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IWD.pngToday is March 8 – International WomenâÂÂs Day. While the focus remains largely on achievers so that they become role models to inspire others, the contribution of a silent majority goes unsung. These lakhs of foot-soldiers brave difficult conditions to save women and newborns across the country. TheIndiaSaga.com brings to its readers a story from Fakirpuri the last Indian village along the international border in Uttar Pradesh. Nepal border, which is just 500 metres away from here, is perhaps its closest neighbourhood.

The village is about 120 km from the District Headquarters at Bahraich. One has to drive through 53 kilometers of dense forest and lush green fields from Mihinpurwa block to reach Fakirpuri which is a small Tharu tribe dominated village with a population of just about 1,440.à Tharu community is an ethnic group indigenous to Terai region (Himalayan foothills) in India and Nepal. The inaccessibility and proximity to the international border make this Tribes village difficult-to-reach with extremely poor mobile and internet connectivity. Other than the deployment of security forces, an anganwadi centre and a primary school show the governmentâÂÂs token presence here.

The entire healthcare system in this village from a sub-centre situated about 8 kms away. The Aamba sub-centre is run by an auxiliary nurse midwife (ANM) Sumitra Devi, and she is assisted by an Accredited Social Health Activist (ASHA) Prem Kumari, who is the first port of call on health-related issues. If Sumitra Devi has been instrumental in ensuring the safety of young mothers and children since 1989, Prem Kumari has been promoting ante-natal care, institutional deliveries, post partum care, immunization and even family planning. The closest tertiary care facility is the District Hospital at Bahraich.

Of and on, the community also contributes its bit in running the show. Just last year in October, the region witnessed massive floods and the village was totally cut-off from the mainland resulting in an acute shortage of drinking water, vaccines and medicine at the sub-centre with the threat of water-borne diseases looming large. The ANM started functioning from a nearby sub-centre where her mobile was partially functional and the sub-centre was not totally submerged in water.à One of the ASHAs coordinated with the Community Resource Person (CRP) â posted by the Technical Support Unit which is helping the UP government implement a comprehensive programme to improve the maternal and child health care — coordinated with the ANM to alert the staff at the one of the larger facilities in the block regarding the urgent need for medicines, vaccines and clean water.

The staff from the Motipur Primary Health Centre brought supplies to the sub-centre where the ANM was stationed at that time. To transfer the medicines and vaccines to the flooded area of the block, local villagers packed the medicines in a series of polythene bags which they tied on their bodies. The villagers used rubber tyre tubes to swim across the flooded area to ferry supplies to Aamba sub-centre and then to Fakirpuri village. Even during normal times, the ANM Sumitra Devi has to fetch medicines and vaccines from the Bicchiya raiway station which is approximately 15 kms away from the Fakirpuri and the last rail head to the region, on her scooty. Alternately, when she goes for the weekly cluster meetings, she picks up the required stock.

Prem Kumari has been running the show efficiently. She has all details on the fingertips and tells without hesitation that there should to be 39 pregnant women registered with her as per the population norms. Her Village and Health Index Register (VHIR) was updated and she was proficient in discussing the 5 key indicators of mother and child care including registration, ANC, Institutional Delivery, PNC and use of contraceptives. However, despite all the initiatives, some deliveries were still happening at home. This was primarily because of lack of mobile connectivity. “”The BSNL connectivity here is not very good and sometimes it is not possible to call of ambulance. Therefore, we have to plan birth well in advance. I tell the families that they should make alternative arrangements for deliveries just in case the ambulance could not arrive,”” she says. But, there are times when deliveries are done at home due to logistical issues, she explains while adding that she was trained in Home Based Neonatal Care as well.

“”ASHA batayin raha kewal apna doodh pilana pani bhi nahi dena,”” says Sumitra a lactating mother when asked what all had she learnt from ASHA. The ASHA is a highly respected individual in the village with people taking her seriously. The umbilical cord of SumitraâÂÂs new born child was dry and nothing was applied on that which normally is the practice in the communities. Her husband said he would have the second child only after at least 4 years, and her wife would opt for IUCD. A large number of eligible couples have opted for modern methods of contraception. But this change did not come overnight. According to Prem Kumari, whenever she used to ask women to adopt family planning methods, women used to tell her that she also have two children, so why had she not opted for sterilization. “”Then I decided to set an example and opted for sterilization,”” she said.

Interestingly, the community does not have a quest for male child and, hence, there is no discrimination among girls and boys. Girls are in fact called as “”babu””, something often used for boys. The use of “”babu”” explains the position of girls in this community. “”The induction of CRPs has brought about a massive change in the healthcare systems in far-off areas. She coordinated very well with the frontline workers and services are being delivered, and little wonder then that healthcare indicators are improving at all levels,”” Jairam Pathak, Zonal Community Specialist (ZCS) said.”