KORIYA INITIATIVE, CHATTISGARH

Manendragarh would not have been on our map, but for Samir Garg a friend from our IRMA days. Together with his wife Sulakshana, they have initiated what they loosely term the Koriya Initiative, working on community health and the public distribution system. Both had come through several years in the PRADAN-model of development, promoting rural livelihoods, questioning the efficacy of this approach in bringing about social transformation and empowerment. A key player in this is Biraj Patnaik, also a fellow IRMAn, working as Regional Manager of Action Aid, in Chattisgarh. With some motivation from Biraj, Samir and Sulakshana landed in Manendragarh, a town in Koriya district in the north-east of Chattisgarh towards the end of 2002. Their work currently spans two blocks of Koriya district – Manendragarh and Janakpur, a total of about 300 villages/habitations.

Riding on the government’s programme for health promotion in rural areas, the Koriya Initiative perhaps demonstrates how government programmes can be made to work and be effective at that. As they clearly articulate – “The challenge was not only to build quality into the health work but also to make the programme unambiguously ‘rights’ oriented.”

The Mitanin Programme

The Chattisgarh government initiated the Mitanin programme with support from the European Union to reform the primary health delivery system in the State. The object was to train a cadre of hamlet based women health workers, called Mitanin (the word means friend in Chattisgarhi) - some 60,000 of them. The regional office of Action Aid played a significant role in setting up the programme and the State Health Resource Centre (SHRC), the state-level project management unit.

The principles of the Mitanin programme sound simple enough – the SHRC would build capacities of selected Mitanin, systematically, through a modular training programme. These women must devote part of their time towards spreading health awareness and at a later stage basic treatment as well. A group of Mitanins are supported by a full time worker, also called ‘trainers’, but who Koriya Initiative chose to call Prerak - Mobiliser. The trainings were organized on a campaign mode, transcending several aspects of building capacities of Mitanins, spreading awareness of ailments and available government services, collecting reliable data on access to health services and continuous community based monitoring. Jan Sunwais are a crucial aspect of maintaining watch on the system and its effectiveness. Most importantly it also helped the government to build reliable health delivery systems and connect with the people it is mandated to serve.

The basic message spread during these campaigns is that, health services is a right which has to be demanded from the government. The Mitanins have taken up the leadership in mobilizing the community, especially women and demanding health services from the Government. This way, The Koriya Initiative places the Mitanins in the centre of a rights based strategy.

We were surprised, quite naturally, that the Mitanins worked quite effectively – at least in the areas we visited - without any remuneration. Santibai in Balashiv village is an example. A normal adivasi woman, with no pretensions of being a ‘doctor’. But that is what she is for the villagers. The sense of dignity (izzat) that women like Santibai imbibed on being given this responsibility is probably the reason behind the success of the endeavour. With a quiet sense of confidence the Mitanins interact with government health officials, and as confidently treat cases of fever and diarrhoea in their village, and accompany patients to the health center when they can’t treat them.

Significantly Mitanins have been trained in reproductive health of women and health, nutrition and growth of children – aspects which are regularly monitored within the communities. As a corollary, Mitanins were pitted head on with ICDS centers on distribution of take-home rations, and ANMs who are mandated to perform immunizations, while on the other hand they had to mobilize enough community awareness to demand these services.

A more crucial challenge was to get adivasi women to acknowledge and articulate problems in reproductive health. This focus has also created the space for women to come together and discuss issues of common concern, and in several instances counter domestic violence and assert themselves in their homes and in the village.

Ensuring food security

The right to health soon led the focus to the need for adequate nutrition, and the members of the Koriya Initiative saw potential to mount a right to food campaign on the base built with the Mitanins. There was also the opportunity provided by the Supreme Court orders on the Right to Food cases. The Court had appointed two Court Commissioners to oversee the implementation of its orders by the Governments. Biraj was appointed an Advisor to the Commissioners for the State of Chattisgarh. KI had a sure-shot method to get the State and District Administration to wake up and take action. The Koriya initiatives mobilized the Mitanins to ensure that PDS worked. From demanding their cards, to understanding what provisions for rations are mandated, to holding Jan sunwais exposing the state of PDS, the momentum was built up. Entrenched social and political orders are being challenged in the process.

