Bill & Melinda Gates Foundation

Baggage of Understanding: Women's Groups in India Managing Money & Health Care

November 21, 2013

I’m back from a field trip in India (Delhi and two cities in the Uttar Pradesh state - Agra and Mathura). I’ve visited the slums and I come back with a baggage of understanding, compassion and hope. Despite the poverty and the difficulties of living in the slums, I have seen extraordinary courage in people. In some cases I have seen smiles, showing how resilient and resourceful the people in these slums can be. I understand better how the Bill & Melinda Gates Foundation helps and how I can contribute to that endeavour with my “Financial Services for the Poor” job. 

I have been several times to India in my previous careers, visiting the large financial or technology centres such as Mumbai, Chennai and Bangalore. While I did see of course poverty in these previous trips, it was always from a distance, from the air-conditioned cars and vans.  So, this trip, align with several of my colleagues, was about getting closer and understanding better the people in the slums we at the Foundation are helping. Seeing for my self, not by watching movies (I did love the “Slumdog Millionaire” movie though)

The first experience on the ground is getting the sense of abstract numbers. Uttar Pradesh (UP), just one of the 35 states and territories in India, has a population of 200 million on a surface of about 240,000 sq kilometres. In other words,  UP has about five times the population of California on 60% of the area. UP has three times the population of France on half the area. Bihar, the other most populous state of India, has two times the population of France on 20% of the area.

You can see and feel this reality very fast. The best illustration is the crazy traffic in the cities. And, on the outskirts of the cities, the slums. The population migration trend in India is very much like in most other countries - people tend to move to the big cities. Delhi and its surroundings is a city of 22 million people  (more than the population of Belgium and Portugal together; three times the population of the state of Washington).

The slums are (sometimes vast) cities within the city. They are not necessarily characterised by poverty. There are many poor people in the slums, but what really defines the slums is that they grew out of nothing to accommodate all the people and migrants, and thus everything is haphazardly cobbled together, from water to electricity to other basic services. And, most noticeably, the open sewers as there is no other evacuation of the used waters. The issues of poverty, health, hygiene, infant mortality are huge.

The Foundation has a number of programs and initiatives to help the poor in the slums of Bihar and UP.

One of these, and the focus of my field trip, is about family planning - empowering families to decide when to have children. Taken for granted in many countries, it is essentially unknown in the slums. There are many reasons for that, going from the lack of education to deep cultural roots.  As a result, it is very common to see families with numerous children, 3 to 8 or more. With very few means to support these children for basic food and health food, not mentioning education later.

The Foundation supports UHI (Urban Health Initiative) in India and other countries to co-ordinate the access to the poor in the urban slums. UHI reach out themselves in some cities, and co-ordinate with a number of other NGOs in larger cities with many slums. They educate the families about the tools available for family planning (such as contraception) and direct them to appropriate private and government providers of health services.

It is an enormous communication campaign - everything is used, from state wide TV and radio information, all the way to street level information.  And it is very important that the information be clear, concise, understandable even by people who can’t read well.

The patience, perseverance and passion of UHI and the NGOs on the ground is an amazing thing to see and experience.

But the most inspiring for me was to meet the women self-help groups. Encouraged and supported by UHI and the NGOs, courageous woman get together to help each other in many domains - going from protection from domestic violence, advising and supporting, domestic tasks. They also manage an elaborate system of saving money in the group, in order to be able to provide loans to the women in need (such as for mariages, deaths, schooling).  This last activity of course has triggered my attention, as this is what my job at the foundation is all about - empowering the poor, and these self-help groups, with access to safe and reliable ways to manage their money. 

These women are extraordinary.  An example of courage, as getting together was not something seen as positive by their husbands and in fact the ancestral culture.

They are enthusiastic, passionate, resilient, full of initiative. And, despite everything around them, they smile. They tell me there is hope. They give sense to the Foundation’s efforts. I will remember them forever.

 
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