Portrait of a Woman

There was a moment in Kajubai’s life when she gave her breath to a newborn baby who had stopped breathing. The baby started breathing again. This is the moment she remembers when she looks back at 18 years of work as a Community Health Worker (CHW) for non-profit organisation SEARCH. Besides giving breath to breath-stopped babies, there are other things Kajubai does. Giving pregnant women information on nutrition; urging them to go to the hospital (or ‘sub-centre’) for delivery; being present for the delivery; checking the newborn baby’s health immediately and helping fix problems. Besides routine care, she is trained “to identify high risk babies and provide intensive care. She also diagnoses and manages morbidities such as hypothermia, breast-feeding problems and sepsis besides assessment and if necessary management of birth asphyxia,” according to SEARCH.

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Kajubai, 53, is a CHW in Aambeshivani village in Gadchiroli district of Maharashtra. Gadchiroli, as Wikipedia will tell you, is in the southeastern corner of Maharashtra and part of the Red Corridor, a region where Naxalites are active. As Dr Abhay Bang, who started SEARCH along with his wife Rani Bang, said: Gadchiroli is a 1000 miles from Mumbai and about 5000 years behind it.

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The people here are mostly members of Scheduled Castes and Scheduled Tribes. Many women here give birth at home and even those who have institutional deliveries, are sent home soon. In the fragile hours or days after birth, babies can develop complications or fail to breathe. They need care. But they cannot travel to the hospital because it is often miles away and there are no proper roads, let alone adequate transport. SEARCH takes basic practices of medical care to their homes.

The Home-based Newborn and Child Care package developed by SEARCH was tested for 8 years in 39 villages in the Gadchiroli district. It was so successful that now it is being implemented by the govt-supported Indian Council of Medical Research in 5 states (Bihar, Orissa, Uttar Pradesh, Rajasthan, Maharashtra). The scale is big. It rests on a crucial link: the Community Health Worker.

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But Kajubai seems devoid of all sense of self-importance. The only time she lets something like pride creep into her voice is when she speaks of her grandson (her daughter’s son) whom she helped save when he developed sepsis. Or perhaps, it is something like joy. Mostly, she focuses on giving us information. Time is short. Talk is cheap. Kajubai seems to have internalised these lessons over years and years of dealing with frail women and their frailer babies. “I visit women in this village and two others from the time they’re pregnant,” she says. “I keep a register. I tell them about nutrition, show them these books.”

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While saving lives, Kajubai noticed unexpected changes. “In the beginning, they used to keep my plate and glass outside on a window sill,” she says. “I had to take it from there and wash up afterwards.” Kajubai is part of a Scheduled Caste, which means that notions of purity and impurity guided the actions of even those who had called her to help. They didn’t want her vessels mixing with the family’s vessels.

In time, that changed. Now they give me food in the kitchen,” she says. How did this change take place? “Very slowly,” she says. And again, “very slowly.”

“But now they invite me for social occasions,” she says.

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Family has been supportive to her cause. They helped with household chores when she had to go out and even now, she lives with her son, daughter-in-law and grandson. Outside her home, her professional identity is proudly displayed. The sign says: SEARCH, Village Health Service, Certified Female Health Messenger, Shrimati (Respected) Kajubai Undirvade, Aambeshivani.

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(This article was written after a trip to Gadchiroli organised by the International Reporting Project in Washington DC. It was first published in Ultra Violet.)