Amlan Ganguly is helping children in slum areas of West Bengal to lead their communities in improving health, sanitation, and hygiene. The children call themselves “area health minders.”
The New Idea
Amlan Ganguly has developed a unique model of child-led activism in which the children of slum areas act as change agents by forming groups and spreading awareness on health, hygiene and sanitation within their community. Amlan and his organization Prayasam support these “area health minders” by providing information and first aid training, creating educational materials, and helping them to become real advocates for their cause. The children have collaborated with more than 60 schools to help form more groups of “area health minders” in the adjacent municipal area, effectively reaching more than 5,000 students and their families.
One of the most pressing concerns of any developing country is health. In India, health services fall grossly short of the country’s needs, making the adage “prevention is better than cure” particularly relevant. Article 24 of the Convention on the Rights of the Child adopted by the United Nations General Assembly in 1989 states, “Children have the right to the highest possible standard of health, and to access to health and medical services,” and all states signed on the Convention, including India, are bound to honor the statutes enshrined within it. Unfortunately, India faces increasing cases of child deaths caused by malaria and diarrhea, both of which are preventable.Although the onus to provide basic health facilities is on the government, the state faces significant constraints for resources and infrastructure. Primary health care centers in rural areas are over-stretched, and clinics for the urban poor are even worse. The majority of the budget of urban local governments is set aside for infrastructure—roads, street lights, water, and waste disposal—while services for education and health are neglected. In fact, education and health services are being eased out of the realm of local government, because in the era of privatization they are still seen as free services with little revenue-generating potential.In this context of falling budgets and uncertain government services, preventive health programs grounded in communities offer some hope to the urban poor. This not only impacts their health, but also their economic earning potential, as disease robs daily wage earners of their income and forces them to spend large parts of their meager income on medicine.
In 1998, while working with the Lutheran World Service in the slums of Kolkata, Amlan noticed that several children were frequently absent from the organized educational and cultural programs. Amlan visited their homes and found that they suffered from chronic ailments such as diarrhea and malaria. The families were heavily dependent on community healers to avoid the costs of medicines and lacked preventive health care. Since Amlan was already friendly with the children, he was able to work with them to develop a questionnaire on health and money spent on medicine. The children were then each given a red bag and, armed with the questionnaire, sent to conduct a survey. The results were startling. It appeared that each family spent a major part of its income on medicine and treatment for illnesses that could be easily prevented. Amlan resigned from Lutheran World Service, and with a few friends started the organization Prayasam, with a vision to make “health for all” a reality, ensuring children’s rights to participation and development. Amlan intended to demonstrate that children could mobilize action in their communities, starting in the poor slum of Rishi Aurobindo Colony in the Lake Town region of North East Kolkata.Amlan has developed a yearly planning process. At the beginning of the year, Prayasam members sit down with Ekjot, the team of 25 children “area health minders,” to develop a plan for the year based on health-related needs. These needs include discussions on how special religious and social occasions can be used for awareness raising and information sharing. With this annual plan, Prayasam staff spend one day every week with the members of Ekjot, reviewing the health information they collected from the community. Together, they develop a plan for campaigns and tools on relevant or upcoming issues for the week. For example, if there is an immunization date in the next month then the children concentrate on spreading information on immunization. The children dedicate a few hours for three days a week and most of the day on Sunday to their role as health minders. During this time, they wear a tunic and carry a special bag with a kit comprised of leaflets, posters, and other materials.Ekjot members also discuss the need to approach authorities about problems they encounter, such as lobbying the municipality to collect garbage, clear standing water, and clean the open drains that serve as breeding grounds for mosquitoes. Ekjot members enlist adults from their community to accompany them for such negotiations. The work of Ekjot is often supplemented by a girls group called Alhadi, also formed by