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.”

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

 

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.