Thinking and reflection: Experience from the field in Bhopal

By Dala Akor Khar Phanbuh

Slum is place in a city or town where the inhabitants are economically poor. The journey of my first field work began in Bhopal, where I was placed in a slum. It was a privilege to get exposure to, and to be able to study and understand the community at a microscopic level. The diversity in the community was unique in that it brought different people together but at the same time distinguished the people from one another in terms of their culture, traditions, beliefs, practices etc.

The social determinants of health were not provided for - there was neither proper drinking water nor proper sanitation, neither proper housing nor land, and they neither had stable job nor sufficient income. Other problems the community faced include people having a low level of education which was one of the factors that also contributed to them falling prey to all forms of exploitation.

There is a single mother who has lost her husband to tuberculosis; not only her husband she has lost everything including her land in her village, which she sold, in order to be able to pay for the treatment of her husband. She is uneducated and lives alone since her daughter is already married and stayed in another district. She struggles for survival working as a domestic worker and earns 3000/- per month. Though she owns a small plot of land she is unable to maintain it due to insufficient income. If she falls ill she first waits for few days and if she is not healed she would go to a doctor. She is not aware about any home remedies such as medicinal plants or ingredients like turmeric, ginger etc that are available in her kitchen. If she has money she goes to a private doctor as she has trust on the services she gets from the private doctor. She cannot afford to go to government hospital though it is free because it consumes more time and more money and if referred from one hospital to another would consume more time and also lead to loss of daily wages.

I also observed the two sides of a coin: I saw slum dwellers struggling for a living and having the least basic necessities, and also the well to do families having comfortable lives. There was a great gap between the have and the have nots.

Thinking and reflecting back about the slum, there is a need to address all the social determinants of health. Looking through community health lens health promotion and health education are very much needed as well as presence of community health workers in order to empower the community and make the people aware about their rights and responsibilities towards their health.

The experiences that I had in the slum were a mixture of feeling of happiness and sadness; I was happy that I was getting a privilege to be able to get exposed to such an environment, and be able to learn and analyse it. At the same time I also felt sad and disappointed to see the condition and the living standards of the people.