to attend the clinic every month. This foundation provides the best possible care for babies with personal one-on-one sessions with doctors, health-care workers and nutritionists. They require children come on a monthly basis so they can track their growth. The children are measured, weighed and excellent records are kept giving the staff at the foundation the necessary information to assess what the mother needs to do to prevent malnutrition in her child before it stunts the child’s growth and intellect. Besides great advice in a loving environment the clinic provides free supplements and protein snacks to the parents to give to their children. Most children who live in slum communities or come from poor families are malnourished and have many other health problems due to low birth weight, overcrowded living conditions and poor hygiene. The doctors at the clinic are always excited by Agya’s weight gain and overall healthy progress.

How does the community participate in a new baby’s life?

Indu: When a friend or family member sees the baby for the first time they are expected to give a gift of money or clothing. Babies are named when they are 12 days old.  A naming celebration might happen if the parents can afford to have a party. The baby’s name is chosen by the parents or the grandparents. At a naming celebration there is music, dancing, food and gifts. The guests attending the celebration bring money or silver bracelets or anklets and put the gift on the baby’s blanket.

Are boy babies more celebrated than girl babies.

Indu: No. Everyone loves new babies.

Although all babies are adored by the community and the parents, female babies are a cause for concern especially amongst the poor. Boys don’t require a dowry payment and their duty is to their parents. They will live with the parents and take care of them in old age. A girl (though loved) will cost the family a dowry and she will go to live with her in-laws once she is married providing no money or care to her parents. There is a saying in India that having a girl is like watering someone else’s garden. In Mumbai it is illegal to determine the sex of a fetus. Every hospital and clinic posts signage in Hindi, Marathi and English outlining this law. Some pregnant women from slum communities go back to their native village to end their pregnancies if they are worried about whether they can afford to have a girl. No paperwork is required and the fetus is disposed of. 

Many babies in chawls or slum communities are born at home. Do you think it is important to give birth in a hospital?

Indu: Yes, because babies born at home usually don’t get identification or birth records.

Many people in slum communities don’t have birth certificates and do not know their own age or the age of some of their children. Illiteracy is high amongst the parents and they don’t recognize the need for paperwork despite the problems they have faced by not having identification.

Do husbands take part in the daily care of their babies?

Indu: My husband will hold Agya when he is at home, but he doesn’t bathe her, change her, or feed her.

Most fathers here don’t take part in the daily care of their children. Many women of certain castes don’t ever speak their husband’s names. Indu calls her husband, “Agya’s father”. When we asked her why, she said it would be very disrespectful of her to call him by his name. 

Are Agya’s grandparents involved with her care?:

Indu: My father and my brother have never met Agya. They are angry that I have a love marriage.  At first my father and brother approved of my marriage but after I was married they refused to see me.They have only met my husband, Akhilesh, once. (Indu’s mother is deceased). My father-in-law lives in Kandivili (one-and-a-half hours by bus). He loves Agya and sees her when he can.  If a family lives with the grandparents, the grandparents have the power in the relationship. The parents must obey what they say regarding school, discipline and sometimes baby naming.

 

Indu, with Agya bundled in her arms, accompanies us where ever we go day or night, six days a week, which includes slum homes, hospitals, clinics, schools and shops, helping us with translation and cultural issues and decision making on behalf of DWP.  She often breastfeeds, expertly covering herself with a dupatta (scarf) while walking through rubble, loose electrical wires, broken cement and insane vehicle traffic. We spend hours in small homes sitting cross-legged on floors or in rickshaws transversing the city to meet people who require assistance from DWP.  Agya loves being on the move in rickshaws, is always the centre of attention for us and for the children and parents we visit.  Indu leaves her home every day with nothing but Agya wearing a tiny dress, a disposable diaper and a bonnet, bundled in a small blanket. There is no baby bag packed with extra clothing or diapers or toys and astonishingly, Agya doesn’t need any of that stuff. She is content, happy, nourished and loved. She has gained weight steadily, is very healthy and active and obviously bright. With enormous amounts of love and attention from Indu and Akilesh (and us), Agya has flourished. She is 6 months old and she weighs almost 5 kilograms (11 lbs.). She is a beautiful child coveted by two loving parents who will strive to keep her nourished and educated enabling Agya to gain access to the “new India” that promises her so much more than her parents can imagine.

