Health Themes at Dharavi Ganesh Mandals

Ganpati fever hit the city earlier this week and Dharavi was no exception. Ganpati mandals appeared at various locations, as many as six on congested 60 Feet Road. Traffic snarls and the incessant rains added to the chaos, but festival attendees were undeterred. It is now well known that most mandals also host a theme-based light-and-sound show, usually on a socially relevant cause, so that the religious can also be responsible citizens. At the Dharavi Biennale, we went in search of mandals that were spreading awareness on health, sanitation or gender issues. Just like the devout, we walked from mandal to mandal, taking in the resplendent gods and elaborate set designs.

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Over at the enthusiastic Hanuman Seva Mandal at Kala Killa, an arrangement of handpainted boards was set up like an orchestra. As a tribute to a 12 year old boy who had succumbed to dengue last year, the mandal’s agenda was to make more people in the area aware of the life-threatening risks posed by vector-borne diseases such as malaria and dengue. Nikhil Bobade, a 21 year old college graduate, was proud of the work that he and his group had done. 56 controls for spotlights were operated singlehandedly. Giant paper mosquitoes hung overhead, posters on the importance of sanitation mixed with Tom-and-Jerry were all around and a long mosquito net was spread across the room like a football goalpost. “Our script has everything – right from the ways by which malaria spreads to preventive measures. Malaria and dengue happen everywhere, but people feel it happens first in Dharavi. Do you know that the famous filmmaker Yash Chopra also died of malaria?” said Nikhil. This year the mandal is distributing 1000 dustbins to encourage proper waste disposal in their locality.

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Last year, the Hanuman Seva Mandal had hosted a similar show on organ donation and enthralled the crowds. They had said that organ donation could be a more purposeful end to a life than burning on a pyre. Some might not agree, but it was an important contemporary message.

As part of our art activities, children gathered at selected mandals and participated in drawing competitions on domestic violence, good food/bad food and malaria. While we were apprehensive that they might be too young to visually take on themes like these, the young artists were confident and kept themselves thoroughly entertained. The mandal organizers were also thrilled to have activities running on otherwise sleepy afternoons.

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In Dharavi, as in many parts of Mumbai, religious activities such as these can play a vital role in shaping people’s views. The Ganpati mandals embody art in its simpler and perhaps more commercial forms but effectively convey an underlying message on health and social issues. With the right kind of attitude that balances health and social messaging with entertainment, the mandals can go a long way in public engagement. Religion, art and science intersect on these platforms and what could be a better way of stating that cleanliness is next to godliness?

Two Doors, Two Choices

There is a dimly-lit community centre with two rooms at Kumbharwada, Dharavi. You reach it after treading clayey paths where workers labour over sacks of mud meant for the potter community. One room is for visits from an allopathy doctor and in the other is a homeopath. No signs advertise the services available at the community centre, but there is a steady trickle of patients, mostly elderly. They enter in a moment of suspense: which door will they choose? Allopathy or homeopathy?

The clinics are part of a charitable trust, the Pramila and Harishkumar Foundation, set up by homeopath Dr Geeta Punjabi in 2009. The 74-year-old veteran meant them to cater for the poor in Dharavi so that they could get quick relief at subsidised rates. The homeopathy centre is currently attended by Dr Poonam Talreja, who has been there since 2010. Her clinic is painted a bright shade of green and most of the space is taken up by trays of bottles of homeopathic medicines. It’s hard to find her unoccupied. As each patient consults her, the conversation is punctuated by the pitter-patter of raindrops on the asbestos roof. The patients queueing outside grumble impatiently in low voices, but are glad that the doctor gives each of them a decent amount of time.

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Dr Talreja says that she has seen some challenging cases cured with homeopathy. “We don’t try to heal just a particular organ, but rather improve the overall immunity of the patient. We won’t claim that all our patients have reached normalcy, but they have surely reached a near-normal state,” says Dr. Talreja.

