Lily Jordahl

Lily Jordahl
ARMMAN India
Mumbai, India

During this past week I traveled to a town called Washim, which is about twelve hours outside of the Mumbai, but still within the general state of Maharashta, to observe a training of health assistants that ARMMAN has been conducting with a community partner. This training program is designed to teach selected women living within rural villages in the surrounding area important skills relating to monitoring of pregnancy and health of a newborn. These women go through an extensive education program then receive supplies that allow them to perform tasks, such as taking a woman’s blood pressure or measuring the amount of hemoglobin in the blood to test for anemia (one of the most prevalent concerns for pregnant women within this region).

This Arogya Sakhi program is somewhat similar to a program implemented by the Indian government entitled ASHA (Accredited Social Health Activist). Yet, it seems while the original goal of the ASHA program was to have a health worker in every village, that has not been the result thus far, so many of the ASHA women are very overworked. So, this Arogya Sakhi program is designed to work in congruence with the existing system and to fill in health gaps that are still present. Additionally, it is being implemented along with the mMitra voice-messaging program that ARMMAN is also spearheading. In some villages women are exclusively receiving voice-messages providing them with information about pregnancy and prenatal care, while in other areas women are also receiving this direct Arogya Sakhi care. The goal is to see whether there is a significant difference between women receiving no support from ARMMAN, those receiving mMitra information, and those receiving Arogya Sakhi care and mMitra information.

Anyways, I was extremely excited to see the training as I have been learning about it for many of the previous weeks. The day that we attended the Arogya Sakhi’s were receiving training on pediatric care, specifically focused on how to detect jaundice in an infant. They also reviewed the various materials that they are to complete whenever they make a visit to a woman or her child. While, unfortunately there was a language barrier for me as the training was conducted in the regional language, Marathi, it was clear just through visual observance that the Arogya Sakhi’s had learned an immense amount in a short period of time. In addition to reviewing extremely detailed information on diagnosis of jaundice and other conditions, the women also practiced using the tools that they had received for diagnosis on one another, such as the blood pressure monitoring (which I have pictured below).

A group photograph of the Arogya Sakhi’s of Washim.

Lily Jordahl
ARMMAN India
Mumbai, India

Before beginning my work with ARMMAN I thought a large amount about women’s health as a human right as well as the history and distribution of this right within India. Thus, upon arriving I was prepared to spend most of my time at the organization considering these topics, and while this has been the majority of my experience I have also been thinking a fair amount about technology. Technology has never been a field which has particularly fascinated me, but the more learn about ARMMAN’s projects, which each relate to technology in some way, the more I have been captivated by the potential which technological innovation holds in the world.

Now, I know that the term technology is extremely broad, but I suppose I have predominantly been thinking about it through the lens of tools which allow for communication and information sharing, such as the Internet, computers, or cell phones. Initially I was interested in the way in which this type of technology was utilized in ARMMAN’s programs because I thought their projects provided an innovative and resourceful way to utilize a prevalent resource (such as a cell phone) to have a positive health impact. Yet, as I have spent more time thinking about the different aspects of these programs, the ideas within them have made me consider the valuable nature of the technology in itself, in addition to the positive health results it can create.

In the case of something like a cell phone, a piece of technology that is critical in ARMMAN’s mMitra program, this tool holds the potential for communication, research, or even education. ARMMAN utilizes cell phones in order to pass along information to pregnant women on health and wellness so as to provide education to these women and allow them to become more informed about the status of their health. Yet, a cell phone can be critical in many scenarios, such as in emergency situations where it is necessary to have tools to communicate and relay important messages to a responder. Thus, it is clear that there are definitive benefits to technology, as well as potentially detrimental effects if technology is not available.

While there are important reasons to have access to technology, I have been thinking about whether this kind of technology is a human right. So, with this question I turned to the Universal Declaration of Human Rights to see whether there was anything written within it that could relate to this type of idea. The most relevant statement which I could find within the document is Article 27 which explains that “Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits.” Technological innovation is linked heavily to scientific development, thus this article could approve the right to technology. In addition, I could also see how the right to education (Article 26) could be linked to these ideas as well as technological tools could be critical in allowing an individual to educate themselves or to supplement their education in ways that they are free to choose. But, even after considering these concepts and ideas I am still unsure of how I would place technological access in the context of human rights. However, I do think it may be important to consider these ideas further as the world becomes more defined by this type of innovation and the connections formed as a result of it.

On a completely different note, this has been a busy week here in Mumbai with one of the largest rainstorms so far in this year’s monsoon season! We had what I am terming a “rain-day” on Wednesday because flooding and train delays were so bad throughout the city that I was told to stay home from work. Here’s a picture of the flooding in the courtyard outside of my office building that I took earlier in the week.

Lily Jordahl
ARMMAN
Mumbai, India

I would like to echo Rebecca’s sentiments about time in the post below me. While the days do not seem to be moving at a particularly unusual pace, I still have trouble believing that I have been in India for almost one month at this point. My tendency to act as an observer rather than a reporter has made me hesitant to put my thoughts on my experience down on this blog, yet having been here for this period of time, I have had significant opportunity for reflection on my involvement in Mumbai thus far. It is challenging to create concrete understandings of my life here, though, as I feel that I see or do something differently each day, even while I generally maintain a similar schedule of activities on a day-to-day basis.

