May 11th, 11:45 pm
A village health worker (VHW) is the backbone of the CRHP (comprehensive rural health project) model and one of the main reasons I'm here which is to learn from them. A VHW as defined by me is essentially a nurse practitioner level of worker who serves her village from multiple angles including health as well as social/financial levels to help better their lives. They still maintain their families, work in the home, and in the fields or their dhanda, but are VHWs in addition to everything else. They are trained most importantly in prenatal care, obstetrical care (perform deliveries, up to 500 for some), post natal care, and they possess knowledge on many diseases including TB and leprosy in the old days, and now more diabetes, hypertension, and even mental health. They come every 7 to 15 days to CRHP to get trained in the various areas and they also help collect data that helps to see the program's effect. They educate their villages using various methods including dedicated visits to pregnant patients, talking about health while picking crops, and by being consulted for their knowledge.
These ladies have amazing personal stories as far as how they have become a village health worker. This is very lengthy to share, but I will try to summarize a few. The overall goal of CRHP is for the village to choose those that are not necessarily educated, but those that are representative of the poor with a comparable literacy level of the women they will serve. Some were natural leaders and some grew into this role with the help of other VHWs. The following stories are from the VHW in their own words.
VHW1 told us that since she was one of the eldest in her family, she had to take care of others and never went to school. She was married at age 9 to a 23 year old. Once she began to menstruate, she went to her husband's home, however he already had remarried. She was eventually taken in by him, however, she was treated very harshly and she couldn't handle the daily 7 km walks for water. She left her husband and went back to her home however they were unwilling to take her in as well. Under the direction of a VHW in her village, she was brought to CRHP where she slowly gained confidence, self-worth, and in her words, she was made a statue out of stone. She recently received a reward from the government for her service for 1.5 lakhs - she's not exactly sure what she is going to do with the money, but she does want to donate some to orphans.
VHW2 is an 8th grade level educated woman who was married at the age of 14. Like her father, her husband was also an alcoholic. She was mentally and physically abused. This led her to attempted suicide by jumping into a well however a passerby rescued her. She went back to that husband and became pregnant twice and gave birth to two girls. Her husband reasoned that since his wife's mother only gave birth to girls, that so will his wife and therefore left her after trying to kill both her and one of her babies. The people from the village defended her and kicked out this guy from the village and he hasn't been seen since. She was shaken up by all of this, and lost it mentally therefore she was taken to a hospital. It took her time after this to realize her self worth, but she was able to do this and was eventually selected by her village to be their VHW. In addition to being a VHW now, she is a successful businesswomen and has both a wedding business as well as a stationary shop.
The concept is simple - put health in the hands of the people. Basic health knowledge like the signs of diabetes, as well as complicated knowledge and skills such as delivering a baby can be taught to anyone with the desire to learn regardless of their previous education, caste, or social situation. It was very inspiring to meet all of these individuals and humbling to know how much of an impact they have made. When I asked a lady what she feels about us coming from far lands to learn from them, she told me, that whatever you learn, just make sure you do something about it.
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