One man's crusade to save India's babies
Gadchiroli is one of the poorest districts in India. But it has witnessed a medical miracle in infant care. What happened?
‘I suppose my name might have something to do with the path I chose,’ says Dr Abhay Bang. ‘Abhay, in Sanskrit, means 'No fear’. No fear of death.'
And his path has been fearless, for, 25 years ago, Dr Bang ignored decades of well-meaning but failing healthcare policy in India – and struck out in a new direction.
A graduate of John Hopkins University in the USA, he returned to his native India with his wife Rani in 1985 and set up the charity Search (Society for Education, Action and Research in Community Health.)
Initially, their mission was simple. ‘We wanted to listen to the people,’ says Dr Bang. ‘What kind of healthcare did they want?’
Traditional western-style hospitals were perceived as too far away, costly and alienating. Why? 'Your doctors and nurses drape themselves in white clothes,’ they said. ‘We wrap dead bodies in white shawls. How can you save lives if you are dressed like a dead person?’
Infant mortality emerged as one of the most pressing issues. In 1988, 121 newborn babies were dying out of every 1,000 births in the area.
Dr Bang's solution was simple: he trained a group of local women in the basics of post-natal care. They were taught how to diagnose pneumonia (using an abacus to count breaths), how to resuscitate children and how to administer some basic antibiotics.
Instead of villagers having to walk miles to a hospital, health visitors – called 'arogyadoots', meaning ‘health messengers’ – went to them, carrying everything in a small health pack on their back.
Dr Bang also built a hospital quite unlike the western model – a series of huts resembling a tribal village. ‘To me, with my modern education, it looked old-fashioned,’ he says. ‘But the people said ‘This hospital belongs to us’.
The results have been startling. The newborn death rate in Gadchiroli has now fallen to 30 per 1000 live births.
There’s also been progress with pneumonia. In 1988, the death rate amongst children contracting the disease was 13%. It’s now down to 0.8%.
In a world where eight million children a year die before the age of five, medical experts believe this model of care has use far beyond Gadchiroli.
‘We are very much part of the community,’ says Dr Bang, at the London launch of No Child Born to Die, a global initiative by Save the Children to achieve a two-thirds reduction in child mortality.
‘I really can't say where the line of separation is between them and me,’ says Dr Bang. ‘It is research with the people, not on the people.’
- ‘I’d always prefer a qualified doctor, with years of training’. Do you agree?
- ‘Good listening is the beginning of healing.’ This was where Dr Bang started. Does he have a point - or is this just true for India?
- Everyone can learn how to do basic healthcare.Research one area of First Aid. And then do a practical demonstration to the class.
- Research the causes of infant mortality around the world. What are the three most important things that can be done?
Some People Say...
“Western medicine is overrated.”
What do you think?
Q & A
- Where did Dr Bang get his ideas from?
- He was very influenced by Gandhi’s philosophy of self-rule. ‘But it was not only India that should be allowed to self-rule,’ says Dr Bang, ‘it was every human being as well.’
- He’s helping people help themselves?
- That’s right. He’s giving individuals and communities a voice in their own health care, instead of relying on distant hospitals and western-trained doctors. He doesn’t believe that model works in rural India.
- And has anyone complained?
- Some have criticized him for allowing uneducated women to administer complex medical drugs.
- What’s his response?
- He says his workers have given 15000 injections with a zero complication rate. Local woman Meena Dhit is pleased: ‘There is a lot of difference from the old days,’ she says after having two children with the arogyadoots.