After completing her specialisation in Gynaecology, Dr. Taru Jindal’s journey led to her to the Motihari district and Masarhi village in Bihar. The state of maternal and child healthcare (MCH) in both these places were abysmal. With the support of hospital staff and community healthcare programmes, Dr. Jindal transformed the state of maternal and child healthcare in rural Bihar. Her book, ‘A Doctor’s Experiments In Bihar‘ outlines her experiences and learnings at the Motihari District Hospital and Masarhi Health Centre in Bihar. Maduli Thaosen talks to Dr. Taru Jindal about her book, the two years she spent working on maternal and child healthcare in rural Bihar and much more!
Q: Can you tell us a bit about your book?
A: I’m Dr Taru Jindal. I’m from Mumbai and have done my MS in Gynaecology from Sion Hospital, Mumbai. After completing my MS in 2013, I was eager to work at a place that needed me much more than cities did. I was itching to work in rural areas of India where I had heard that mothers delivered at home and children’s health suffered due to lack of facilities. I immediately found a project in Bihar, or should I say the project found me. It was sponsored by Bill and Melinda Gates Foundation and managed on the ground by two NGOs: Care-India and Doctors For You. They sent me to Motihari District Hospital and the mandate that was given to me was to improve the skills of doctors who were responsible for the maternity unit. As it turned out, I worked with not just doctors, but also nurses, sweepers and Dais, and worked on much more than just their skills! These 6 months turned out to be a milestone in my life and in the history of that hospital as well. Motihari District Hospital went from being one of the worst performing District Hospitals of Bihar to winning the prestigious ‘Kayakalp Award’ from the Government of India twice.
After this, I moved to working in villages of Bihar and helped to establish a health centre in a remote village called Masarhi in Patna district. Its aim was to provide 24×7 delivery services and manage childhood malnutrition. This too, turned out to be a transformative experience for me and the people there, with loads of unforgettable lessons and experiences.
After returning from Bihar, I wanted to find a way to consolidate and store these experiences and its learnings, so that it could be shared with others and act as a window to the rural India of the 21st century, about which most city bred people are ignorant of. Also, I wanted it to prompt others, especially the youth, to spend some time of their lives, even if it’s just one year, in rural areas and use their skills to solve some issue there. Hence the book. This book was graciously accepted and published by Speaking Tiger as ‘A Doctor’s Experiments in Bihar’. It is available in all leading online stores. It was also translated into Marathi by Rohan Prakashan—’Haa Yeh Mumkin Hai‘, which released to excellent reviews by readers.
Q: What is the status of Maternal and Child Healthcare (MCH) in rural Bihar?
A: 89% of people in Bihar live in rural areas, as compared to 61% in rest of India. According to the data in the Sample Registration System (SRS) 2015, Bihar has the highest total fertility rate (TFR), i.e., the number of children being born to a woman. However, the per capita income of its people is the lowest in the country: Rs 31,200 (India’s average: Rs 74,380). To add to the challenge, the number of children dying in the 0-4 age bracket is the highest in the country, 22.4. The maternal mortality ratio is 228, also one of the highest (India’s average: 167).
This made it extremely important that I choose Bihar as my field of service after getting my MS degree.
Q: Tell us a bit about experiences and learnings at Motihari District Hospital and Masarhi Health Centre.
A: The conditions at Motihari District Hospital were beyond anything I had imagined. The very first day, I saw a sweeper deliver a mother in the Labour Room and people were moving freely in and out of the operation theatre! The women doctors, who were responsible for the maternity system, were busy in their thriving private practices, coming to the hospital only for high risk cases. The nurses and sweepers were managing most of the deliveries, but were not skilled to even measure blood pressure. This was leading to a lot of mishaps. Babies were dying during delivery and mothers were landing up in complications. The challenge presented to me was much bigger than the mandate with which I had arrived there.
I decided to do what I could. Before working on their skills, I decided to work on their attitudes. Taking example from Gandhiji’s ‘Shram-daan‘, I took the broom and started sweeping the hospital. Some joined in. I sat with them hearing all their saas-bahu stories, just so that they would accept me. Soon, they became receptive to my suggestions and I did lot of training sessions with them. Their augmented skills were in full display in the labour room where they started saving mothers and babies. The hospital infrastructure was also simultaneously being worked upon by the hospital and district administration. In just 6 months, people said the hospital had completely turned around.
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After this I moved to working in a remote village called Masarhi, where challenges were even more severe. Here I had to work not just with few nurses and doctors, but with the psyche of the whole community. The mindset of people was orthodox, women were suppressed and healthcare was in the 1970’s. 70% deliveries occurred at home and more than half the kids were malnourished.
The challenge started with getting people to accept me and the health centre. In order to get the community to open up, we did many Community-Connect interventions like ‘Community Baby Shower’, ‘Holi Milan’ etc. Slowly people accepted us and the health centre was fully functional. We started a ‘Nurse Assistant Programme’ to deal with the lack of skilled work force in our health centre. We trained housewives of the surrounding villages into nurse assistants and they became our major force behind managing childhood malnutrition. This health centre has now been converted into a 100 bedded hospital in Masarhi and has also become an isolation centre for Corona cases. Those nurse assistants continue to work there. Many mothers have seen the beauty of skilled deliveries and the malnutrition programme has cured hundreds of children from the malady.
The experience of working in rural areas of Bihar for those two years (2014-2016) is one of the high points of my life. I hope readers will be prompted to reflect over their own true purpose in life and hopefully, get the courage to walk on it.
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Featured Image Source: Dr. Taru Jindal