Interview with Rhambabai, Village Health Worker of Saradwadi
Interview and written by Meredith Burns
Saradwadi, a rural village about 7km from Jamkhed, has been one of CRHP’s Project Villages for the past twenty years. The partnership started when Raj and Mabelle Arole began training a local 20-something year old woman named Rhambabai to be the community’s first Village Health Worker (VHW). Since that time, she has been a force for change in her community. On the day we visited Saradwadi, Mr. Pandit, a CRHP social worker, informed Rhambabai that CRHP wanted to take photographs of her making the rounds. She immediately disappeared through her concrete doorway, reappearing in a cotton pink and lime-colored sari and a large, ornate nose ring with tiny golden beads. She grabbed her reusable mesh bag and scooped up her two-year old granddaughter as she headed out the door.
The first visit was to Rami, a 21-year-old mother who is due with her second child in two weeks. Though Rami now lives in another village not served by CRHP, she returned to stay with her mother for the months leading up to delivery. Over the course of her pregnancy, Rhambabai has performed frequent check-ups and provided prenatal education to the family. Rami reported that she felt fine despite incessant kicking from the baby. Rhambabai checked her blood pressure, took her pulse, examined her fingernails and eyelids for signs of anemia, and confirmed that she was well before heading out.
En route to the next house, we passed a small parcel of land where Rhambabai pointed out her livestock—goats, cows, and water buffalo. She beamed modestly as she showed us the baby calf that was only two weeks old. Her animals were an example of many products from the Women’s Self-Help Group investment. She greeted a neighbor and pointed out the fruits of another project, a kitchen garden.
“But I knew how to swim.”
Rhambabai has a presence of humility, practicality, compassion, and resilience. You can tell that she takes her job seriously and sees her work as an honor—both to be entrusted with such responsibilities and to have been selected to serve her community. As the VHW of Saradwadi for the past 19 years, she is well-versed in the social, health, and economic needs of the local people; she is skilled in her job; and most importantly, she is aware of her capabilities. Despite that, she faced a lot of opposition when she first took on the role. It is difficult to imagine that in an act of desperation caused by others’ hostility, she once attempted suicide by throwing herself into a well many years ago.
For the first two years of her work as a VHW, she faced resistance from her husband and the community. People warned her husband that she was “not of good character,” coming and going for CRHP trainings when women were supposed to stay at home. This finally came to a head when Dr. Raj visited Saradwadi for a meeting. He asked Rhambabai the population of the village, and when she responded with the incorrect number, a townsperson seized the moment to speak out against her. They criticized her as uneducated, saying that she shouldn’t be a VHW. Dr. Raj rebutted, “She’s working for the village—for you. She is not educated [formally], but she has good knowledge. She is a good listener.” She was so upset by the animosity that she decided to commit suicide.
She tells the story in a matter-of-fact manner, but as she pauses, a crooked smile crawls across her face, “But I knew how to swim.”
After the well incident, her husband stopped giving her problems. He realized how important being a VHW was to her, and like other villagers he began to see that she was helping people. Over the course of her career, she has delivered 250 babies, helped develop the Women’s Self-Help group, helped lead the Adolescent Girls Program, lessened casteism, improved the status of women, and identified and referred numerous patients with high blood pressure and diabetes for further medical services. Her stories, along with those of other local women, are a testament to the major changes that began with her trainings at CRHP.
At the second house, family members gathered around to see Rhambabai take the blood pressure of two women. When one of them had low blood pressure, she recommended that the woman increase her sodium intake by adding more salt to her food. As daughters, granddaughters, nephews, and nieces drifted away to work, one of the blood pressure patients, Khantabai, sat with Rhambabai, and the two discussed changes from the past twenty years. Khantabai started by stating that in the beginning they simply didn’t have any health knowledge in the village.
Khantabai explained that the most significant changes and improvements revolved around water. She said it continues to be the biggest problem today—having enough for drinking and irrigation. It was through Rhambabai that she learned about soak pits, the connections between illness and water, and how to have safe drinking water using moringa (drumstick) as a natural purifier. With clean water, they were able to achieve the most basic foundation of health.
Rhambabai and Khantabai became quite animated when asked about their schooling. They shook their heads and waved their hands, explaining they were not allowed to study. Though Khantabai’s brother went to school, both women and their sisters (five each) were not permitted. The women explained that exposure to different media—TV, radio, newspaper, and books—“brought knowledge to the people that boys and girls should have education.” They said that everyone in the village studies now, even continuing on to university. Rhambabai added that more girls are now going to other places to study and are even earning the highest marks in their class. This is evident when introduced to any of the adolescent girls. When asked about their exams, they are congratulated and encouraged for their high marks.