 *Chawls are one to four storey blocks of homes – a home being one or two rooms maximum usually shared by numerous people in an extended family. Chawls are legal residences in Mumbai.

 

 

 

 

 

 

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5 Women & a Baby

Posted in News on September 24th, 2012 by admin
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Written by Cindy Ryan

 

Maya is so tiny. Still under 80 pounds and she is six months pregnant with her fourth child. But there has been progress (She has gained almost 20 lbs in the last 7 weeks) and the sustained hope that with four women watching over her she will deliver a healthy child from a healthy body.

For a poor woman in Mumbai to deliver a baby in hospital and receive a modicum of care, she must register with a municipal hospital. This will ensure her baby has a record of birth, the first step in being counted. Maya, in her early twenties, and already a mother to three children, is one of millions of poor women, pregnant, malnourished and frail who must rely on inadequate maternity care at a municipal hospital or remain at home foregoing any prenatal care.

Maya’s home is a tiny cement box just off the lane way, near the bridge where the traffic flows day and night and the bad kids from the slum gather to lounge, spit, and pass time. Standing in her home I have to be mindful of the fan just above my head. Maya turned it off and giggled as she rummaged through the plastic bags hanging on nails, looking for her past medical records. Her husband, Pramod, sat slumped against the wall, sleepy from a night of work at a powder coating company. He made a comment in Hindi to Maya and her eyes glossed over with tears and her face became tight. Reluctantly, Maya left her home with me to go to a municipal hospital to register and get the first check-up for her pregnancy. Once in a rickshaw, Maya let the tears flow and I anxiously asked Indu, who was accompanying us, to ask what was upsetting her. Maya told Indu that her husband told her she was to return home within two hours or she should not come back. Hoping this was just a sleep-deprived man talking nonsense, we continued on our journey to the hospital.

We arrived at the hospital and took our place in a line-up outside in a cement courtyard to wait over an hour for a clerk to open a window to process maternity patients for one hour only. There were at least 80 women in front of us, and soon, over 100 women behind us.  Maya perched on a ledge wet with spongy green moss while Indu and I kept our place in the line. The women waited, tolerant and patient. The hems of their sari’s wafted in strong breezes, fluttering and falling with each gust of wind that suddenly came and went. There were burka-clad women chatting in tight groups and women sitting cross-legged on the ground continuously wrapping the end of their sari’s over their heads for shade.  A few husbands littered the crowd. I was envious for Maya that some of these women had husbands by their sides.  When the rain started, the chatter became more animated, and the wait became more frustrating.

Once inside the hospital, Maya was separated from Indu and me, and made her way upstairs to sit in rows of a few hundred pregnant women for her turn to be weighed, measured, have her blood tested, talk to a doctor, and then return downstairs for a tetanus shot and supplements which, in Maya’s case they were out of. This was a four hour process. Indu and I took turns sneaking up the stairway to peer in at the waiting women, trying to spot Maya in the crowd, trying to determine when it would be her turn. The public area of the hospital has two benches for hundreds of people coming and going, waiting and worrying. We eyed the benches, waiting for a turn to sit if only for a few minutes.

Municipal hospitals are for the poor and are run by the government. The services provided are barely adequate and anyone who could afford to go elsewhere would not enter this place. The interior of this hospital had moldy, smeared walls and large rooms with numerous beds and no privacy. Rusted iron tables sat beside sagging iron beds covered with dirty pink pieces of rubber laid over stained sheets. The staff seem burdened and sluggish. The cleaners mopped lazily over large swaths of floor, moving dirt around in concentric circles.

