With a population of over a billion, India has over 35 million people living in poverty. Despite having made commendable strides in economic growth and reduction of poverty through aggressive economic and trade policies under its Structural Adjustment Programme, in 1998 India was still ranked number 128 in the United Nations Development Programme (UNDP) Human Development Index. The incidence of rural poverty at 37% is higher than that in the urban areas which shows a figure of 31%. Among those ravaged by economic poverty, women and children and indigenous communities, especially in rural areas, are the most disadvantaged. A different version of poverty - a socio-political one, arising mostly out of caste-based discriminations and denial of fundamental rights - makes their status even worse. Gender bias, which cuts across communities, exacerbates the already disadvantaged positions of women and girl children. In India average life expectancy at birth is 62.9 years, the adult literacy rate is 55.7% (39% for women, indicating low enrollment for girls consequent to gender inequalities in access to education) and the GDP is US$2,077 per capita. But behind these global figures there is a very uneven distribution of wealth and development. 99% of the country's wealth is concentrated in the hands of 3% of the population. The overall development picture is compounded by regional disparities: in the poorest states, such as Bihar, Jharkhand, Orissa, Madhya Pradesh, Rajasthan, Uttranchal and Uttar Pradesh, millions of people live in abysmal conditions of poverty, malnutrition, ill health and illiteracy. These millions are in the position of poor food security or marginal livelihoods. In the area of health there are extreme regional variations in health status. For example in 1996 the Infant Mortality Rate (IMR) varied from a low of 13 deaths per 1,000 live births in Kerala to a high of 97/1,000 in Madhya Pradesh. Gender-based violence is fast becoming a major cause of concern and is evident with the rise in infant mortality rate (IMR) in states where female infanticide is rampant (eg. Tamil Nadu, Rajasthan, Punjab). Female foeticide continues to be on the rise even in states like Haryana and Punjab which are rich with natural resources and have a thriving farm economy, indicating that gender-based violence is cutting across economic barriers, though poverty is found to be aggravating such violence. Policies to ensure social justice and equity have been found to be inadequately addressing the question of land rights and equitable distribution of land and other natural resources like water. Denial of rights of women and children in all sectors of development has remains a critical concern, in spite of the Indian sub-continent's achievements across other sectors like trade, Information Technology, defence and nuclear advancement. India is a signatory to a number of international treaties and declarations, including the Alma Ata Declaration of 1978 promising 'Health for All' by the year 2000 and the UN Convention on All Forms of Discrimination against Women (CEDAW). Yet application of the provisions and clauses therein are still a distant dream, countered by poor implementation and dis-investment policies affecting social and health sectors. Location: State Uttaranchal Uttaranchal was created as the 27th State of the Indian Union, on 9th November 2000. Uttaranchal has thirteen districts named Uttarkashi, Dehradun, Tihari Garhwal, Rudraprayag, Chamoli, Pouri Garhwal, Haridwar, Almora, Bageshwat, Pithoragarh, Nainital and Udham Singh Nagar including district Champawat. Uttaranchal is primarily a Himalayan State with 11 out of is 13 Districts totally or partially falling in the mountainous region. As per the 2001 Census Uttaranchal has a population of roughly 8.5 million within an area of about 55,845 sq. km. Uttaranchal has a total 550,000 hectares of land, out of which 12.5% are agricultural and 2.5% are other utilised lands. The literarcy rate is 60.26% for female and 84.01% for male. The majority of the people are dependent on subsistence farming for their livelihood, as there are few commercial and industrial enterprises to support large-scale employment. Uttaranchal is known for tourism and pilgrimage. Many sacred places like Haridwar, Badrinath, Kedarnath, Yamunotri and Gangotri and hill resorts like Musoorie and Nainital support the State's revenue. A famous park named Corbett National Park is also in this State, which is situated about 240lms from Delhi. Placement: District Champawat KAGAS' main office is located in Pithoragarh districts. Champawat is an area of 1039.35 sq.km. with a total population of 1,01,416 (1971). The altitue of the region varies from 375m to 2209m above sea level. About 66% of the total geographical area of the region likes between 600m and 1800m. The highest and lowest temperaryres recorded for Chapmawat, are 26 degrees celsius and 4 degrees celsius respectively. Rainfall can be as high as 1547mm. About 525 sq. km, of Champawat's land is covered by forests, amounting to 50.5% of the total area. Even though land is equitably distributed among people and the incidence of landless families very low, the average land holding size is less than 1 acre per family in the hill areas. Harsh climatic conditions, poor logistical support and infrastructure, unproductive and labour intensive farming on fragmented landholding in the absence of appropriate farming techniques, make agriculture yields rarely enough to meet the basic food and nutritional needs. The region is rainfed and hence dependent on a single crop. Despite the abundance of natural water sources, absence of irrigational infrastructure makes it impossible for the mountain communities to maximize the yield from their farms. Male members are therefore forced