Both Khantabai and Rhambabai agreed that major changes had occurred for women in the village. They said that now they know their rights, more girls are getting educated, and they know how to take care of themselves. The Self-Help Groups that Rhambabai established in the community have been active for the past 14 years and boasts 60 members. The group has helped women invest in sewing machines, livestock, fertilizers, and seeds amongst other projects. Each woman started off paying a small fee, which has gradually increased to 20 Rupees a month (about 30 cents). These schemes have helped women generate an income, giving them more power at home. Khantabai explained how previously, only men handled money, so they were in complete control, but since women started generating their own income, they share power. Now both parents will arrange their children’s marriages instead of just the father.
As for the practice of dowry, both women laughed and shook their heads, saying that because of son preference when Rhambabai first started working, the ratio of boys to girls who are of marrying age is now highly skewed. Dowry is slowly going away though. They explained that people didn’t want girl children before, but they are slowly trying to increase the number of girls in the village. The women made sure to mention that they are teaching boys as well, recognizing the importance of comprehensively addressing gender equity.
Rhambabai admits that dealing with caste was difficult in the beginning but asserts that it is no longer an issue in Saradwadi. Khantabai agreed that gradually the differences amongst caste have been eliminated. Despite increasingly politicized tensions between Hindus and Muslims throughout the country, both women shrugged and said there is no difference between the groups. Everyone lives and works together, including the Dalit and tribal families in the village. After founding the Women’s Group and Farmers’ Club, people slowly began to participate in the meetings and activities. “I had to bring two women from the village [to CRHP trainings],” Rhambabai explains. Inviting these women helped expose more people to new ideas. They were able to “get some knowledge,” which then spread rapidly throughout the community.
Though villagers used to look for cures to medical ailments with traditional healers, the last one passed away relatively recently. Rhambabai encouraged people to access proper medical services, but some still visited a woman who supposedly practiced black magic. On one of Rhambabai’s rounds in the community, she discovered that this woman had diabetes. She referred her to the hospital where the women received the medicine and education she needed for treatment. This woman became injured and needed an operation, which she also received from the hospital. Rhambabai explained, “That was a very good example for the people that a woman working with black magic had diabetes. I asked, ‘How did she not save herself?’” Since then, people in Saradwadi no longer turn to traditional healers for medical issues as they have learned through experience to trust Rhambabai.
As for current pressing issues, Khantabai reiterated the importance of water. The community has encouraged the planting of trees to stem deforestation and subsequent water loss. Rhambabai also mentioned that only about half of the families in Saradwadi have a toilet. There appeared to be a lot of controversy over a previous toilet project. She provided several reasons why the project failed, mostly attributing it to a lack of funds and a conflict over the project’s leadership position. Rhambabai explained that the government has a current project that helps subsidize costs at different rates for families below and above the poverty line. At this point, people see it as the village council’s job to help provide toilets. Whether discussing an infrastructure project or changing people’s attitudes, both women were aware of the lengthy process such undertakings require, but appeared optimistic and patient. Seeing how much they have accomplished in the past two decades, they have good reason to be.
“It felt good to have knowledge.”
There is an ease with which people interact with Rhambabai, surpassing the familiarity inherent to village life. It encompasses both mutual respect and quiet admiration, accumulated through years of action. Though she has contributed greatly to the advancement of Saradwadi, to put her on a pedestal would be remiss. CRHP, the VHWs, and each community work together to identify and address fundamental needs—primarily knowledge and health. Just as Rhambabai and Khantabai’s stories demonstrated common struggles, addressing them is an equally communal affair. When Rhambabai shared what she was learning from CRHP’s trainings, women were interested because they wanted more for themselves, their families, and Saradwadi. Without the commitment or the initiative of the community, such changes would have been impossible.
While there continue to be ongoing issues with water and sanitation in Saradwadi, health is not a one-time achievement, but rather a dynamic, continuous process. Instead of emphasizing the struggles that persist, it is important to recognize and uphold the sense of empowerment borne out of what has been learned and disseminated. As Khantabai expressed succinctly, “It felt good to have knowledge.”
Meredith Burns, Attends University of North Carolina at Chapel Hill. Completed her MPH practicum at CRHP, Summer 2016.