For the poor, the alternative to having their baby in a municipal hospital is to have a home birth. Maya, who is from Nepal, had her first daughter, Suman who is now six, in a field in a remote village where she lived.  Her second child, Prem, now four years old, came suddenly while Maya was in her home. Her third child, Nandini, was born in a hospital in Mumbai, just over a year ago. Maya and the many poor, pregnant women like her, need much more care than what a municipal hospital can provide. Thankfully, Mumbai has a Foundation for Mother and Child Health clinic (www.fmch-india.org) which provide mothers free information on nutrition, health care, hygiene, as well as necessary supplements and personal attention from Dr. Rupal Dalal and her team of social workers and nutritionists. When we first took Maya and her children to Dr. Rupal a few months ago, she weighed 70 pounds at four months pregnant. Suman and Nandini were malnourished and Prem had calcium deficiencies. Watching Dr. Rupal handle her caseload of women and children is inspiring. A pediatrician and a mother, Dr. Rupal is devoted and dedicated to their care. She requires the women to be pro-active with the health of their children and themselves and to visit the clinic on a regular basis. It is a struggle to keep these women, many of whom are illiterate and abused by husbands, to maintain the regimen Dr. Rupal and her team aim for, but the success stories, of which there are many, are worth the fight. Months ago, we took a family of six kids to Dr. Rupal, all of them malnourished, and they are now healthy, active and energetic.

Since our departure from Mumbai in August, we have enlisted the help of two wonderful women (Jaita Guhu and Aarti Kalro) who had volunteered with DWP in the Saki Naka community, to ensure that Maya and her family continue to get the care they need to become healthy. Jaita and Aarti have kept Maya and her children on task with supplements, hospital visits and visits to the Foundation for Mother and Child Health. This is no small favour. Maya can’t manage any of these trips on her own and her husband has so far not accompanied her, so Jaita and Aarti must take hours out of their day to ferry her back and forth through the thick of Mumbai traffic to ensure she gets to the clinic and the hospital. Because Maya can’t read, they must also help her to understand instructions for medication and supplements. Her health and the health of her children count on them.

Aarti and Jaita report that both Nandini and Prem are now healthy and Suman is progressing, but not quite there yet. Maya is now almost 90 pounds at 6 months pregnant, but still needs more nutrient rich food in her diet. Dr. Rupal gave Maya some food bars containing essential nutrients as well as some health bars for the children. She has instructed Maya to include eggs three times a week in all their diets. Aarti is suggesting that she take Maya to register at a municipal hospital much closer to the community which will make it easier to get to when the time comes for Maya to give birth.

With the expert care, and loving attention that Maya and her children are receiving from all of these selfless women, we are hopeful that she delivers a healthy baby while improving her own fragile health. The problem Maya and most poor women in India face is the lack of knowledge regarding basic nutrition and the lack of quantity and quality of food they can afford. One out of every three malnourished children in the world live in India. Many kids in the slum live on glucose based biscuits, sugary tea, watery dal and white rice. As Dr. Rupal has pointed out to me, malnourished kids have stunted growth, lower IQ’s, and higher rates of infectious diseases. Cramped living conditions, open sewers, and not boiling drinking water leaves them at risk for constant illnesses. The Foundation for Mother and Child Health (FMCH) is taking the necessary steps to educate those who come to their clinics. Kane and I met with Dottie Wagle, the Chairperson of the India Branch of FMCH. In our short meeting we understood how determined she is to continue this initiative in other areas in Mumbai, making this amazing, free service for the poor accessible to more communities throughout Mumbai.

We are hoping that Maya and her young family can be the example of what quality care, education and a community of caring women can do for the poor, the illiterate and the abused. Maya is becoming less shy and more capable and is already showing signs of a take-charge attitude to her children’s health-care. This is progress. We had a chance to talk to Maya, Suman and Prem on the phone while they were with Jaita a few days ago. Though the conversation is limited to the little Hindi we could understand, it was great to hear Suman’s raspy voice and Prem’s constant chatter. And sweet Maya was as happy to hear our voices as we were to hear hers.

 

 

 

 

 

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To be loved…

Posted in Projects on January 22nd, 2012 by admin
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Over the coming weeks we will be interviewing every woman working for GCB/DWP and bringing you their stories.

 

Tears roll down Maya’s cheek as she brings her orange dupatta to her face and dabs at her eye. Her cheek quivers as she stares down at the tray of fruit sitting on her lap. When she looks up, our eyes connect. I place my hand on her knee and tell her that we don’t have to do this. A small smile crosses her face and she gestures for us to continue.

