Nav Jivan CHDP

When you've gotta go - you've gotta go!

Sheba and I were a year into our marriage. We were both totally sure that God had brought us together - for each other and to serve Him in North India in a rural setup. We had been working at the Nav Jivan Hospital, running the Community Health and Development Project (then called "DISHA") and had just started up a tuberculosis control work which we had christened "DOST" (to point out that it was not yet at the level of the Govt. sponsored DOTS programme).

We were just about to launch into a project to build a community health training centre and TB control place. A young architect had come and designed a Laurie-Baker-inspired plan. The cost was going to be something like Rs. 40 lakh. This brought pause for reflection. Not only was this a lot of money - but it also meant that if we were jumping into it, we would need to be sure we would be around for the next 5-7 years at least.

Surprisingly for us, as we prayed about this step together - neither of us had peace to move forward. Puzzled we decided to carry on in what we were doing (there was plenty to do - as there still is today) while being open to God leading us to wherever He wanted. We decided that we would not actively look, but if someone called us, we would take it seriously and go and pray on that site.

When the requests came they came as a threesome. We first got a call by our dear friends Drs. Isaac and Vijila David to join them at the Prem Jyothi programme in Sahibganj Dist of Jharkhand. Then Rev. Viju Abraham asked us to join the ACT HIV/AIDS programme in Mumbai. Finally our supervisors suggested we also look at the Purnatha Bhavan in Igatpuri. To cut a long story short - after visiting all three places and coming back to Nav Jivan Hospital to consider and pray we found ourselves shocked to be suddenly telling our colleagues that God had clearly said to shift to Mumbai and work among people with HIV/AIDS through local churches.

If we were shocked at this sudden turn of events - our colleagues were more so. What would happen to the community work that we started? There were no successors in sight. Who would take up the TB work? None of the senior hospital officers showed much interest in taking things forward.

One thing we knew - that if God was in this - He would take undertake. We came across a book at that time by Oswald Chambers where he talked about how Abram had to leave in obedience to the call - and leave God to sort out the rough edges of his departure.

Last week we were in Jharkhand - 8 years after we left Nav Jivan Hospital. We are humbled by what has gone on in the time of our absence. In many ways both the community and TB programmes have gone well beyond what we could have thought for them.

Meeting with the current Community Health and Development Programme team we found out that they are now doing reproductive and child health work in 30 villages! 20 of these villages are directly being served by the CHDP team, with another 10 being looked after by partner NGOs. These are some of the most challenging parts of Jharkhand - places where the Maoist insurgency has dug deep roots - and where our staff have over the years met up with armed groups on multiple occasions. We salute our colleagues - a few still there from our time - and a whole cohort of new members - for their love of the people and willingness to serve in what is basically a thankless job. The community team is often misunderstood by the rest of the hospital community, and by the village communities that they serve as well.

The challenges of seeing true health change take place continue. During this visit to Nav Jivan the CHDP had their monthly meeting with the "ASHAs" from their project villages. The term Asha (Accredited Social Health Activist) is the new term for Community Health Workers as part of the Government's National Rural Health Mission.

Seeing these ladies took us down memory lane. The training of women to help their communities through practical and life-saving steps continues. While we were at the hospital a child was brought in a critically late stage to the hospital. Pneumonia. The child died during admission. Another life that could have been spared if the parents had started treatment in time. If the child had come from a village in which the CHDP was working, it would have hopefully been detected by the local 'Asha' and then taken for early (and cheap) treatment.

Probably the main difference between our time and the CHDP of today is the degree with which the CHDP is able to work with the government. In our day the government was indifferent to what we did. It still is largely - with so many of the functionaries and employees milking their position for the lucrative salaries and doing minimal work. The presence of the Maoist forces are used by many govt. officials as an excuse to shirk their duties at remote postings. But the difference now is that in the villages where the CHDP is working, the government posted ANMs (nurses) are very open to working with the CHDP since the team is now an accredited part of the government rural health mission.
The challenges that our colleagues in the CHDP face continue. This year was a drought year so many homes in the village are shut as people have migrated in search of livelihood-work. The rigours of daily visits to distant villages. The dangers from the low-intensity conflict that is being played out between the Maoists and the Paramilitary forces.

We are humbled by the on-going service that the team of the Nav Jivan CHDP, lead ably by Prabodh and Julieta Kumar, are rendering to the villages they touch. The challenges continue - and the need for them to be involved in the community-changing work they are doing has not lessened, with so many villages still unreached. Hats off to these unsung heroes!

We are proud of each one of the team - and humbled to see how much things have developed since we left in late 2001.

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P.S. The tuberculosis control programme has also developed in leaps and bounds - and now covers the whole district under the amazing guidance of a string of remarkable doctors and field workers - but that is a whole different story...