Once an adversary of the immunization programme

Written by Sujata Shirke
Translated by Alka Gadgil

Bhiwandi, March 17, 2020

As one enters Bhiwandi, largely impoverished loom town outside Mumbai in Thane district, one can’t miss the rows of shanties on both sides of the dark and extremely narrow alleys which double up as overpass for the drains. You have to tread with caution in these gullies as the paths are broken in many places creating ditches with overflowing sewage water. As it is ruptured in parts, one has to step on to a side to avoid falling into the ditch. That way you literally land on to someone’s doorstep.

Little ahead you see children defecating in the open; women are washing clothes and utensils at their door-step. The houses on these crowded and dark lanes have no ventilation or sanitation to mention. It is easier to get Tuberculosis (TB) if you have little or no heating and if you are living in damp, dark or dusty conditions without windows.

The living condition of Bhiwandi is consuming its women, children and adolescent girls, taking a toll on their health and wellbeing.

In Gayatri Nagar’s several lanes and by lanes, the air is filled with the deafening sound of the power looms. Minute ahead is the Anganwadi Centre (AWC) donning colourful posters and banners of Poshan Pakhwada Campaign. Asmita Zende, the Anganwadi Worker (AWW) of the Gayatri Nagar AWC greets me.

The AWWs do formidable work but the community gets a glimpse of their passion and commitment during the Poshan Fortnight which is celebrated publicly.

Besides Zende and her assistant Savita Koli there’s no one in the AWC. ‘We have been asked to stall our programmes. All the preparations that we made to celebrate the Poshan Fortnight have been rendered meaningless. Covid19 outbreak has put a stop to the functions and gatherings including Poshan Fortnight Celebrations. However, we have been asked to deliver the midday meal to the children at their door-step,’ shares Zende.

How does the AWW motivate men to participate in pregnancy care and child nurturing? I open up the discussion on the issue of male involvement.
According to the AWW, there are many migrant families from Uttar Pradesh and Bihar in Gayatri Nagar. “These men never used to visit the AWC but now after years of persuasion few men have started attending our meetings and functions. During our home visits, we make it a point to speak with the man of the house. We sensitize them about the pregnancy and post- partum care. Pregnant women need nutritious diet, regular check-up and immunization and men have to actively participate in the pre and post- natal phases.”

AWW emphasise on the needs of the lactating mother. “They need helping hand and in its absence, she finds it difficult to manage cooking, cleaning and tending to the child. Some families try to get a female relative from the village for cooking and cleaning. She’s properly remunerated.”

They further inform that among Muslims, the woman is given a break from cooking and from other household work for 40 days. If there’s no one in the family to attend to the household chores, the help of the woman next door is sought for preparing meals, she’s paid for the work. While in nuclear families there are instances of the man of the house taking charge of cooking and cleaning – this trend is on the rise. One can see men fetching water, cooking and cleaning during the post-partum period of women.
However, AWW feels that north Indian men are reluctant to take the responsibility of managing the house while the woman is recuperating. In such families, women can be seen taking charge of cooking and cleaning just after three days of delivery. Of course, there are exceptions.

“After the delivery of his wife Vimala, Mahendra Choubey, a power- loom worker, took upon the responsibility of all the household chores and also looked after their older child. He would leave for work after completing all the morning tasks. On every occasion, I would find him busy in some task or the other. When I tried to compliment him, he stopped me saying that it is his responsibility,” shared Zende.

Change is taking place in the dark and dingy by lanes of Bhiwandi and the credit goes to the efforts of the AWW. The participation of men in pre and postpartum care is slowly increasing. However, the AWWs have to deal with superstitions and misconceptions while promoting nutrition and immunization.

Fighting the Superstition

‘There’s a case I would like to share with you, it’s pertaining to immunization,” Zende is eager to narrate her success story.
“Shahnaz Shaikh 25, has three children aged six, four and two. Her husband Firaq (29), is a power loom worker who has to put in 14 hours of work daily. I would meet Shahnaz’s 62-year-old father in law – Yakub, every time I visited her house, but never got a chance to meet Firaq. Yakub Shaikh had no faith in modern medicine and he had stopped his daughter in law from taking the children for immunization. I tried to persuade him, but in vain. Once, when he was out of the town, Shahnaz got her older child immunized, however, she missed out on all consequent doses. Very soon the child was infected with polio and consequently, his leg was paralyzed,” said Zende who felt agitated because of the incidence.

“I had to take a final call. I was angry and agitated. I visited the Sheikhs and made Yakub Sheikh understand the irreparable harm he had caused to the child by refusing immunization to him,” narrated Zende. Afterwards, the grandfather felt remorseful and accepted his folly. Soon after the health hazard of his oldest grandchild, Yakub Sheikh not only got all his grand children immunized, but also turned into an avid advocate of the immunization programme.

In many states AWWs have been roped in to check symptoms among the large number of migrant labourers and to track Covid 19 patients. Their help is sought in the times of national calamities and emergencies. For all their efforts the AWW makes a meagre Rs 10,000 per month. But their own struggles apart, this band of amazing frontline workers continues to be driven by a sense of community, compassion and camaraderie.

All Names have been changed to protect identity