Since DWP opened the newest initiative called “Girls Can Be” we have been able to hire 6 full-time staff from the community. One of these women is Maya. I first met Maya two years ago (http://dirtywallproject.com/blog/?p=1383) in a chance encounter as I was leaving the community for the day. Since that day, I have watched as her two oldest children walked in to a school for the first time and was there for the birth of her youngest daughter, Nandini. Maya has packed a lot into her first 21 years on earth and for the first time in her life someone asked her to tell her story.

Maya was born in a small village in the far western reaches of Nepal in a district called Baitadi.  Maya’s life was tough from the beginning; her first month marred by tragedy when her parents both died of TB when she was only one month old. Maya’s older sister cared for her when the two sisters and brother moved into a relative’s home.  During our talk we learned very little about her early childhood years except that she remembers spending two days in school and liking it, but it’s a fleeting memory.  We picked up her story again when she turned 15. A beautiful young girl with no parents and a sister who was now dying from TB, Maya had few options so her sister did what she thought was right and arranged Maya’s marriage, hoping that it would ensure Maya’s safety and provide for Maya the possibilities she never had.

Living an equally tough life a few villages away was a young man named Pramad. Pramad’s father died when he was very young and a relative then sold him to someone else as a labourer . Pramad worked his childhood years until he saved up enough money to run away. As a young man he worked odd jobs before he began his search for a wife. Through family connections he met Maya’s older sister who was desperately looking for a husband for her. A deal was made and shortly after Maya turned 15 a small ceremony took place in her village; Maya’s beautiful face hidden under a veil looking towards an uncertain future with a man she had just met. A relative of Pramad’s urged him not marry Maya stating that she was not good enough for him or pretty enough.

A few months after her marriage Maya became pregnant. Not quite 16 years old and nine months pregnant, she was out collecting cow dung for her cooking fire near her home when she felt severe pain and collapsed. She remained unconscious during the birth and woke to find local village women tending to her newborn daughter. Remarkably, both mother and child were happy and healthy and Maya and Pramad named their first daughter “Sumitra” which means “good friend”.

A year after Sumitra’s (Suman) birth, Pramad’s relatives kicked the young family out of the shared home. Pramad (24 years old) and Maya (16 years old) packed their meagre possessions on their backs, including their curious one year old Suman, her head covered in a small Nepalese toque, and set out towards a new beginning. They walked for one full night and one full day before they reached a larger town where Pramad purchased two one way train tickets to Mumbai, India.

A few days later the tired young family arrived in the “Mega City” seemingly worlds away from the tiny village where they had spent their young lives. Their only connection in Mumbai was a distant relative living in a slum community in Saki Naka where they lived until they found a place of their own. Over the last few years they have moved several times, twice since I have met them.  With a small tin shack to call their own, Pramad set off to find work leaving a newly pregnant wife and young daughter Suman at home. He found work in a factory and over the last few years learned the trade of powder coating and continues to work there today, earning around 5000 INR – $104.16 CDN per month.

With Suman nearly 2 years old, Maya was due to give birth any day with their second child. Throughout her pregnancy Maya didn’t receive pre-natal care even though hospitals and clinics were within walking distance of the slum. Her second birthing experience was no less dramatic than Suman’s birth in Nepal. Home alone once again, she felt a sharp pain and realized quickly that the baby was getting close. She climbed down the rickety wooden ladder to the tap below and began washing her face and was about to call her husband. (During this part of our conversation Maya became very animated and laughed as she told the story). Still standing over the tap, she heard the small cry of a child and looked down. Without so much of a warning or much pain at all, the newest addition to her family was poking his head out of the bottom of her loose pants. She let out a small scream to alert her neighbours and sat below her tap with her newborn son wrapped in her clothing. (Maya laughed loudly as she explained the story and said she literally felt no pain when he was born.) Neighbours arrived and helped cut the cord freeing her son. The birth of a son is a joyous occasion for most Indian/Nepalese families and they decided to name their new son “Prem” which means “love”. Prem’s interesting birth experience may explain his fear of heights and swings.

Mumbai, the city of dreams, draws thousands of rural Nepali villagers every year to the already overcrowded streets with rumours of well paying jobs, hospitals and schools. These rumours travel on the backs of distant relatives and friends who send back stories of their success, whether true or not, luring families with bright hopes and dreams. Mumbai has an altogether different reality and the dreams are available for the relatively lucky ones. With a population of nearly 20 million people, over half of the city live in slum communities made up of rural villagers from India and Nepal.

