On a Monday morning, I paid a visit to Pahal Jan Sahyog Vikas Sansthan’s medical center in Khajrana, located just a few minutes away from the Khajrana temple, where the initial seeds of the organisation were sown. A small, non-descript entrance lead to 4 hospital-like rooms. These serve as Pahal’s OPD/IPD. In one room vaccinations are done, in another medicines are distributed, and the last serves as the Gynecological room catering to women only.

The medical center was set up in 2010, when a baseline survey revealed that a large of children in Khajrana (which comprises of 52 slums) had not received a single vaccination. The survey also revealed that pregnant women did not go for regular checkups during their crucial nine months; only if they felt unwell, would they make an occasional trip to the doctors.

Makes you wonder why the Government isn’t more concerned about the health of these slum-dwellers, doesn’t it? It turns out that there is a Government hospital in the area but alas functions like most Government services do. Frequently absent doctors, long waiting lines, you name it – everything that makes the poor and uneducated lose faith in medical help and leave their health in the hands of God instead. Mr. Gokhale also shared with me that when the medical center was first setup in 2010, it was in fact a public-private partnership. While the Government pulled out in 2012, Pahal had no intentions of abandoning its patients. After all, why make the poor lose faith in medical help yet again!

Khajrana comprises of 52 slums; 80% of its inhabitants are Muslims. Men are construction workers, garage mechanics, truck drivers and the like; women are mostly housewives. Being a slum, Diarrhea and TB are common illnesses that plague its residents. Malnutrition amongst children is common too. Many women also suffer from Gynecological problems too.

From 2-3 patients a day in the initial months, today the medical center caters to 70-80 OPD patients a day, mostly women and children. It was heartening to see the good rapport doctors have developed with some of the patients; clearly, a big factor in encouraging patients to seek health services when needed, that too for their entire family. At the same time, they have patients who start treatment and stop it midway at their own accord. This is frustrating because a patient on the way to recovery has a relapse and getting better takes longer and is tougher. This was the case with Pradeep, roughly 30 years of age, who used to do odd jobs as his mother begged on the streets to make ends meet. That was till Pahal came into contact with him. I visited him at the Government hospital, where he effortfully pushed his frail body up to sit, to chat with us. Thanks to the TB that has eaten him for the past months, he had not been able to walk; but had just 1-2 days earlier managed to pull himself out of bed, walk to the sink to wash his dinner plates and come back. A proud moment given his near-death experience, which is why he mentioned it twice during our brief chat!

In addition to direct checkups, the team also conducts awareness camps frequently. After all, issues like AIDS ( which is a prevalent due to the truck-driver occupation of men ), keeping a gap between pregnancies, feeding children well from the time they are in the womb etc. need to be tackled on a mass, not 1:1 basis.

I also learnt that when the medical center first started, services were offered for free. But the team came to realize, as is usually the case, that the free service was not being valued by the patients. And in fact, family members accompanying patients would want to get their check up done too, which was turning out to be a major waste of time and effort. So, in order to make their services more appreciated, Pahal started charging Rs. 5 per session ( valid upto 15 days of visit for the same checkup). The Rs. 5 per patient does not go a long way in making ends meet. It costs approximately Rs. 2 lacs a month to treat 70-80 patients. Funds allow the organisation to give medication for the common cold, fever, Diarrhea etc. but not for advanced diseases like Blood Pressure, Diabetes etc. In addition to providing medication for chronic ailments, the organisation also wants to start a Physiotherapy unit. This will greatly benefit women like Tabassum, who takes her Diabetes medication “as and when my sons have disposable income to buy the same.” Or women like Ayesha, who’s old age is giving her much pain in her knees.

After interacting with patients at the medical center, I drove down with their team to Barwani. Thanks to the monsoons, the three-hour drive turned out to be quite a picturesque one. En route, I learnt all about Barwani. One of Madhya Pradesh’s 51 districts, it is also one of its poorest – all thanks to the poor agricultural productivity. It also pained me to learn about the child labour situation here. The employment of children in factories to make guns and other small weapons is quite rampant here. To counter this menace, Pahal runs a school for children. Run as a small basic setup, Pahal’s teams enliven the place through colorful paintings on the walls as well as their enthusiastic teaching. The team does not follow the textbook style of teaching simply because these are first generation learners. If the kids don’t enjoy their time at school, they will stop coming; and their parents will quite easily allow that to happen too.

I interacted with a classful of bubbly children. Not aware of where Bombay was, they were all fascinated to learn that I had come from quite far away. I even planted a tree with one of them – as plants was the topic being taught, the day I visited.

Pahal also helps people with disabilities in Barwani. A baseline survey conducted by them revealed that the area has a fair share of disabled. During the survey, they asked for help in developing a skill so that they were able to contribute to their family’s earnings too. This was the case with both beneficiaries whom we visited at their home. One used to teach at the local school but found it difficult to commute on a daily basis. Thanks to the tailoring training she has received from Pahal, she now stitches blouses, uniforms etc. for the villagers as well as conducts tailoring classes herself. The other used to make necklaces, mobile cases, baby clothes etc. which the Pahal team then helps sell at the local market.

Pahal’s work in Barwani is quite similar to how every drop makes the ocean. Through small steps in the areas of education, disability and more, they hope to lift the standards of living of Barwani’s people above the poverty line.

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