Sreelatha Menon: Defining healthcare

EAR TO THE GROUND

'Mitanins' may be unpaid, and often unlettered or semi-literate, but Chhattisgarh officials link the fall in infant mortality from 105 to 53 per 1,000 to the work of these village activists...

Infants remain malnourished despite a network of Anganwadis, while primary health centres 'function' without doctors.

There has been a need for someone to act as a link between the services and the beneficiaries, for someone who can counsel the villagers and make them claim their rights, even fight for them and seek improvement in services as a matter of right. Chhattisgarh has an answer "" the mitanins.

In fact, it has an army of them "" about 60,000 unpaid, often unlettered or semi-literate, volunteers from the community. They are not content to be helpers to ANMs (Auxiliary Nurse Midwives) and Anganwadi workers, like the health activists deployed by the National Rural Health Mission in other states.

Mitanins, who are constantly trained in health, hygiene and nutrition, besides being given a bag of basic drugs, take their role of activists seriously.

In Chhattisgarh's Koriya district, these community women, who are held together by a unique partnership of the government and NGOs, began sending complaints at a furious pace to the district collector on the inadequacies in the Anganwadis and the health centres. When no action was taken, they approached the Supreme Court Commissioners on the right to food. They wrote to the state government and action was immediate.

About 10,000 complaints have been received so far against the public health centres alone, according to the programme officials.

The government-funded network was formed after an MoU between the state government and NGOs from all over the state in 2001. The programme is held together by an autonomous state health resource centre parallel to the health department. Director Sunderraman and state co-ordinator Raman of the centre draw their salaries from the government but say they are totally free of government control. In fact, everywhere different NGO partners are motivating mitanins and acting as their support groups.

In the 72,000 hamlets in Chhattisgarh, there are mitanins in 58,000. "At least 45,000 of them are active in organising the community for accessing public health facilities and 6,000 were able to bring about some change in their community, to get doors opened for the villagers," says Raman, a former activist of Kerala Shastra Sahitya Parishad who was recruited six years ago under the programme to head the resource centre.

"Mitanins don't get salaries. The honour they get in society makes them come forward," says Raman. "In fact, 5,000 of them stood in panchayat elections and got elected," he adds.

This is the biggest band of activists after China's barefoot doctors, the proud officials claim, linking the fall in infant mortality from 105 to 53 per 1,000 to the work of these village activists.

As for the petitions being filed by mitanins against various government officials, Raman says this is not the objective of the programme. Merely the happy side effects.