Sometimes mistaken for a “lady-doctor,” she points out that the commonest health issues she sees in Dharavi are chronic fatigue, joint pains and asthma attacks. “These are mostly female patients. They neglect their health and they hope that if they pop a pill they’ll be fine instantly,” she says, nodding her head. Most of her female patients are daily wage-earners and she says that a quick fix is a must or it could mean losing out on a day’s pay. People also come with digestion problems. “Many Dharavi people have problems such as constipation or diarrhoea, but I am careful before prescribing medicines. I always check to make sure that they have toilets in the vicinity of their homes. Otherwise, it could be a big problem for a patient who has just taken some laxatives.”

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With subsidised rates for medicines (globules are free, tinctures and laxatives are half-price), Dr Talreja says that not everyone is Dharavi is poor. There is a donation box in the clinic and more affluent clients are advised to purchase the medicines at retail rates.

When clients enter the community centre, which door do they choose? Have they made an informed decision about which medical recourse will work best for their health issues? Or do they try both allopathy and homeopathy with the hope that something might eventually work? 

The Blockprint Life

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The walls of Ahmed Razak Shaikh’s workshop are streaked with colours, his children’s rendering of Urdu letters and mini statements on his weekly orders. The 49-year-old blockprinter deciphers his most recent order, barely legible and written with a temperamental red pen. “On the 15th, I did 80 metres of cloth. On the 16th, I did a rye dana (seed) blockprint on 120 metres. Yesterday I did 90 metres of dupattas. It has been a good week,” he notes. We are on the second and uppermost floor of an assemblage of rooms in AKG Nagar, Dharavi, that seem put together by a child (it would be hard to call it a house or a building). It is a clammy afternoon, but there are no fans in his workshop. It is a room dependent on the elements – daylight from a couple of windows and hints of a breeze.

“Colours dry fast and fabric flutters under fans,” says Ahmed. He doesn’t use jargon, but his technical knowledge is obvious when he explains the different chemicals he uses for blockprinting. For a man who grew up in a family of blockprinters from Mirzapur in Uttar Pradesh, blockprinting is as easy and inevitable as a surname. It is more than just a source of money. “I saw blockprinting everyday at home. Back in my village, they had a stone table lined with sackcloth on which bedsheets were printed. It was part of my daily life,” he says. Living from week to week, he stays put when there are no orders rather than take up some other job for daily wages. He was destined to do this and nothing else, it seems. “This is all I know and orders have kept coming over the years. I have never felt like I wanted or needed to do something else.”

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Having worked in various parts of Mumbai and in others’ workshops as a teenager assisting his father with blockprinting, Ahmed has had about 17 years of experience as a professional. He is now finally glad to have a workshop of his own. A number of blocks are heaped together under the line of tables. To the untrained eye it looks like a mess, but Ahmed knows his florals from his abstract designs.

There are rejects among the blocks – styles that have fallen out of fashion, broken corners, brass embossed. Ahmed discards them and there is no particular attachment to the blocks that have served him faithfully over the years. These days, a Nepalese artist purchases the rejected blocks from him. “They arrange these blocks into some pattern back at hotels in Kathmandu. I really wonder what they achieve by doing that. But I don’t ask questions,” he shrugs. Is he an artist? “No, I am an artisan. Blockprinting is an art, of course, but it is like this: I am happy when I get 20 pieces to block print but I am happier when I get 200 pieces to print in a day,” he says with no hint of doubt in his voice.

The room, otherwise spacious, is primarily for the long worktables and it is not easy to navigate from one side to the other. Ahmed’s three-year-old granddaughter has figured it out, though; she monkeys around and swiftly disappears under the tables. Occasionally, we see her little head popping up in different parts of the room. “I have six sons and one daughter. This is my eldest son’s daughter,” he says. The youngest son, Altaf, is asked to take the intrepid child back home (home is a floor below). Altaf, an eighth standard student and as tall as his father, was attending school until some months ago. He shows surgical scars on his left hand and leg. There is some confusion as father and son discuss the problem. “One doctor told us he has a brain tumour. Another told us he has tuberculosis. Another surgically removed his abscesses,” Ahmed says. “Cold abscess,” Altaf chimes in. There is no anguish on their faces; it is just dealing with the everyday. Ahmed is more hopeful now since they have visited a baba at the outer edge of Mumbai. “Altaf has been advised to have shellfish… you know, the kind that the Kolis sell. Baba has promised that Altaf will be cured by doing this.”

