Sarah
Simpson, University of Medicine & Dentistry of New Jersey, MPH-Epidemiology
Candidate
Home to more than
18 million people, India’s most populous city, Mumbai, continues to be an
attraction for millions looking for a better life for themselves and their
families. Migrants from different parts of India, religions and cultures end up
in the crowded slum communities around Mumbai. This past winter I had the
opportunity to learn about urban health issues in these slum communities along
with 20 other students from around the US and the world for three weeks at the
Tata Institute of Social Sciences (TISS) in Mumbai.
My project group
and I sped around town in rickshaws, trudged through sludge, and dust to study
urban health issues in the slum areas of Shivaji Nagar. Located in the M Ward and home to some of the
largest slums in India, about 600,000 people live in this area, which is
located near the Deonar dumping ground, a man-made mountain of debris and
trash. The health of the urban poor is complicated by many issues ranging from
waterborne illnesses to infectious and communicable diseases, and when
compounded by inadequate nutrition and overcrowded and poorly constructed
living conditions makes for a dire situation for millions of people.
During our first day, we were
introduced to the “Mahila Mandals” or women’s groups there are instrumental to
addressing these public health issues. Parts
of Shivaji Nagar are plotted slum areas recognized by the government; however
they have minimal access to facilities and services provided by the
Brihanmumbai Municipal Corporation (BMC). Imagine sharing 28 bathroom stalls
(14 for men, 14 for women) with 1,000 other people and as you can imagine they
quickly become unsanitary. The breakdown of government services has lead to the
organization of community based organizations such as Mahila Mandals.
Instead of using a needs-based or
problems-focused approach which would highlight only the worse aspects of a community,
we decided to highlight the community’s assets by writing a case study using
SWOT (Strengths, Weakness, Opportunities and Threats) Analysis to help us
investigate how to best utilize these important community assets. We
interviewed 6 Mahila Mandal groups consisting of some registered and
unregistered groups and varying in size and number of members. We concluded that not only do the Mahila
Mandals work to solve issues with sanitation, but they also promote immunization
of children, maternal and child health education and resolve domestic violence
issues. However, their impact is limited mostly due to funding and support from
the local community.
At the end of our study, we recommended
that the government provide more funding and implement community-based
participatory research programs which would allow the communities to identify,
support, and mobilize existing resources to create a shared vision of change
and encourage greater creativity in solving community issues.2 Community
organizations like these groups and community engagement are important for
continued public health and social change. Further research is needed on how to
best utilize these valuable community assets.
Our
internship presentation can be found at: http://prezi.com/i0lbgveimbyc/copy-of-indian-urban-slums/
References:
1. Mili, D. Migration and Healthcare Access to Healthcare
Services by Migrants Settled in Shivaji Nagar Slum of Mumbai, India. TheHealth
2011; 2(3): 82-85