Pramad and Maya soon realized that life in the big city was never going to be easy with two mouths to feed, rent and bills to pay. Tension grew in the small home spilling over into physical and emotional abuse with the blows landing hard on a frightened Maya. As tensions grew, so did the violence in the home with the realization that Maya was pregnant once again.  Suman and Prem were also very sick, weak from malnutrition, worms and overall bad health. Maya attempted to borrow money from neighbours but with no luck. The children were taken to small clinics but when the prescriptions came Maya’s husband ripped them up because they didn’t have the money to fill them.

This first time I met Maya, she was five months pregnant with two very sick children in her arms. She barely looked me in the eyes as Ashley and I asked her questions about her children and their health. The next day we took Maya and her children to a hospital and found out just how sick they were. We also learned that Maya had ingested a small amount of poison in an attempt  to abort her third child. The doctor prescribed supplements, de-worming medications and a new diet for the children which DWP supports financially.  An ultra sound  gave us the good news that Maya’s unborn baby appeared healthy. Maya was given a choice by the doctor to abort this 5 month old fetus and she quietly refused.  Over the next few months, my mom, Ashley and I visited with the family daily and started to see signs of improvement in the children. Their eyes became less glazed over and even brimmed with excitement from time to time and we were excited to see them slightly rambunctious. Just under a year ago, Maya gave birth to the worlds most precious and beautiful baby girl. (Those of you who have had the opportunity to visit DWP here in Mumbai, can back me up on this.)  Little Nandini was born in a hospital and is the first person in the family to have a birth record. The last year has seen tremendous change in the kids. Both Suman and Prem are now enrolled in our free Kindergarten School and while Suman is attentive and eager to learn, Prem, although bright and energetic, is more interested in his toes, but he likes his uniform. The kids laugh easily, their good health allowing them excess energy to burn. All about mischief, they are adept at hiding, playing and initiating a chase. Suman is often seen lugging a smiling, teething, Nandini on her hip searching the laneway for someone to play with.

Dirty Wall Project has been involved with this family for almost two years, supporting them financially and emotionally.  Keeping them in this community where the kids are safe, doing well in school and loved by many has resulted in DWP paying the rent on their slum home when they were about to be evicted and continuing to support them by paying milk bill. Maya is now employed by DWP to buy, cut and serve fruit to the children in the community and spends part of her day with the women in the GCB centre where she is valued as a contributing member of the community as well as taking part in the chatter of many exuberant women. She provides an example to her children when she attends the English literacy class, notebook and pencil in hand. While it is her nature to be shy, Maya laughs easily when with people she knows and we have noticed she has a ‘voice’ and uses it to protect her children or make a point. Maya has come a long way and just like her children she has found some reasons to smile.

When our conversation turned to her future, Maya looked down and away and with barely an expression, she told us her fears include her husband’s wish to take her and the children back to the village in Nepal where he will leave them and return to Mumbai to work. With a voice neither shrill or sad, she said her husband wishes she was beautiful, that he finds her ugly and he deserves better. He slaps her face to make his point. She worries his future plan may include a marriage to someone else whereupon he will return to Nepal to take the children from her. DWP will endeavour to remain a part of Maya’s life, to do our best to help her keep the family healthy and safe, but this will take educating Maya about how to contact us by mail or telephone. We discussed how we would need to be able to contact her and she seemed both overjoyed and overwhelmed by the task and the instructions we would have to give her. This will be a daunting task for her, but one we hope she will conquer so that we can continue to support her and her children. It may take (literally) climbing mountains in Nepal to find them. Maya and the children feel like family and not a day goes by without us spending a huge chunk of time with all of them. Moving mountains will seem like a small task to keep them safe. Maya may have lost one part of her family in Nepal but she has gained one more in all of us.

As we wound down the conversation, we asked Maya what she would like for her children’s future. She replied, “I want them to go to school.” When asked what would make her happy, Maya replied, “To be loved”. 

Sincerely,

Kane Ryan

 

 

 

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