By Sneha Rajaram
Originally published on 14 August 2015.
Since 2003, Video Volunteers, a community media organisation, has been working on the use of ‘media for development’, as they succinctly call it. Their videos and films have documented and publicised issues like child marriage, women’s empowerment, environmental campaigns, girls’ health and education, disability, and human rights, among others. They often cover news in media-dark areas; for instance, a recent video posted on their home page intriguingly reads, ‘A domineering man hides the village handpump’ in Badasangrah village, Madhupur District, Jharkhand: “Akhulu Das removed the head of the handpump and for two years the people of the village could not use it.” This in itself is the kind of news hardly anyone tells us. And the icing on the cake? Their video got the problem fixed.
IndiaUnheard is a community news service launched by Video Volunteers to bring the world news reported by members of marginalized communities in the country: trained correspondents report (and take action) on problems in their own communities, and anyone can apply to be a community correspondent. One series of IndiaUnheard videos focuses on rural pregnancies in, so far, Bihar, Chattisgarh, Jharkand, Orissa and Maharashtra. These videos have been produced in the light of maternal mortality rates in rural India, and of the government’s failure to implement initiatives undertaken to reduce this alarming number.
Nupur Sonar from Video Volunteers writes that India sees 56,000 pregnancy-related deaths every year:
Infections due to non use of a sterile kit during delivery, home births without trained providers, eclampsia, postpartum haemorrhage, early pregnancies, anemia and unsafe abortions are the leading causes of maternal deaths.
Lack of infrastructure, failure to implement schemes devised by the government to incentivise institutional childbirth (as opposed to home births), overworked ANMs (Auxiliary Nurse Midwife), corruption and poorly staffed or unmanned health centres are some of the contributing factors that the IndiaUnheard rural correspondents tell us about.
Each of the videos is around five minutes long, narrated by a correspondent who is also a member of the community on whom the video focuses. The viewer is told horrific stories in a quiet, fresh style, without the intrusiveness of conventional journalism. The narrators themselves are deadpan, letting the stories tell themselves in a deceptively effortless way: it couldn’t have been a simple endeavour to get people to talk to a camera, many of whom have survived, or are still in the throes of, a nightmare. And the interviewees are only slightly less matter-of-fact in their narrations, which leads to the conclusion that any hysteria on the viewer’s part would be insulting.
But we don’t just hear about people’s past experiences – in one of the videos, we witness a labour live. The description accompanying the video tells us:
A 24-year old woman in labour was kept waiting for the doctor for 6 hours. The doctor on duty did not turn up and she delivered in the presence of a nurse. She was forced to pay INR 400 for her delivery and even, to use the toilet. She neither received free medicines nor nutrition. This is despite the provisions of the Janani Suraksha Yojana, the Indian government’s scheme to bring down maternal deaths, which makes provisions to reduce out-of-pocket expenditure for women below poverty line —providing free antenatal check ups, IFA tablets, medicines, nutrition in health institutions, provision for blood transfusion, and transport from health centres and back. Mary Nisha reports from Godda district, Jharkhand.
The effect of watching this video while seated on a plush, padded couch, looking at a woman in labour on the cold bare surface of a steel hospital cot, deserves special mention. The disconnect between urban-rural, pregnant-not pregnant, Adivasi-Brahmin, behind-before the camera, among numerous others, makes for a surreal, powerful viewing experience – especially with the understanding that this is not something to be lazily objectified or romanticised. Video Volunteers seems to have hit on the perfect medium with its audiovisual reporting. The written word would be impotent here: this is the place where statistics get in your face.
Mary Nisha Hansda, the rural correspondent who made the above video, begins by telling the camera, “Yeh mera Adivasi Santhal samudaay (This is my Adivasi Santhal community)”. When asked why she reported this, she says over the phone, “It was the pain. Looking at the difficulties of this mother’s delivery. I’m a mother too.” She narrates the episode in large-as-life detail – the nurse’s anger when questioned about the cost of what should be free medicines, and about the absence of a doctor throughout the six-hour labour. Why does she think this sort of thing happens? “Vibhaag ke laaparvaahi,” is the reply. (“The indifference of the concerned department.”) And sure enough, every video ends with a request to call and badger the bureaucrat/official surgeon responsible for maternal health in the corresponding district.
Video Volunteers tells us about incentives promised by the government to those who choose to give birth in a health care facility:
In 2005, the Ministry of Health and Family Welfare launched the Janani Suraksha Yojana (JSY), a cash transfer programme, that incentivised institutional deliveries, in order to reduce maternal deaths in India. Women are awarded Rs 1,400 in rural areas and Rs 1,000 in urban areas to give birth in public health facilities, under the scheme.
