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Volunteerism at Work

Fundamental health care practices benefit Kerala’s poor.

text and photographs by Sean Sprague

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Thirty-four-year-old Amala is animated and humorous, bursting into occasional raucous laughter as she describes her life. We sit in her tiny home, a hot, one-room dwelling in Karimadom, a poor neighborhood in Trivandrum, the capital city of the south Indian state of Kerala. Amala is a single mother with two children ages 12 and 13. She is a confident, warm woman who works as a volunteer for Kerala’s Health for One Million (HOM) program.

“Health care is more important than disease cure,” she exclaims, stating one of the guiding principles of HOM. She and hundreds like her are the backbone of a remarkable primary health care program providing medical care to more than a million people in Kerala.

“We want our health services to take primary health care to the masses,” said India’s Catholic bishops in 1978.

This mission inspired the late Lawrence Mar Ephraem, then the Auxiliary Bishop of the Syro-Malankara Catholic Archdiocese of Trivandrum, to begin the HOM program.

To support this ambitious program, Mar Ephraem enlisted the support of the Bethany Sisters, a Syro-Malankara Catholic religious community of nuns who combine Eastern Christian monasticism with the essence of Indian spirituality and an active commitment to serve the poor.

“The enjoyment of the highest attainable standard of health,” states the constitution of the World Health Organization, “is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” Health is a basic human right that usually falls short of realization in countries like India. Zones of urban blight have developed in what was once rural Kerala – open drains, lack of latrines and safe drinking water, muddy puddles breeding mosquitoes, shanties tacked together with scraps of plastic and cardboard, unemployed parents and hungry children. More children in these areas die of easily preventable ailments such as diarrhea than from any of the more serious diseases such as malaria or tuberculosis. Primary health care, with its emphasis on prevention and early detection, is the answer to this alarming problem.

As Amala leads me through the muddy alleys of Karimadom, she explains HOM. The program works primarily through women who are trained in primary health care and encouraged to take responsibility for the health of their communities.

The HOM worker is a volunteer in the truest sense of the word. Any mother who is interested in her community, able to communicate her knowledge to others and willing to volunteer roughly two hours each month may become a village or neighborhood worker. The primary volunteer position is the “mother leader,” who is responsible for 10 families in her community. The families choose their mother leader on the basis of a volunteer’s organizational and leadership abilities. Amala is one such volunteer.

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Tags: Kerala Health Care Poor/Poverty Women in India