This past winter, I traveled to Jamkhed, Maharashtra, India on a Global Health: Ethnography study abroad session. I was humbled by the successful, sustainable health care the Comprehensive Rural Health Project (CRHP), founded by Drs. Arole, provided to the rural villages in Jamkhed and surrounding districts.
Sustainable by Development
Dr. Raj and Mabelle Arole believed in “comprehensive health care,” which means that the living conditions of the villagers were just as important as their health. And this so logical, since we know that how we live directly affects health repercussions. Because of this mindset, Drs. Arole decided to progress the development of villages to improve their health. Some examples of this were providing clean drinking water, covering water pits (to prevent mosquitos from breeding and spreading malaria), and improving irrigation (for water supply during dry seasons).
In the doctors’ book, Jamkhed, one story particularly struck out to me about the importance of development in rural areas. During a demonstration when the villagers went up to thank the Aroles, the majority of villagers were grateful for the water pumps installed in the villages rather than for the medical work the doctors were providing. In impoverished areas, it is vital to provide basic necessities to improve health.
Sustainable by Empowerment
Another aspect of CRHP I was impressed with was that it strove to change the traditional social structure. The caste system is thousands of years old and embedded in the Indian way of life. On top of that, the society is heavily patriarchal. In order to fight these norms, Drs. Arole had to come up with tactics to change the perspectives of both the health workers that worked for them and the villagers. They sat in circles rather than having the highest status person sit at the head of the floor mat. They placed the water pumps in areas where the Untouchables (lowest of the caste system) lived, so that different castes had to interact to get water. One key tactic was to train women to become village health workers. This gave the women more respect and responsibilities in the village. Furthermore, training a villager rather than bringing in someone new to be the village health work allows the village to stand on its own instead of relying on CRHP.
CRHP’s mission and impact in Jamkhed has shown me that sustainable health care in underserved areas is attainable. My experience in Jamkhed has reinforced my desire to serve in an underdeveloped community. And now, when I hope to improve people’s health, I will remember that development and empowerment are just as important factors as medicine to better comprehensive health.
Written by: Sharon Pang
Jamkhed: A Comprehensive Rural Health Project, by Mabelle and Rajanikant Arole