However, Chunnu Hansda reports from Indira, a village in Jharkhand’s district of Hazaribag, that the scheme is often not implemented. His video finds 70 women who have not received the money they are entitled to. They aren’t interested in running around for it either, given red tape and the lack of transport to the concerned office.
In addition, Chunnu Hansda tells me over the phone that a ‘sahiya’ – woman who assists with the birth – is promised Rs 200 per delivery. He heard of 7-8 sahiyas who hadn’t been paid for deliveries and asked if they would participate in a video report. They said no. Why? They would have come under pressure from the government, he says.
Another video tells us about three women in the village of Khatti in Chattisgarh’s Gariaband district:
This video follows three women – one who lost her baby within 6 days of birth due to lack of medical assistance; another, had a still-born baby due to unassisted home-birth and a third who is 9 months pregnant has no access to healthcare.
Reena Ramteke, this video’s correspondent, tells me how she came to make this video. Every time she goes to Khatti, she sees a lock on the health centre. She asked around and heard that everyone goes elsewhere for treatment. The place opens for vaccinations, but that’s about it. The nurse who’s supposed to live behind the centre – in a building built for that purpose – doesn’t. No delivery has taken place in the centre for 15 years.
These stories, and the rest of the videos in the series, steadily and unhurriedly build a picture of massive institutional-level failure. Video Volunteers’ YouTube playlist on maternal health has no shortage of stories to tell. We hear about a health worker who’s been allotted 14 centres, a nurse who charged Rs 500 to cut an umbilical cord, out-of-pocket expenditure for facilities that should be free, and a literally crumbling health centre, to name a few. Pregnancy becomes the dangerous enterprise that it used to be before modern medicine. As Nupur Sonar puts it:
Having a baby in a remote village […] means being pregnant with anxiety and a sense of helplessness. Without access to health infrastructure to monitor pregnancies and provisions for emergency care, it is a life threatening situation for both the mother and the unborn child.
Abortion is no less risky. Navita Devi, another correspondent, interviewed the husband of a woman who succumbed to abortion-related complications in Fulvari village, Kishanganj district, Bihar. Masuhun Khatun was turned away from government health care and her termination botched by a private facility. Her widower, a daily wage labourer, is left with four children and a large debt for Masuhun’s treatment.
So what does one take away from watching these videos? And what compels one to watch them in the first place?
This was the effect the videos had on me: I am familiar enough with being made to writhe by my own gaze on someone less privileged. One comes across that in urban life too, after all. How does one look at a beggar, for instance? One knows intuitively that the averted gaze is wrong. And with these videos, it seems impossible. So as I watched IndiaUnheard report on rural pregnancy after pregnancy, I squirmed, off-balance, watching someone in danger far, far away. This kind of danger is very, very personal, a time bomb in the belly that forces a woman to think of the debt it’s going to create, the unnecessary humiliation and pain she might encounter, the likelihood of her survival.
But the videos themselves aren’t interested in precipitating an existential crisis in their well-to-do urban audiences. That, one assumes, would be supremely useless. Each video simply gives you a number to call and asks you to take action. It’s all very well to look at a series of reports on unsafe rural pregnancies and feel cloying empathy in one’s own uterus. But can you become a loudmouth? Can you call and pester a bureaucrat or civil surgeon who’s likely to be very rude to you? Can you do that the way you would for a family member who’d been mistreated by a hospital?
Can you set yourself on fire for “these women”?
This is what is so compelling about these videos for me: they’re asking me – and the urban bourgeois junk-food-eating woman I represent – the above question, central to the beginning of any kind of activism.
Vietnamese Buddhist teacher Thich Nhat Hanh compares consuming media to consuming food: ‘eating right’ thus becomes a matter of “ingesting things that grow our understanding and compassion”. * And Video Volunteers’ work isn’t the sort of news that usually shows up on a daily Facebook news feed – it’s straightforward, and it doesn’t distrust its viewer. A lot of the socially aware news that one consumes on the Internet is telling the viewer that she’s stupid and uncaring: it’s framed for a tiny attention span and a tinier capacity for compassion. The IndiaUnheard videos, however, treat their viewers not just as adults (a novelty in itself), but adults capable of understanding, compassion, and action – hopefully a self-fulfilling prophecy.
So. As adults capable of these admirable qualities, do we want to get a sense of the maddening difficulties of rural pregnancy in India? Video Volunteers has made it easy: the indifferent health care centres, the hostile health workers, the large-scale corruption, the unfulfilled promises, everything is at our fingertips. All we have to do is click.
View IndiaUnheard’s series of videos on rural pregnancy here. Read more about Video Volunteers’ rural maternal health coverage here.
* From The Art of Communicating, Thich Nhat Hanh, HarperOne.