Over a period of a year, campaigns were launched in several villages to get Public Distribution Centres to work effectively. This too was in sync with efforts at the State level by several NGOs and the Action Aid team to demand that PDS centers be run by Panchayats, or Self Help Groups, and not by private dealers. While this been discussed on several occasions at the national level and in different States, no State had actually come up with necessary legislation.

Following hectic lobbying, a state level order was passed that PDS outlets be operated henceforth by Gram Panchayats with one-third of shops being run by self-help groups. Several private operators protested while several others attempted to subvert the order, especially the clause on SHGs. Originally the State Act had specified that SHGs that were three years or older would only be eligible for running the PDS shops. Trader lobby pressure ensured that this clause was changed to make one-year old SHGs to be eligible.

Samir is also coordinating a Chattisgarh state-wide network on Right to Food. Seven adivasi-dominant districts are covered by this network. Local activist groups are provided support in the form of inputs and guidance on logical and organized ways of approaching the issue. This involved collection of relevant data, its analysis and target-specific presentation. Nine schemes of the government, meant to provide food security to the most vulnerable among the rural population, are being closely monitored in Koriya and other districts. The schemes are:
- Public Distribution System, Antodaya Anna Yojana, Annapurna Yojana
- Integrated Child Development Scheme, Mid-day meal in schools
- Social security scheme including old age pension, widow pension and disability allowance
- National Food for Work Programme
- National Maternity Benefit scheme, National Family Benefit scheme

Mankuwar is a Prerak working in the Visrampur area of Manendragarh block. When we met her, she was suffering from severe malaria. The fever, however, could not douse her spirit. She narrated the saga of their struggle with a local political leader-cum-trader named Lakhan Srivastava to get the PDS shop to work well. Srivastava and his cronies who ran the shop kept to themselves the PDS cards meant to be issued to the poor. When the KI began its work on collecting cases of PDS non-functioning, this was one of the first to come up. Mankuwar, escorted by her husband who constantly nagged her to give up this task, walked from village to village collecting testimonials from families and organizing meetings. Srivastava’s goondas tried to intimidate her and other women. She narrated the incident of three of them having to take refuge behind the embankment of a pond on hearing the sound of a jeep. All three of ended up in the pond, unable to find a grip on the slope of the embankment!

The PDS shop in Visrampur now functions properly. All families have got their cards and are regularly being supplied food grain as per the rules.

It is amazing the way Santibai and Mankuwar relate to the reality around them. Also the confidence they exude when talking about what lies ahead.

Activist professional?

A thought that kept coming to mind – ‘Is such action possible without intermediaries?’ – Samir and Sulakshana in this case. The State backing and the capacity building and coordination provided by SHRC are important, but are they enough to challenge and influence and change practices at the local level. Samir explained how efficacy differed among different areas. In adivasi pockets especially there is need for greater support, sensitivity and accompaniment, which the framework by itself is not designed to provide. This also led us to question how long the loose formation of the Koriya Initiatives and Samir and Sulakshana’s presence is necessary. They choose to remain in the background, not project themselves as surrogates to the people. They project the Adivasi Adhikar Sanghatan (a loose formation as yet, soon to obtain a formal form) as being the legitimate body to take up issues of adivasi rights. Within the levels of information available and entrenched socio-political systems, how far is the AAS likely to go? Will they not need, at least in the foreseeable future, the kind of external support that the Koriya Initiatives provide, till they gain enough confidence and capacities to challenge centuries of practices, socio-political structures?

This takes us to one of the primary questions that we set out to explore. Where and how does one draw the line between the work of an activist and that of a professional? For now, at least, we would like to submit that the work being done by KI is more that of a professional than that of an activist. As they themselves have proven and continue to articulate, their role has been behind the scene – organizing, coordinating and enabling interface of the communities with external actors. Samir may baulk at this, but what else is professional action?