Before leaving the UK, I was programmed to believe that successful maternal healthcare came from plugging large funds into training highly-selective doctors and midwives. The maternity ward at CRHP’s Julia Hospital is indeed a success, but it is neither built nor sustained on this ethic.
From the very beginning, CRHP has fought to demystify medicine, rather than place it on a pedestal. In May 1988, in Washington DC, Muktabai, a Village Health Worker, spoke of doctors as ‘shining chandeliers…beautiful and exquisite, but expensive and inaccessible’. Instead she talked of ‘Health for All’, a vision in which healthcare, like light from a wick lamp, can be easily transferred ‘so that workers like me can light another and another and thus encircle the whole earth’. The doctors at CRHP are indeed highly competent, but the majority of pregnancies and deliveries are uncomplicated, and ultimately, not medical problems. For CRHP, childbirth and motherhood are just a natural parts of life.
This Jamkhed model, the model of ‘Health for All,’ is low-cost, high-impact, and can boast countless safe deliveries and healthy mothers. For the past month, I’ve had the privilege of witnessing this first hand. Most of my time is spent with women in the female ward of the Julia Hospital, talking to them, hearing their stories, and observing the work of the nurses, midwives, and VHWs who work with them.Throughout the mother’s pregnancy, delivery, and after-care, it is quite possible that a doctor will never need to be involved.
Ultimately, their presence is rarely necessary. At every stage of the mother’s pregnancy, she and her baby are given the best possible care, not by doctors, but by local women trained by CRHP. Harmful practices are refuted, helpful traditions are encouraged, and the mother is empowered to take charge of her own body. This was the vision of Raj and Mabelle Arole over forty years ago, and in Julia Hospital, I see it daily fulfilled. Women from Project Villages tend to be older, so their bodies are ready to bear children. They are healthier, stronger, more independent, and ultimately happier. As a result, their deliveries are smoother, and their babies are born at healthy weights.
It is a daily joy to witness the impact CRHP is having on individual lives as well as entire communities, and being part of something genuinely impactful. For me, the ‘success’ of maternal healthcare is no longer driven by the official qualifications of practitioners or the income of the institution, but by the calibre of care. Good care, and good maternal and infant health is not just in the hands of the few, but all. Working with CRHP constantly forces me to reassess my shoddy notions of successful healthcare, and it has been a privilege to witness a system which changes lives, because it really does work.