Reframing Community Health


The photograph lured me in: the baby’s eyes in contrast to the woman’s fingers, stumps of various lengths. I had to read more. What I learned was an exciting model for community health being implemented in villages across the state of Maharashtra.

“They are not doctors. They are not nurses. They are illiterate women from India’s Untouchable castes. Yet as trained village health workers, they are delivering babies, curing disease, and saving lives—including their own.”

The article recounts the story of two village health workers, Sarubai Salve and Babai Sathe, who look after pregnant women, babies, old people, and other basic health needs of the community. Sarubai Salve has been working with the village of Jawalke for the past 24 years.

What is amazing about this story is not only the success of the community health model but also its major aim of providing dignity to women who are untouchables. These two women were once illiterate, lacked a self-identity, and were extremely poor. Through the program Jamkhed, founded by a husband and wife doctor team, Raj & Mabelle Arole, this is no longer true. In fact, they have also organized 8 women’s groups and started a revolving loan fund and business skill training.

Many groups have tried to do as Jamkhed but have not succeeded with the same results. The Aroles goal from the beginning is the key, I feel, to why Jamkhed has seen such transformations. In order to work with the poorest of the poor: “empathy, knowledge of how poor people live, and willingness to work were more important than skills and prestige.”

Today the villages where Salve and Sathe work have two prevalent illnesses: hypertension and diabetes. This is not the status quo for the majority of rural India. In fact, they are considered to be diseases of developed countries. Who would have thought that these untouchable women would be such change agents? If nothing else, this is another testimony to never draw within the lines and accept the norm as the end all be all.

Quotes and photo from Necessary Angels Article in National Geographic

Photograph by Lynn Johnson, National Geographic 2008

Baby in Village of Jawalke, India. Photo by Lynn Johnson, National Geographic

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