The parent of a daughter has great awareness of the needs of adolescent girls. As a mother with an interest in public health, I spent a huge amount of time at my daughter’s school, as well as in many other schools, teaching the girls about the importance of nutrition, physical fitness, learning first aid, and the importance of immunization.
Some of the progress was easily measured. I started a “No Polio Zone” in the early 1980s after I saw a girl paralysed waist downwards with polio. My friends from medical college joined me in street plays about the importance of vaccination. We found that mothers rarely completed the three doses needed for complete immunization of their children and so we donated a metre of a colourful striped cloth to children who completed all the doses of vaccines. Soon we found little girls who had completed the vaccinations wearing frocks of the same striped cloth—a simple but effective solution to the problem of noncompliance for vaccine dosages.
That experiment was to stay with me later as we formed several programmes on HIV/AIDS awareness, prevention of anaemia for girls, sound nutrition and physical exercise, especially in slums. While these programmes were in city schools, we also turned our attention to rural areas. The Piramal Foundation runs a programme on clean water (Sarvajal) and mobile health units (108 mobile service) in four states dealing particularly with maternal and infant mortality, and in the tribal areas with remote tele-medicine for women, as well as programmes for leadership in rural schools. The Piramal School for Education Leadership helps improve education in rural schools.
In both urban and rural areas, chronic diseases such as diabetes and heart disease are striking early and the numbers are climbing. India has a double whammy with both infectious and chronic disease affecting young people. A helpline helps health workers deal with complex problems such as difficult pregnancies, and this service has already reached lakhs of consumers across three states. These were really basic health problems, but we tackled the sensitive issues, for example, the lack of knowledge of contraception.
The helpline called i-canhelp by Piramal Healthcare was started with the help of a non-governmental organization (NGO) trained in medical advice and counselling, in particular about various methods of contraception. Unsurprisingly, the anonymity of speaking over the phone helped many young adolescent women get answers to questions they were afraid to ask family members. The lack of such education in schools meant that young women do not even have the basic knowledge for prevention of unwanted pregnancy. When this occurs, the services of a quack are enlisted, often with serious consequences to the girl’s health. India has one of the highest occurrences of fatalities due to unsafe abortions.
Knowledge could make a difference between life and death. It is astonishing that ignorance about safe contraception is widely prevalent even in educated girls. The helpline has been an amazing success story and it is intended to start in other local languages. Knowledge of contraception is a fundamental right of every young woman so that her safety and health are assured. It is clear that a young adolescent woman is the foundation for a family, so her education and good health are the very foundation of a developed society. It is a shame that India still has the poorest record of maternal and infant mortality—major health indicators.
India is a signatory to the plan to improve this Millennium Development Goal. How can we make a quantum leap in improving these health indicators? Sharing success stories and applying technology in getting it to reach women across the country may be one solution. The work done by NGOs should be quickly replicated in far-flung areas as well. If the 50% of our population who are women can make a contribution to the economy, a leap in gross domestic product is likely, and their health, safety and well-being are critical for the nation.
Swati Piramal is vice-chairperson, Piramal Enterprises Ltd. She has worked in public health since 1992, focusing on the prevention of chronic diseases such as diabetes, arthritis and heart disease. As director of the Piramal Foundation, she helps promote health in rural India with HMRI (a mobile health service) and women’s empowerment projects, and supporting community education that creates young leaders. She serves on the dean’s advisory board of both the Harvard School of Public Health and Harvard Business School.