Despite destiny, confidence and resilience, Ahmed does admit that the blockprinting business has been affected in recent years. Screenprinters can print around 1000 metres of cloth in a day, compared with the 100 metres he accomplishes singlehandedly. “It was also a cheaper life back then. I would buy around 10 kg of rice for the whole family on a Sunday for just Rs. 2. Everything is changing now,” he says. Ahmed’s children are not keen on taking up the trade and he is not keen on teaching others. As one of the few blockprinters left in Dharavi, a family legacy will last as long as Ahmed can print. 

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Dharavi diaries: The mystery of Aryan’s malnutrition

Originally posted on healthyurbanworld :

Healthyurbanworld will be following a severely malnourished child for a six months and note how the programme helps the baby’s development. 

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Aryan (centre) at SNEHA’s day care centre

Two and a half year old, Aryan Kothari is sick yet again. Almost every month, he suffers from a bout of diarrhoea or fever with a cold. Aryan is severely malnourished. He weighs just about 10 kgs and is only 86.8 cms tall. He been malnourished for nearly a year and has been in SNEHA’s day care centre at Matunga Labour Camp, Dharavi since September last year. He has been on medical nutrition therapy (a supplement with essential micronutrients mixed with peanut butter) for a few months.

His mother, Lata Kothari, 22, is at her wits end. “He does not eat well. I try so hard. People also say that since both my husband and me are thin, he is also thin,”said Lata. She…

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The Rise and Fall of a Midwife

“If you write about me, will I get a job in a hospital?” is Shanti Devi Jasiwar’s first question. She claims she is 55 years old, but somehow that is hard to believe. With wrinkles, greying hair and betel-stained teeth, she seems older. She agrees, saying that she hasn’t really kept count of the passing years. She hasn’t recorded the number of babies she has helped deliver in the last 23 years either. Locals agree that it could be anywhere between 50 and 100 (and never a stillborn, they say). She breaks into a characteristic hoarse laugh and says, “Well, I am poor and I haven’t studied or I would have noted down these things.”

Shanti Devi has worked informally as a midwife and masseuse for infants and new mothers in Dharavi. She comes from Basti, a district in Uttar Pradesh, and came here after marriage. As she tells her midwifery tales, you understand that this is more a way of life than a source of income. Her first ‘case’ was “before the lafda (problem)”, referring to the 1991 riots, when a thin, heavily pregnant woman came back home from a local hospital. She went into labour suddenly and her baby was crowning. “I uttered God’s name and I helped her deliver her baby. That is how I started my work,” says Shanti Devi. Locals chime in when Shanti Devi says that she never takes any money for delivering babies. People offer her water, tea, two rotis or money to buy betel. Young boys from Mukund Nagar are busy playing around where we sit and she points to them and says, “I helped deliver some of them and even massaged their mothers after delivery.”

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These days, Shanti Devi is cautious. She has stopped working as an informal midwife due to deteriorating health (she can’t see properly and can’t climb the steep stairs in many Dharavi homes). Only when a woman is going into labour in the middle of the night and there is no other alternative does she offer her services,

While Shanti Devi continues to massage young mothers and babies with rye oil, the major reason why her work has come to a halt is the implementation of government schemes such as the Janani Suraksha Yojana (JSY) – a scheme designed to reduce maternal and neonatal mortality by encouraging institutional delivery for poor pregnant women. Along with the institution of auxiliary midwives, such schemes have been key ways of bringing down alarming maternal mortality rates. The WHO estimates that there were 50,000 maternal deaths in India in 2013, as opposed to 148,000 deaths in 1990. However, the WHO notes that world-over there is a need to bring into hospitals skilled midwives who can specialise in deliveries and newborn and postpartum care. Currently, auxiliary midwives are found in rural India and urban trends indicate an over-medicalization of pregnancies and deliveries. Training people like Shanti Devi specially as one who will accompany a pregnant woman to the hospital, negotiate hospital formalities, help care for her and the baby with formal training might be beneficial for the time constrained, urban poor.