Prayasam, which provides young girls living in the slums the opportunity to perform songs and dances as recreation. Alhadi members help Ekjot develop special programs to mark World Health Day and other important events. While Prayasam members are always present to provide support, specialized resource persons are invited to the weekly meetings and to special workshops to enhance the children’s skills. In the last three years, 25 Ekjot team members have grown into mature health workers with training in first aid and effective strategies to combat superstitions that affect the community’s beliefs on health. These were skills developed in collaboration with other organizations such as St. Johns Association and West Bengal Science Communicators Forum. For the immunization drive, Ekjot members have worked steadfastly with UNICEF and serve as a shining example of the power of children to mobilize community support and participation. In fact, the children were the only Indian representatives featured in A Life like Mine, a worldwide UNICEF publication celebrating examples of innovative programs employing children’s participation to achieve social change.Rishi Aurobindo Colony is now a model, with clean alleys and few cases of malaria and diarrhea. The children take pride in their attention to hygiene and cleanliness, as described in a rhyme (translated from Bengali) written by Ekjot members: “We bathe daily and try to be neat, or else we will fall sick and our fun will be beat.”Based on the success of the Ekjot model, Amlan is now spreading the idea to other urban areas of the state through government channels. He has developed a strategy to reach out to public schools, beginning with the three municipalities of South Dum, Kamarhati and Bidhhannagar; each contains approximately 50 to 60 schools. Initially, two Ekjot members and two Prayasam staff visit the municipal schools twice a week, then once a week, and finally once a month over a period of six months. These visits are made during school hours to ensure that the school authorities slowly gain ownership of the idea; a condition made possible by the support of the municipality. During these sessions Ekjot members explain their work through role plays, songs and simple narration of their experience. Based on the response from the students, most schools ask them to return. Children from the municipal schools who show particular interest in the work are then trained by Ekjot members and brought to Ekjot residential areas to witness changes in the slum environment and compare their living conditions with that of Rishi Aurobindo Colony.Ekjot members have approached 60 schools and the children have formed more than 30 Parent Teacher Associations to support the cause; a necessary first step for the community to embrace the idea. Amlan estimates that in those 60 schools approximately 7,900 children will be exposed to Ekjot’s model and about 3,500 children will become “area health minders.” Amlan is leveraging several new programs being undertaken by the municipalities in West Bengal using funds from the British DFID to spread this model to 40 other municipalities in West Bengal. With Paschim Banga Rajya Shishu Shiksha Mission this model will soon be introduced into 16,117 Shishu Shiksha Kendras all over West Bengal—work has been started in Purulia and Bankura.With another program that targets child laborers and their families working in brick kiln industries in central Bengal, Prayasam has introduced Ekjot’s model to these poor and remote areas. The model has to be appropriately altered for the brick kiln children since their situation differs from that in urban slums. After presenting his model in a nationwide workshop on children’s right to participation, organized by UNICEF, Amlan has been asked to take his model to the Northeastern states. In developing the Ekjot model, Amlan partnered with many private organizations, raised resources from the citizen sector, and managed to garner support from the media. Prayasam’s activities are frequently in the news and its public programs are attended by famous personalities from all sectors of society; an effective way to spread awareness about its work as well as generate resources.
A lawyer, Amlan began his career as an apprentice to the most reputed criminal lawyer in Calcutta. He was soon disillusioned with a legal system that provided little justice to the poor unable to pay fees and withstand the long drawn legal process. Amlan decided to make a complete switch and joined Lutheran World Services in 1996. In 1999, he created Prayasam with the purpose of enabling children to participate in the decisions and factors that affect their lives. To raise the initial funds, Amlan approached his previous employer, LWS, and set up a boutique that sold clothes to raise money for the organization. Amlan personally continues to raise money for Prayasam through consultancies and hosting radio and television programs. With his team at Prayasam, he manages events for overseas agencies like UNDP, UNICEF—Kolkata, DFID, World Vision India as well as for corporations such as Eveready, Exide Industries, governments and COs.