WITHOUT HER – IS IT POSSIBLE ?

[susmita mukherjee]

Sharing thoughts on the status of women on the occasion of World Mosquito Day today. voices of tribal women from Jharkhand in India tells how women are unheard even to address NTDs.

‘Garibi ke karan khareed nahi pate hain. Humare ghar mein koi machardani mein nahi sota’. (we are unable to buy due to poverty. Nobody in our house sleeps under a bed-net). Says a tribal woman of age above 50 years from Dumka in Jharkhand.

Jharkhand is one of the highly affected states from mosquito-borne diseases including Malaria, Filaria, Japanese encephalitis, etc. Neglected Tropical Diseases (NTD) remain neglected as they affect the poor, marginalized, and underserved sections of society the most. However, the vector – the mosquito does its job of spreading the parasite without any discrimination towards caste, community, or gender; therefore, it is high time for us to recognize the burden of the disease that women carry silently on their shoulders directly and indirectly.

At Project Concern International we are working towards eliminating NTDs from India. When our team reached out to interact with more than 80 tribal women in Dumka and Godda districts of Jharkhand, to understand their level of awareness, usage of preventive measures, and opinion about further prevention of mosquito-borne diseases, it found that more than half of tribal women in these endemic districts are aware of the dreadful short to long term impact of mosquito-borne diseases on their families and community. Malaria is recalled as topmost among the name of the mosquito-borne diseases followed by Filaria. Mass level activities about the diseases have led to a high level of awareness among women (98%) about the diseases, their cause, and potential ways to safeguard from the diseases. However, point to be noted here that largely it is understood that Kala Azar is also a mosquito-borne disease. Interesting to note the level of clarity women have about such diseases.

Women are conscious that, just one patient in the family startles their entire household. They get in the role of attending to the sick members along with other regular household chores; which not only adds to their workload but also their mental stress and anxiety. Efforts of treatment for the ailing family members further cause loss of daily income for the earning member and increased expenses if they fall in the hands of the private health service provider. Women are then left with running their families with a further diminished budget and probably the least allocations are made for her health and wellbeing.

Having a bed-net to safeguard from mosquitos is a luxury item for rural poor tribal families. Even if the family has one, the preference is given to children and other family members. The family continues to use that one bed-net, even if gets torn till it becomes completely unusable and the ability to buy a new one seems to be beyond the reach of most families.

All of the Women with whom we interacted knew the reasons and sources of mosquito breeding near to their houses. Regularly cleaning the area surrounding their houses was mentioned as the most practiced preventive measure; however, nearly a third of the women have a load of responsibility with the accountability of keeping the surroundings clean singularly; whereas another 30% reported receiving some support from their husbands. However, they are completely helpless when the sources of breeding are in the public or community places like the area around public hand pumps, big potholes on the roadsides, garbage dumps, and poorly maintained water bodies of the villages. Women due to their limited agency at public spaces are hardly able to raise their voices to demand management of such areas and men in such families due to engagement in livelihoods, social dynamics, etc., hardly care for such issues.

Have we ever pondered what are the voices of women in this regard? What do they expect from the government for their well-being whom they elect for the purpose every 5 years. It’s amazing to know that women demand – just three things - 1. Bed nets so that all can have a good and fear-free sleep at night, 2. Clean surrounding areas and locality. Can the system take a look at these demands and plan for the well-being of those; to whom they are duty-bound and accountable.

Mosquito-borne diseases have become part and parcel of their lives, it's like a normal for these communities that they have learned to live with. Although the data from the Mass Drug Administration, under the Filaria elimination program, shows that there is no difference in preventive drug consumption by sex; however, women’s ability and participation in decision making for the health of the people at the community level is still short of expected levels. It’s not about who is falling sick; it's about that least heard and most neglected woman who is bearing the brunt of the disease – directly and indirectly.

Taking the learning from COVID-19, it becomes more imperative that women share the table for they are the lead contributors towards making India free from Mosquito-borne diseases.

https://indiantd.blogspot.com/2020/08/without-her-is-it-possible.ht...

[Rituu B Nanda]

Thanks Sushmita for highlighting the gender aspects in a public health issue. Women need to have a voice and a meaningful one. 

Women alone cannot take responsibility for health issues. As major part of my work is around public health and behaviour change, I focus on building family and community ownership so that they take responsibility of the health concern. Institutional response is critical but not enough. Catalysing community action can strengthen the public health response. I tried many approaches and have found Constellation's approach very effective https://www.communitylifecompetence.org/our-approach.html This was used on the issue of Malaria in Togo and other African countries.