Last month, a depressing story in a newspaper related how in Gorakhpur, Uttar Pradesh, where Japanese Encephalitis is recurrent, the wards in the district hospital were full of boys. Was it possible that no girls had contracted the disease? The answer, sadly, is rather obvious. When faced with a choice of loss of several days of paid labour, poor families chose to treat only their sons leaving their daughters to either succumb to the disease or be permanently impaired as a result of contracting it.

Their work is already beginning to yield significant results in the health parameters of some of the poorest parts of the State.

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This is only one of the many harsh realities of women's health in this country that begins at birth, goes on through girlhood to adolescence and adulthood — an unchanging story of callous neglect. Every year, the statistics of infant mortality or maternal mortality only tell part of the story. For, the real burden of a shamefully inadequate public health care system in this country, particularly in the poorer and more deprived regions, has to be borne by women. It is like living under low-intensity conflict; you can never be sure from which direction you will be attacked and whether you will live to see another day.

But sometimes out of this gloomy scenario you catch glimpses of light, of something positive that is being done. In the midst of a serious discussion on the repercussions of conflict on women's health, at a National Dialogue on Women, Health and Development held recently in Mumbai, I chanced upon that glimmer of hope.


The three women sat quietly through the discussion. Then one, Bhuvaneshwari, got up and began speaking. We were spellbound. She transported us to the State of Chhattisgarh and the picture she drew of life in the district of Dantewada illustrated only too well what conflict does to women's health and lives. Chhattisgarh, which came into existence in November 2001, has a large tribal and scheduled caste population. Parts of it are also "Naxalite-affected", as the condition of having the Communist Party of India (Marxist-Leninist) operating in any territory is now termed, as if it was a contagious disease.

Instead of dealing with the crippling poverty that creates fertile ground for such a radical movement, the Chhattisgarh government's solution consists of arming villagers and relocating them in fortified camps through what is known as Salwa Judum. Bhuvaneshwari described life for the people from 35 villages in one such camp of 16,000 people. This is only one of 18 such camps in Dantewada district.

"The women are so scared", she said, "They see only death". The nurse and anganwadi worker have stopped coming to the camp. There is no drinking water. Every day a couple of children die. There is no woman doctor. As a result, women with health problems have no one to whom they can turn. "On one side there is the police, on the other the Naxalites. People are caught in the middle", she said. People in the camps are also cut off from their means of livelihood, which consists of collecting mahua flowers and tendu leaves from the forest. They are told not to step out of the camp if they want to stay alive. But the real danger to their lives is from the living conditions inside the camp.

Despite this grim picture, there is another side of Chhattisgarh that is now shining a ray of hope. This consists of women like Laxmi and Maan Kuwar, both Mitanins, the Chhattisgarhi term for "friend". There are now 60,000 women like them who have been trained to become community health volunteers. Most of the women are illiterate; they are selected by the community and are paid no salary. Yet, their work is already beginning to yield significant results in the health parameters of some of the poorest parts of the State.

Laxmi, married with two children, does not read and write. She has recently learned how to sign her name. But that does not deter her from doing her job as a Mitanin, she tells me proudly. What does she do? Every day she visits people's homes, checks on women who are pregnant, reminds them of what they should eat and how much, checks the Balwadi and makes sure that the Anganwadi worker is doing her job of providing children with a nutritious meal. Every Friday, she holds a meeting with the women in the village. Sometimes, she has to call two meetings as the women work and cannot get away at the same time. At these meetings, the women speak of their problems. At one of them, the women complained about the teacher who would come drunk, never go to school and misbehave with the women. Laxmi and other Mitanins took up the issue to the block office. As a result of their campaign, the teacher was removed and they have another teacher.

The Mitanins have successfully tackled the diversion of food grains meant for people with Below Poverty Line (BPL) ration cards.