Thus, to briefly reiterate my previous posts from before my travels began, I have been working in Mumbai, India during this summer where I am examining the right to maternal healthcare and the different methods through which this care can be distributed. The NGO I am working with, ARMMAN, has three predominant projects in the works at this point and while I originally believed that I would exclusively be working on one entitled mMitra, which provides voice-messages and animations to pregnant women giving them information about their health and how to take care of themselves during pregnancy, I have also been contributing towards a different on-going project at the organization as well. This is an endeavor entitled Project Hero, which has the goal of creating a database of publicly available information, updating at a real-time pace, stating the amount of beds accessible at hospitals and the availability of blood at blood banks throughout the city.

At this point, ARMMAN is in the midst of discussions with various hospitals during which they are trying to convince them to use a web-application which will be the methodology through which this information is provided to the public. There are eleven hospitals in Mumbai that have already agreed to participate in Project Hero, the challenge now is ensuring that this web application is satisfactory to each of these hospitals. Thus, during these past weeks I have been participating in several different tasks for the project. The first is assisting ARMMAN with communication and outreach to the greater Mumbai area. While this program is significant, and unlike anything that exists at this point in the city, it is not a useful tool unless the general public knows about it. So, I have been working on outreach strategies that can be executed when the web-app is launched to increase awareness. Additionally, I have accompanied the project coordinator on a hospital visit, and will likely go on several more throughout these next weeks, during which I was able to see the hospital setting, including the admitting area and blood bank, where Project Hero will be utilized most. From this visit, another intern working at ARMMAN and myself will try to put together information on how the staff working at the hospital’s admittance can be trained and reminded to use the web-app.

One aspect of ARMMAN that I have found to be incredibly interesting thus far is the way in which health gaps are examined in subtle ways. When one initially hears about an idea like Project Hero, the first thought may not be related to maternal healthcare, yet there is a clear link between the two. If a woman is in an emergency situation during pregnancy and arrives at a hospital that is unable to treat her then there could be severe health consequences, thus this information offers a way for pregnant women and their families to plan in advance. Yet, the downside of this program is that the information will only be available for those living in Mumbai who have access to the Internet, which excludes a significant portion of the population.

Outside of my working life, I have been exploring the city a bit and really enjoying it. I have always found that I personally learn such a great amount from seeing the daily activities of a city and this case is no different than others. While it is consistently cloudy and rainy because it is monsoon season, I have still been able to see some different parts of Mumbai which has been extremely interesting. I will write about some of these experiences in a later post, I simply wanted to use this one to give a glimpse into what I have been up to with my project for the past several weeks and thus will try to write more consistently as of now.

Lily Jordahl
ARMMAN India
Mumbai, India

When I left Delhi at the end of July of 2012, it was difficult for me to imagine how I could find a way to come back to India in the near future, yet I remained determined to do so. While my seven week trip to Delhi and the Northern regions of the country last summer was wonderfully fulfilling and left me with a host of memories that I will likely never part with, it also felt more like an introduction than a conclusion to my relationship with the country. As I became comfortable there, I found myself wanting to know more about how different parts of society intersected and to delve deeper into the parts of culture which I have been drawn to in most places that I visit: gender and health.

Thus, it has been a complete shock and blessing to me when I realize that I will be returning to India in several short weeks to examine both of these subjects in greater depth. This time, however, I will be traveling to Mumbai, India where I will be working for the nonprofit organization Advancing Reduction in Mortality and Morbidity of Mothers, Children, and Neonates, or in shorter terminology ARMMAN. This organization has several projects in action, yet the one which I will be working directly with is an initiative which transmits voice messages to the mobile phones of pregnant women living in rural areas outside of Mumbai, which provide them with information about their body and the growing fetus, as well as ways which they can care for themselves during this time. This project is extremely interesting to me as it takes an approach to public health that is localized and also gives women the opportunity to control their own healthcare by providing them with knowledge, rather than simply the administration of medical care.

At times, especially as my departure date looms closer, I become nervous, as I am sure anyone does when embarking on this type of trip, about traveling to India and taking on this type of human rights project, but I tend to assure myself by remembering the whole host of research that I have done on the topics of gender and health. I have created a concentration in Gallatin titled Reproductive Justice and the Politics of Motherhood, which focuses specifically on the way in which reproductive healthcare is skewed and manipulated by public viewpoints and socially created ideals about gender, sexuality, and reproduction. Furthermore, I have focused even greater on this topic, specifically in the context of India, through my independent study during this past spring. Through this course, I have been able to gain a greater perspective of the historical nature of Indian development, as well as to understand the different actors in the field of social welfare. I believe that all of this information that I have accumulated will be helpful in my journey to India. But, this study has also made me recognize the extremely complex nature of the way in which international relationships and pressure have influenced the development of the Indian state and population. As a result, I believe I will have to think very cautiously about my own role in the country as a white American woman traveling to work there.

In all honesty, however, some of the best advice that I have received about my upcoming trip is that as much as I can prepare for it, much of it will be about learning to release my own expectations for everything that I will be doing there and simply take what comes my direction. One of the most wonderful things that I learned when I was in India the previous summer was to relax and recognize that things may not go as planned, but then a better plan may appear as a result of that. I am extremely positive that this upcoming trip will hold amazing academic prospects that will expand my way of thinking about my subjects of interest, yet it is difficult to say exactly where I will find the most moving and interesting information.