Devika Biswas
(The Humanity is a NGO based in Balangir district in the state of Orissa in India. They have been working with the local communities in 12 villages in Patnagarh block raising awareness in the community about health related entitlements and expenditures and training the local Village Health and Sanitation Committees to make local village plans for spending the Rs 10,000 that they receive from the Government every year as ‘untied fund’. This is an extract from a field visit report )
In Khutanpani village we went to the Anganwadi Centre ( Pre-School Centre) and met the Anganwadi Worker (AWW) Golapi Tummia. She organized the village meeting with GaonKalyan Samiti ( GKS or Village Health Committee) members and women group. In this meeting with we came to know that the GKS had done village planning and involved community in cleaning drains, repair of bund (embankment) by giving the contract to the local women’s Self Help Group. They were also pro-active in giving cash assistance to a person who was sick and in need. They had also repaired a tube well made arrangements for drinking water for cattle and cleared a pool of stagnant water. Some male members of the GKS were not very happy to work under the leadership of women like the AWW, ASHA (Female Community Health Worker) and female Ex-ward member. In this village the GKS refused to make payment of Rs1400/- to the District Programme Management Unit appointed contractor for DDT spraying saying that the decision was not taken in the GKS meeting and paid the contractor Rs 600 only.
The GKS members were found to be very highly motivated and also acknowledged the contribution of Humanity ( the local NGO who had trained them). The women all are using AWW/ASHA and ANM services and 100% having institutional delivery. They also been knew about JSY and Mamta ( conditional cash transfer schemes for pregnant and lactating mothers) money as entitlement. However no one used Janani Express ( government arrangement for free transport for pregnant women) and went to government facility by hiring a private vehicle. They also said they had to pay a tip to all hospital staff after child birth in government hospitals. They said they seek services of private providers or government doctors practicing privately for speedy recovery. They said that if they complained against erring staff it would adversely affect them in future so they do not complain and avoid confrontations.
In Tentulkhunti village the GKS is functioning well. The AWW Monabermati Meher, the convener of GKS as well as the ASHA, Sarojini are active. GKS members meet regularly every month and did spend money on the various items as suggested in the guideline provided by govt. such as cleanliness of village drains, cleaning of drinking water sources (by bleaching powder), DDT spray and so on. They had also organised a health camp where villagers blood group was tested. We interacted with some women were either pregnant or who had young (upto 2yrs) children and pregnant women to know how far they knew about their health service entitlements. All of them knew of services for antenatal care, institutional delivery and immunization of children, weighing of children at AWC. They also knew of the Village Health and Nutrition Day or Mamta Diwas and knew their AWW, ASHA worker as well as their ANM (female community outreach paramedic). All of them went for institutional delivery at Patnagarh (government) hospital, but by hiring a private vehicle and also had to spent for child care kit (soaps, powder, oil etc as ordered by Ayah, ANM, Nurse) and give tips to all the hospital staff involved in delivery including ASHA). But they also got Rs. 1400/- as JSY and also other incentives under Mamta scheme. When asked whether they knew all services were free and why they did protest and complain to authorities – they said if we do so our health condition would be worse as the staff may take revenge and not give good treatment.
Most women knew about GKS and also knew that activities they carry but many of them had never attended any meeting of GKS but all attended the health check up camp for blood group organized by GKS and knew that GKS do some health and sanitation activities. In the meeting with GK members we were shown the GKS meeting register which showed the decisions relating to spending of the untied fund in the years 2009-10, 2010-11. Most of it has been spent on cleaning drains, DDT spray, adding bleaching powder to water sources for disinfecting them, health camps and so on. They had regular monthly meetings and also inform and involve other members of the community.