Family Planning in Rural Bihar

Today was the family planning expedition into rural Bihar, four of us in an old jeep boldly going where the electric pylons and wires have not gone. I have seen poverty, but this was literally dirt poor. All mud roads impassable during monsoon, mud and thatch huts with the animals and people living side by side. No running water or sewage system, just a shared village pump and open air bathroom in which ever field took your fancy. The narrow main streets had just enough room for the jeep and were lined with buffalo or cows grazing just outside the house door or roaming around amount the goats, chickens and half naked, matted haired children. Due to living in such un sanitary conditions in close proximity to animals Dr Sunil told me that villagers suffer from all kind of skin diseases and worm infestations, along with TB, childhood diseases and malnutrition.

Dr Sunil was also helpful in translating the conversations between the health worker Sunita and the village women; being a man it was not culturally acceptable for him to talk about family planning with women directly. In one village we had to meet with the men first before we were allowed to talk with the women and the men also listened it and gave their opinions. This was a new area for EDLT to work in and we were doing the first on many information sessions to introduce ideas on family planning and EDLT’s work to the villagers.

 The Indian government has a program set up where they pay for women or men to be sterilized; of course the men will not even think of having it done so it is up to the women. However the government relies on local NGO’s to do the leg work of informing the people of this service, bringing the people to hospital and assisting patients with after surgery care. The very thought of recovering from a big surgery like that in the comfort of your own home in the village is just asking for major infection and come to think of it I am not so sure I would trust a Bihari hospital either. Anyway EDLT’s family planning program uses the government funded surgery as a platform to talk about all kinds of contraceptives and offers ideas on how to plan the gap between children. EDLT tries to encourage parents to have fewer children and emphasis a better quality of life for the family; such as less worry, work and money providing for fewer children, getting the children and education and having time to spend enjoying children. I met women who have 6 or 5 children, they were thin and looked exhausted and were hardly 26. The danger with big families is that not only may there be not enough food but there is a high risk that parents will send their children off to work in the city or worse still sell girls unknowingly into the sex trade. So good family planning, stops over population and abuse of children.

Sunita and Dr Sunil were so kind in answering my question about women’s health and told me about the variety of problem’s women face. Girls getting married in their teens is a huge problem, because the mother and baby do not get enough nutrition during those years of maternity and breast feeding. There is a high infant and mother mortality rate at birth, the villages closes to towns have a higher rate of AIDs and STD’s and I learned about an infection called Leucorrhoea, brought about due to bad sanitation which can render a woman infertile; and an infertile wife in rural India can become a social outcast, since motherhood brings status. Dr Sunil helped me talk with some of the women and I backed up what Sunita was saying that having fewer children equals a better quality of life for everyone; what else could I say. After a day of talking and driving around to different villages I think Sunita and Dr Sunil had spread the gospel of fewer children pretty well and I am sure gossip travels fast in the area. Next week they will go back and talk some more, answer questions and maybe take along some women from Bodhgaya are who have already gone through the surgery, and who have used other contraceptive methods. In the village I also noticed that Suntia would pull in the older women into the conversation to get their approval and for them to give their opinion. It is essential to get the approval from the older women and men as they will have a lot of say in how the program proceeds or does not proceed. I have learned so much today and in many ways it is hard to describe and truly relay the range of emotions I secretly went through while seeing such abject poverty. It is also so evident in the village that education is the key to end poverty. Not necessary a formal university education, just basic knowledge of health, the human body and nutrition in relation to the environment, the three R’s and some street smarts about the world outside the village.