Pauri (Uttarakhand), March 14 (IANS/ 101Reporters) After resisting institutionalised healthcare for centuries, some women from Uttarakhand’s nomadic Van Gujjar community seem to be opening up to it. They would also like to train as community health workers under the Accredited Social Health Activist (ASHA) programme, which aims to provide healthcare to marginalised communities such as the Van Gujjars, who stay in forests.
Van Gujjar Tribal Youth Organisation has picked up this slow but emerging sentiment during their field interactions. “Their main concerns are the safe delivery of the baby and their vaccination later on. Instances of people getting hurt during the felling of trees have also necessitated hospitalisation,” says Meer Hamza, president of this youth organisation.
Traditionally, the women from the community would double up as midwives and deliver babies at home. But the changing forest use has affected their lifestyle in recent years and given rise to health complications among menstruating girls and pregnant women that warrants the attention of the formal healthcare system, of which they have nothing to speak of.
Add to this, they don’t get to access the healthcare schemes. Hamza explains why, “Since a majority of the community lives in temporary settlements in the forest, they don’t have land documents, most don’t hold a ration card, and they are not part of the gram panchayat. Now since the government schemes are implemented via gram panchayat, they miss out on vaccination drives for their children and fail to obtain their birth certificates.”
For the same reason, ASHA workers, who play an important role in implementing the health-related schemes in rural areas, don’t visit these communities, Hamza alleges. The apathy doesn’t end here. “Since the Van Gujjar women aren’t regularly monitored by ASHA workers, government doctors often refuse to treat them and send them to private hospitals instead. Delays such as these have caused the death of infants and new mothers in a few cases,” he claims.
Contrary to Hamza’s claims, Sujata Singh, deputy director, Women Empowerment and Child Development, Uttarakhand, told 101Reporters that ASHA workers visit the Van Gujjars regularly for the checkup.
Hamza feels the only way the Van Gujjar community will lap up the formal healthcare is if some of their own women become ASHA workers. “They feel hesitant to talk to women from outside their community, also because of the language barrier,” he shares what these women have told him in the past. The existing midwives, who are well-versed in the traditional medicine, should be the first ones to go up for the ASHA training, he suggests.
However, Tarun Joshi, president of Van Panchayat Sangharsh Morcha in Uttarakhand, says, “We have been trying to increase the participation of the Van Gujjar women in the Van Gujjar’s meetings but they don’t leave their homes at all.” This, in turn, reduces their chance to access the social schemes that have been floated by the state government to promote institutional deliveries and neonatal care and reduce infant mortality rates.
These women prefer home birth and mistrust the modern healthcare. “It’s how we have lived our lives, inside the forests, for ages,” says Mano Bibi, a village elder. The younger Fatima Biwi echoes the views: “We feel safe when our child is delivered in our home. Only when the complications arise do we go to the hospital.” The 30-year-old recalls the time when she took her five-year-old daughter, who is sick with a blocked artery, to hospitals in nearby Rishikesh and Dehradun but the visits didn’t help much.
However, Dr Anupa Lal, a Dehradun-based gynaecologist, sounds a word of caution against home deliveries. “Since delivery is a complicated process, improper techniques used in home deliveries can cause arterial blockages, affect the development of the brain and even lead to cerebral palsy.”
Since this forest-dwelling community is stuck to their old beliefs, Hamza feels they need to be sensitised about their healthcare rights and amenities through workshops and the government needs to do more. “We had written a letter to the state education department to open an anganwadi centre [which looks after the basic health and child care in villages] two years ago but nothing has moved,” Hamza shares. But Singh defends this, saying, “the state provides anganwadi centres in areas with more than 200-300 residents, but the Van Gujjar community lives in small numbers.”
Joshi feels a lot of these healthcare problems can be resolved by reclassifying the Van Gujjars as a Scheduled Tribe from the current Other Backward Class status. “The Bhotia tribe in Uttarakhand gained a lot from the ST status,” he makes his case while signing off.
(The author is a freelance journalist and a member of 101Reporters, a pan-India network of grassroots reporters)