Patience for Patients: What I’ve learned in India

 Sophie is a sophomore at Elon University majoring in public health and double-minoring in geographic information systems and environmental studies. She recently spent a month at the CRHP completing her practicum. This is a reflection on her experience.


As a sophomore at Elon University, I’ve completed the required practicum for my Public Health major at the Comprehensive Rural Health Project in Jamkhed, India. Here, my 15 other classmates and I have learned a lot, like when to give goats the right of way on packed Indian roads or how to bobble your head and say “Namaste” to people that pass. While these things are definitely important, we’re mainly here to learn about the Jamkhed Model, which the CRHP has created in order to help surrounding villages address their health issues. Today, as we seated ourselves in a class room (with our shoes faithfully outside the door, of course) we had the privilege of listening to several Village Health Workers (VHW), who play a crucial role in implementing this model. At first glance, they looked like typical Indian women, wrapped gracefully in intricate saris whose patterns were punctuated by the bright golds and silvers of exquisite jewelry. However, as the women began to share their experiences, it was clear that they are impacting India in incredibly unique ways.

Personally, I was most intrigued by the long term effects of their work. VHWs are responsible for taking care of villager’s immediate health needs by giving prenatal care to pregnant women, helping with births, making sure children are adequately nourished, giving immunizations, curing illnesses, and ensuring villagers use daily hygenic practices. Besides these more direct tasks, their work extends into a far more complicated realm as they also try to eliminate gnder inequalities, social stratifications by caste, and the marginalization of women. This, of course is exceedingly more difficult than administering a shot or telling mothers to breastfeed.

In my Public Health courses at Elon, our discussions about health interventions always seemed to end with everyone admitting that long term change is impossible unless people adjust their mindsets and personal actions. For example, it’s insulting simple for a doctor to tell a patient with diabetes to eat more healthfully. But it’s infinitely harder to make sure that the patient picks up bananas instead of potato chips at the local Food Lion every week. Anyone in Public Health can tell you that convincing people to accept new ideas to improve their health is one of the most frustrating aspects of the field.

For VHWs, many focus on empowering women to ensure their village’s future well-being. However, their messages often clash with cultural traditions that are inextricably enmeshed in a village’s social and economic infrastructure. As I sipped at a delicious cup of tea (which is served at every class session- just another reason to love India!) and continued to listen to the women, questions coursed through m mind. How could one woman fearlessly face the backlash from neighbors and friends who saw her ideas as threats to their everyday lives? How could she adamantly continue her attempts to help them even when they treated her poorly for doing so? Is it really possible to change centuries old customs and constructs in a quest for improvement?

Fortunately, the VHWs answered yes. As they discussed their personal lives, many mentioned how their own sons and daughters began to live out the ideas they’d worked to spread. One VHW’s daughter remembered her mother always teaching other women to stand on their own. As she grew older, this inspired her to start and run a successful business. The son of another VHW learned how important it was for women to wait for marriage and pregnancy until after age 18. As a result, he agreed to marry only if his bride was beyond her adolescence. Other women in the villages decided to follow the VHW’s example and made sure their daughters were not being married for a dowry. By not only educating others but also standing by these teachings for many years, the VHW’s were seeing the changes they’d worked so hard for and their hopes for the future finally coming to fruition through the generations after them.So what does this have to do with me? How do these stories of marriages and Indian villages relate to an American girl who has never had to question her freedom? What can I do with these lessons about persistence when I’m back in the U.S. trying to improve the health of my own country? I was unsure of what to do with this extraordinary wisdom until we had an eye-opening lecture with the CRHP’s director, Dr. Shobha Arole. As we listened to the doctor turned mental health practitioner and minister (her 3 titles are enough to start their own movement for Indian women empowerment), we were reminded that many public health efforts in the U.S. are focused on the short term. Americans, she reminded us, are often driven by emotionalism that immediately prompts them to look for a quick fix. When skewed data, impure motives, and the erroneous belief that change is immediate is combined, American (literally) start to buy into a false reality. As a result, monetary efforts for a certain cause can become emotionally charged endeavors that are short-lived and unsuccessful.One quick glance at our culture and it’s pretty evident that “quick” has unfortunately become synonymous with “best.” I know this is a pretty hackneyed idea which people have bemoaning since the rapid increase in technology use and the advent of drive-thrus. But ironically, as much as American love what’s fast, they can be very slow to change. As I think about the work my future in public health might hold, I wonder if I’ll be able to overcome my American predilection for immediate gratification. The stories of patience displayed by the VHWs are phenomenal examples of letting time distill ideas into tangible outcomes. Can I be satisfied with waiting until my children are old enough to marry to see my work actually become manifest? Am I ready to be that committed?

Fortunately, my current experience at CRHP has reminded me that accurate knowledge and an understanding of how to make this knowledge livable are the two most important tools I can arm myself with in order to feel confident in the efficacy of my work. So when I leave this wonderful country where the tea is as strong as the traditions and the roads are as full as the people’s hearts, I’ll remember that waiting may be difficult but can ultimately be rewarding.



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