to migrate in search of work as workers in the plains and a lesser number as soldiers in the Indian Army and other paramilitary forces. In the absence of male members, the burden of subsistence agriculture and food security falls on women. Primary health care services are limited. For example most children are not immunized. Pregnant women do not seek ante or post natal care or food supplements and immunization. Pregnant women are dependent on local traditional birth attendants (Dai Ma) or elder female members of the family for a safe delivery. Under a large Community Based Economic Development Programme supported by the Canadian Centre for International Studies and Cooperation, (CECI), primary farm producers are being organized into producer cooperatives, and women's Self-Help Groups are being federated as Thrift and Credit Cooperatives. A recently enacted self-reliance Cooperative (equivalent to MACS in the State of Andhra Pradesh) has paved a new path for fully-owned and controlled community cooperatives, without political influence and interference. Health infrastructure built by the State and the District administration lies vacant in the absence of qualified personnel, who refuse to serve in remote areas due to lack of basic facilities. In the event of illness, the first step is usually a home remedy and some times is the only remedy provided to women and girl children. The next step is to seek help from the unqualified medical practitioners or quacks in the area, whose 'injections' seemed to have had a great influence on the health seeking behaviour of the local communities. The district hospital is inaccessible for most, in the absence of roads. To seek emergency medical help at night or during the rainy seasons is a severe ordeal. The patient if seriously ill has to be carried on a make shift stretcher by 5-6 able bodied men over tough treacherous passes to the nearest road, from where if luck permits, they will find a taxi, normally a dilapidated jeep. Pregnant women thus resort to older women in their villages for delivery. State medical care personnel visit the villages rarely; even if they do the visit is restricted to villages adjoining motorable main roads. Thought he care is meant to be free, it is common for the ANM to demand money especially for conducting delivery. Interestingly, the fee is less for a girl child (normally INR1000) and more for the boy child (about INR1500)!! Women's trek in search of water, driftwood for fuel and fodder often causes accidents. Many cases of the women falling from treas and breaking a limb have been reported. In the absence of appropriate medical care and social protection like insurance, families suffer loss of income. Lack of basic awareness on health and nutrition cost an average of three months of man hours every year to each family, besides at INR 1000 per visit to the district headquarters, if such help is sought. Most diseases are water born, affecting children and adults alike. Incidence of malaria and gastro-enteric diseases is common. Low temperatures throughout the year and sut inhaled during labour in stone-breaking units or mechanized threshing units ensure that lung infections and wheezing bronchitis affect most of the working population, men and women alike. Most of the scheduled castes and tribes are landless or have small land holdings, making them dependent on local landlords for cash economy. Traditional artisans like carpenters and bamboo craftspeople are unable to earn sustainable incomes, in the absence of market intelligence and access to markets, as usual enriching the middlemen. In short, women and their families in the area need mechanisms to manage their health concerns, besides appropriate support to ensure sustainable livelihoods. Having already been organized around thrigt and credit and made voal to an extent, they are now willing to contribute to making health care affordable and accessible in their villages.
Essential
Desirable
Currenly ISLD is working in villages around Aurangabad city and also in urban slums within the city. The ISLD offices are located in Aurangabad city. The HT will work within the slums and villages, besides conducting training sessions in the office/clinc premises of ISLD. The project area is characterised by extremes states of poverty especially amongst the tribals and lower castes. This is due to social inequalities, low agriculture productivity, climatic instabilities and lack of public policies in favour of development of this region. The rural communities depend on an agricultural economy. Children's education, good nutrition and good health care have remained low priorities. Large - scale inward migration and increase in the urban slum settlements also brought with it an increasing number of HIV/AIDS cases. ISLD is currently conducting a survey to assess the spread of HIV/AIDS among the slum population. The current ISDL intervention aims at equipping client communities with adequate skills not just to manage their health status but also to access existing services and facilities trhough creation of adequate backward and forward linkages. ISLD has a referral care centre with medical and paramedical personnel to carry out its programme. The referral care centrre has two examination rooms, two doctor rooms, one pathology laboratory, one opthalmic care room and one X-ray room. Equipment available for the health trainer to use in their work includes an X-ray machine, a well equipped pathological lab, a well equipped opthalmic unit, Nebulizer, ECG, Sonography machine. There are no computer facilities. ISLD normally makes use of the local internet centres/cafes. The organisation utilises hired vehicles. Terms and Conditions: To be provided to applicants upon request
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