The SOCHARA Team on providing community health in India

The Society for Community Health Awareness Research and Action (SOCHARA), an Indian NGO, is recognised widely for its promotion of community health through networking, innovative training, research, policy engagement, and solidarity with movements and networks such as the People’s Health Movement, medico friend circle, and COPASAH. Recently the occasion of SOCHARA’s silver jubilee gave us the opportunity to reflect on 25 years of experience. The SOCHARA family is large not just because of the “once you enter, you will always be a part” culture but also for its partnerships and solidarity. This was well reflected in the diversity of participants at the meeting. Also in attendance were those who received and continue to receive mentorship in their respective community health journeys from SOCHARA members over the years. Our ethos of social justice, scholar activism, and non-hierarchy have reportedly played a role in shaping the work culture of several individuals and organisations.

Power packed sessions on key contemporary health issues of salience locally and globally held the participants attention. We as an organisation are increasingly engaging with these issues. Activists from Tamil Nadu made graphic presentations about the causes, impacts, and relief measures related to recent floods in coastal cities and towns of the southern Indian state. Rather than the heavy rains, it was the poor management of land, surface water bodies, and canals, with unregulated construction over years that led to severe floods with deaths and damage to property (mainly affecting the poor and vulnerable). Ms Kausalya, from Positive Women’s Network discussed the plight of people living with HIV due to the floods, who were unable to access medications or replenish their stocks. More importantly, they faced discrimination and did not receive the same level of support and relief from neighbours. However, in most areas, it was citizens, neighbours and able bodied persons who helped each other beyond societal barriers. Sujata Mody related how domestic workers continued work despite their own homes being destroyed.  It was suggested that disaster prevention and relief would be major campaign themes for future elections in the state.

“Food” and the agrarian crisis too have become a key public health concerns due to their impacts on non-communicable diseases and environmental health respectively. Presenters included individuals involved with campaigns protecting traditional seeds, addressing agrarian distress, and adapting to climate change. The health of the country was stated to be dependent on the health of the farming community and agriculture. Livelihood challenges are huge in rain-dependent agricultural areas. The role of the “Green Revolution” was analysed in this context. “Our blood has become the most polluted river” (due to widespread use of chemicals), in the opinion of the panel chairperson, Mr Jayakumar from Thanal. Critical challenges concerning access to sanitation facilities – such as gender, mental health and corruption, were also discussed.

Communitization,” a buzz word indicating the institutionalisation of community action for health, including monitoring and planning of healthcare services and health at all levels, was the theme on Day Two. Several SOCHARA members and network partners are deeply committed to this important process, which has evolved over the last decade. Participants shared their thoughts about processes of engagement and support to make “communitization” a reality, and the challenges faced – from the system, the partners, and the people. Communitization was also discussed within the contexts of child rights and health systems. The associated parallel workshops brought to light other aspects of communitization, such as the engagement of women, religious minorities, and those living with mental illness; the role of local governmental representatives; and the possibilities provided by ICT.

The deliberations highlighted the need for people to come together in order to address growing health challenges. There is a need for a paradigm shift from current mainstream approaches such as expert driven and cutting-edge technology oriented (short term) solutions to social justice and ecological sensitivity oriented (long term) solutions. SOCHARA will continue to engage with community health in India.

The SOCHARA team co wrote this blog.

Competing interests: None declared.