Akshya Mishra; the youth advocate from Pittal
It is half past one in the night and the downpour is quite heavy. Three youths are pulling a rickety cycle rickshaw through the mud-slippery village roads. They arrive at the primary health centre (PHC) carrying a pregnant woman.
Sumati is a 20 year old woman in the throes of her first pregnancy. Her husband is a farmer and she has come to her father’s house to deliver. Sumati left her studies early and helped her family in agricultural work till she got married. The labour pains of Sumati had started in the evening, since 6.30 pm and the situation became complicated towards the midnight. The ANM staying next doors was absent and in any case the family had preferred the delivery at their home itself.
As Sumati was screaming in pain and her parents wondering what to do, three village youths - members of a local youth club virtually forced her mother and her to sit on the rickshaw to the PHC. Understandably, the family was in no mood to take pregnant Sumati to the hospital as it would cause them unnecessary expenditure.
The next morning Sumati gave birth to a healthy baby at the PHC, but the doctors failed to keep her alive to even take a glimpse of the new-born.
While narrating the story at a Workshop on Safe Motherhood, Akshay Mishra (23) of the poorly literate Pitala village in Orissa’s Ganjam district had a sign of satisfaction on his face that their attempt could save a child from sure death, but at the same time in serious pain of loosing his childhood friend Sumati. What the doctors said, a little early hospitalization could have prevented the untimely and needless death.
Even if the Pitala villagers call it “God’s Will”, the woman’s death had a deep impact on young Akshay’s mind and he became determined to prevent casualties of this nature in the future, at least in his own village. Thus he was at the training workshop for Youth Advocates on Safe Motherhood, organized jointly by Unicef and Nehru Yuva Kendra Sangathan (NKYS), one of the 100 youths attending the workshop. Not to be called a civil society network or any formal mode of launching a campaign, a cadre of about 4500 sensitized youths on maternal and neo-natal issues is on the making to take up the challenge of safe motherhood in Ganjam.
This initiative is part of the UNICEF Maternal Mortality Advocacy Project funded by United Kingdom’s Department for International Development (DFID).
Ganjam is the largest district of Orissa with 22 blocks and a population of around 3.4 million. Close to 70 percent of the district’s population live in the villages. The problem of a high maternal mortality and high infant mortality rate is always a worrying trend for the health authorities and administration.
“Last year, 13 confirmed maternal deaths due to unsafe delivery were reported. If a proper survey is done, the figure would surely increase. Even if the government measures for preventing such casualties under various state as well national health-related programmes are taken to the easy reach of people, the response has been very disheartening,” Chief District Medical Officer Dr Umakant Tripathy says.
District Nuclear Medical Officer Dr B P Mohapatra supplements, “Hardly 20 to 25 percent of the pregnant women in the district come for institutional delivery, while the rate in rural areas is below 10 percent. This should reach at least 80 percent.”
Apart from imparting trainings to the 500- odd ANMs working under the 444 health centres, under the National Rural Health Mission (NRHM), as many as 872 Accredited Social Health Activists (ASHAs) have already been recruited in the district. Recognized and supported by the ASHAs, the ANMs and other district health officials, the Youth Advocates would motivate the people in their villages and localities for institutional deliveries and would make them aware about the available welfare schemes for safe motherhood.
“The Youth advocates would play the role of facilitators and build linkages for monitoring pregnancy and birth, ensuring safe motherhood in their community. Being from within the community and having better understanding of the minds of their people, they can be seen as the future soldiers to tackle this big social challenge.” says Project Officer, Advocacy and Partnerships of Unicef, Lalatendu Acharya.
Safe motherhood youth advocates at the workshop
Youth Clubs Putting on a New Garb
Youth Clubs, whose spheres were mostly restricted to recreational and knowledge-development activities would now play a much bigger role of shouldering the responsibility to promote the concept of institutional delivery and safe motherhood in a novel way.
The Unicef-NYKS combine is sensitizing 450 Youth Advocates, each representing a youth club in the district. Each of the 450 Youth Advocates would again sensitize at least 10 members in their individual groups, which would be called the Matrutwa Sahayak Yuvak Sevasangha (MSYS).
Regional Coordinator of NYKS, Berhampur Region Naveen Kumar Naik say, “The Youth Advocates are being taught how they can on their own play a vital role in the reduction of maternal and neonatal mortality. Besides, they would be enabled to interact with other stakeholders like the media, panchayat raj institutions, health functionaries and the field level workers like the AWW, ASHA and ANM.”
The MSYS are also free to define their roles and responsibilities and produce their own action plans for reduction of maternal mortality in their own communities.
According to Naik, so far 60 MSYS have become operational and 600 Youth Advocates have been prepared in Ganjam district. Even if it’s a bit early to say that the Youth Advocates would bring radical changes in the field of safe motherhood, yet the beginning has remained quite impressive. In each of the training workshops the participants are coming out with their own action plans and ideas of tackling maternal mortality, most of which are being taken on a serious note by the administration and health authorities.
In addition to Ganjam, Youth Advocates are also being prepared in 14 other districts of the state namely, Puri, Khurda, Phulbani, Kalahandi, Koraput, Bolangir, Nuapara, Sambalpur, Dhenkanal, Keonjhar, Sundergarh, Cuttack, Balasore and Mayurbhanj.
By the end of December, 2006 the Unicef-NYKS joint venture targets to prepare at least 1.2 lakh Youth Advocates from 12,000 youth clubs of the state in these districts.
As one youth advocate proudly says after the workshop, “Safe Motherhood is an issue of collective responsibility. We must save our mothers from dying.”