Back in her heyday, Shanti Devi was a much-sought-after midwife. She has never used a mobile phone and locals joke that she gets lost in Dharavi as easily as the average tourist does. People just came running to her when in trouble. She looks old mostly because you know she has seen it all as you listen to her stories. She is a mother of four; five more children passed away. Her husband, who makes a living selling undergarments on the footpath, has tuberculosis. So does her eldest son. “All the earning members of my family are sick,” she cries. She consoles herself by saying that God gives and God takes.

Shanti Devi encourages women to seek medical attention these days. She also advises youngsters to have fewer children and recalls, “My father was asked to do a nasbandi (vasectomy) during the Indira Gandhi government. He was adamant that he wouldn’t. He had fathered 16 children and swore that he would have 16 more. In those days, having children was cheap. The expenses that you incur for celebrating a child’s birthday these days … that money you could use to get your daughter married off in those days.” As women sitting beside her laugh and talk in eyebrow-raising numbers about the children they have given birth to (Shanti Devi’s neighbour had 10, of whom 6 survived), Shanti Devi is clear about one thing. That the practice of a midwife is one of sisterhood.

Read more: www.who.int/bulletin/volumes/91/11/13-021113/en/

Comics and Health

 

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With two participatory comics workshops in our  list of artboxes, the Dharavi Biennale was selected to participate in a niche conference conducted by Graphic Medicine and The Johns Hopkins University School of Medicine Department of Art as Applied to Medicine.  The conference, “Comics & Medicine: From Private Lives to Public Health”, involved a mix of artists, healthcare professionals, academics and comics enthusiasts. Worlds you might have thought would never meet – comics and healthcare – interacted, presented works, and exchanged ideas and cultures.

To recap on our work, Dharavi residents made comics on health issues (such as injuries and nutrition) under the guidance of Chaitanya Modak, a comics artist based out of Mumbai. For many of them, comics were  a new medium that few had heard of and even fewer had read. In the course of the workshops they were mentored to create poster-comics with a standard panel format telling stories about health. The posters were then put up in Dharavi and the participants interacted with locals and shared their stories with them. For Dharavi viewers, who had little comics literacy, this was a new format of storytelling and could engage even those who lacked education. This was for Dharavi, by Dharavi. 

Since many of the comics were personal experiences transformed into monochrome comics for public engagement, our work fit perfectly with the theme of the conference. We called our presentation “Comics Epidemic” with good reason. Dharavi often makes people think of disease and dirt, but we believe that comics, and the Biennale, might help shake up the stereotype.

Benita Fernando, the blogger, presented our work. It was an honour to be at the Comics and Medicine conference along with figures like Arthur Frank, James Strum, Ellen Forney and Carol Tilley. It was also an eye-opener to see the number of comics and graphic novels that address health issues like depression, cancer, Alzheimer’s and diabetes. The thing about a comic is that it can make even the most intimidating topics into a non-threatening subject for discussion. The serious and the sober become more approachable.

You can read more about our comics workshops here and here.

The Comics Journal covered happenings at the conference here.

Thanks to all our Dharavi participants, mentor Chaitanya Modak and Lydia Gregg, who chaired the conference’s organization committee. 

Young photographers show you Glass

From our latest photography workshop conducted by Nitant Hirlekar. Young photographers ventured into the recycling units in and around Dharavi. Here are some snapshots of the glass recycling workshops in Prem Nagar, as seen by them.

By Ankita, Mehzabeen & Roshni

By Ankita, Mehzabeen & Roshni

 

By Pooja & Ahmed

By Pooja & Ahmed

 

By Roshni, Sameer and Suhani

By Roshni, Sameer and Suhani

 

By Ankita, Mehzabeen and Roshni

By Ankita, Mehzabeen and Roshni

 

By Roshni, Sameer & Suhani

By Roshni, Sameer & Suhani

 

By Roshni, Sameer and Suhani

By Roshni, Sameer and Suhani

 

By Ruksar & Nazmeen

By Ruksar & Nazmeen

 

By Ruksar & Nazmeen

By Ruksar & Nazmeen

 

By Ruksar & Nazmeen

By Ruksar & Nazmeen

 

By Ankita, Mehzabeen & Roshni

By Ankita, Mehzabeen & Roshni

 

And, here is one that shows our young shutterbugs at work!

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Occupational Hazards in Dharavi

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It is by now common knowledge that cheap leather bags are made and sold in Dharavi. Export quality, the shopkeeper will tell you. As much as the thrifty buyers and the choosy entrepreneurs flock to the line of leather goods shops on the Sion-Bandra Link Road, people are repelled by the stench of leather curing workshops on 60 Feet Road. The air smells of brine, sulphur, decay and human negligence. As vehement as animal rights groups and brand empires are about saving innocent animals from the clutches of fashionistas, something must be said about the manner in which the lower income groups work in these units. No rubber boots, no gloves, no masks, no legal interventions to protect them from the conditions they work in. To stand outside a leather curing workshop in Dharavi is to remember the stench of pukish drunken nights. Meet these brazen curing labourers, and you know that it takes more than just alcohol or drugs to get you through a day. You are driven by a desperate need to survive.

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The conclusion is, however, not to close down the units. Especially not when the shutting down of a big manufacturer means the loss of jobs, however unorganized, for these daily wage earners. Especially not in a country which has a history of so called ‘lower’ castes and certain religious groups being the ones who fetch you your leather. The point is to investigate better working conditions that will provide improved health for these workers.

At a recent workshop, some high school students from Dharavi were accompanied by Nitant Hirelakar to photograph some examples of occupational hazards in their localities and make a pixel art installation that highlights the dual nature of these Dharavi businesses. There is lots of money, there is little consideration for human value. However, this is not just a Dharavi thing. It is perhaps how many labourers are hired all across the country. Your body is a piece of equipment that keeps the machinery running. If the equipment is defective, you can always get another here. Labour is the cheaper than water.

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One of the sites that Nitant and his photography group visited was Prem Nagar, on the outskirts of Dharavi, near Kurla. This is the mega-hub of glass recycling, where tons of surgical vials, ketchup bottles, jam containers and the likes are dumped here to be sorted, cleaned and re-sent to factories for fresh packaging. That which can’t be resent is turned into shards that shall be melted for renewed purposes. As the young photographers alternated between mesmerized and repulsed, the labourers and the middlemen at these tiny, dark workshops were bemused. A little wary of these photographers, even.

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Here again were the lack of basic protection for the cleaners and the sorters. On the banks of a little channel running from the guttery Mithi, a man sorted metal caps of soda beverages using a handy magnet. Hunched and focussed, here was a Gollum of present day Dharavi looking at his precious. Fumes, waste fluids and reminiscences of Katherine Boo’s depiction in Behind the Beautiful Forevers of young disadvantaged Indians inhaling Eraz-ex for their nightly high come to your mind.

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At one musty workshop were a group of men and women who specialised in the niche job of removing zinc from discarded batteries to be repurposed. They are covered in zinc powder, only their eyes are flashing. Again, no gloves, no masks and definitely no health check-ups either.

The labourers themselves have nothing to complain about. As long as the job gets done. As long as there is yet another day with a job at hand. Life goes on.

Occupational hazards, as mentioned before, are definitely not a Dharavi feature and not merely a symptom of the lower income groups. However, traffic policemen with varicose veins will get sick leave, IT professionals with slip discs can avail a mediclaim policy and teachers with laryngitis can consult school doctors. What will a daily wage earner do?

Dharavi’s once-booming leather industry losing its edge | India Insight

Originally posted on CHINDIA ALERT: You'll be living in their world, very soon:

A busy street in Asia’s largest slumDharavi leads to a quiet lane where Anita Leathers operates its colouring unit. As children play near shops that sell everything from mobile phones and garments to raw meat and sweets, the mood at the leather unit is sombre.

The leather business is one of the biggest contributors to the Mumbai slum’s informal economy, estimated to have an annual turnover of more than $500 million. About 15,000 small-scale industries, spread over an area of 500 acres, deal in businesses such as pottery, plastic recycling and garment manufacturing.

But the leather trade has been hit hard by increasing competition, an influx of cheap Chinese goods, rising raw material costs and labour shortages in recent years, leading to a decline in demand and dimming prospects of the once-flourishing business.

At Anita Leathers, which has been colouring and supplying leather sheets to merchants in Mumbai…

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