February 15, 2010

Dasrath’s Story, Part III: Jhum Bai’s Dream

For background, see previous postsPart I: Initial Presentation and Surgery and Part II: The Harshness of Village Life

Jhum Bai returned to Ganiyari with Dasrath to discuss her life, even her destiny, defined by abject poverty, her husband’s will and childlessness.  Expecting despair, I found instead hopefulness and resiliency.  Dr. Ramani Atkuri joined me for this interview.

Jhum Bai with Ramani at the JSS medical compound in Ganiyari Village 

Jhum Bai explained: “There are no children at home – except Dasrath (age 10), my brother-in-law. My husband’s older brother is single and has made clear he doesn’t want to marry. So the burden is on me.  I have one or two years”, she relates, “to have a child. If I don't, my husband, Kunwar, will take another woman…and I will leave; go back to my parents’ home. There is further pressure from my parents. They remind me disapprovingly that my brother married about the same time I did. He has two children while I have none.”

We brought up adoption as a remote possibility.  In rural India, the custom is to adopt within the family.  For example it could be a relative’s girl child where there are too many mouths to feed.  Not Jhumbai’s situation.

“Would you marry again?”
“No, no one will marry a woman who can’t have children.”
Nor, she added, would she consider living with another man not her husband.
But this fate, feared by all childless women, is not sealed.  Jhum Bai is yet hopeful.

“Why haven’t you sought medical help after six years of trying to have a child?”
“Over the past two years, every time, I bring Dasrath for a visit to Ganiyari (the site of JSS’s clinics and hospital), my husband says: ‘Why don’t you have yourself checked up?’ He has been urging me to get examined almost from the beginning.”

She hasn’t, she admits, because the thought of a gynecological exam has overwhelmed her with embarrassment, even if the doctor be a woman.  But now that she is more familiar with JSS, she says, she hopes to overcome her shyness.

Ramani adds that among village women, there is a shroud of secrecy about vaginal bleeding, discharges or pelvic pain. Further, itching, irritation or a white discharge from the vagina is so common as to be considered normal. Help is seldom sought and practically never discussed with others. Only when pain, as in the late stages of cervical cancer, becomes overwhelming do village women seek medical help.  Mothers even avoid discussion of menstruation with their daughters.  Jhum Bai has never talked with other young women in the village about her concerns.

 Jhum Bai with a hint of embarrassment

Dr. Ramani explained that in any case, the initial approach would be to determine if her husband is fertile, a sperm count.  Her husband would only have to go to Shivterai, a JSS sub-center close to their village. The idea of male infertility was a realm beyond. Jhum Bai promised to speak with her husband. To Jhum Bai and Kunwar, the idea of male infertility is novel. His response is in no way assured to be positive. Generally in village India, a rumor, any hint, of a man’s lack of “virility” would by itself bring shame and ridicule.  So why then be tested?

Other than an explanation, at menarche, from her mother that menstrual flow would come monthly, and awareness that sexual relations may result in pregnancy, Jhum Bai has no knowledge of reproduction or the relevant female anatomy. That the uterus exists was news to her today.

Jhum Bai absorbing the revelations on causes of infertility.

Jhum Bai’s education ended during the preschool years as her father had fallen ill and the family needed her to do the household chores and to take care of the infants in the family. Even had she continued through the primary grades, sex education has not come to the village schools of Chhattisgarh nor to most schools in India, even in larger towns.

We asked about her happiness.  “My husband treats me well”, she replied.  "He doesn’t get drunk or beat me.  I know he loves me as I do him.  And I have friends my own age in the village.  We go together to the forest to get wood.  Sometimes I go with Kunwar to Kota, the nearest village with a market.

“What do you think about all day?” I asked.
“If I were better off, I wouldn’t have to do all these chores. If I were rich, I would buy jewelry and some farm land.”  Jhum Bai has a few, commonplace bangles and hardly any other jewelry, marking her as the poorest of the poor.  Today, she arrived dressed in a sari in tatters.

“How will life be different if you have a child?”, I asked.
“A child will give me inspiration to live. Someone to live for and build a future. It doesn't matter whether it will be a girl or boy. I will devote my life to that child and do everything possible to see that my child receives a good education. Without an education, a child can’t get anywhere.”

Jhum Bai added that the Mangalpu village school goes through the 5th grade.  Then, in the nearby village of Karka up to the 8th grade, only two kilometers away.  In Kota, 5 kilometers distance, there is a high school. Currently, three children from the village go there, two boys and a girl.  All have bicycles.

“You are young”, we said. “Would you like to go back to school?”  Jhum Bai replied: “Yes, I would if my husband would agree.  I could go to school from eight in the morning until one and then go home and work until eight in the evening.” I mentioned that we could help her financially make this possible.  Jhum Bai said she would seek her husband's consent. 

“If not, and I don’t have a child and am rejected, once back with my parents, I’ll find work and, then, I’ll try to go back to school. I would not be interested in marrying again nor living with another man.” All of this as if we were discussing the weather, her mood betrayed only by the self-control borne of a lifetime of the lowest of expectations.

A moment of reflection

We asked how she came to marry, here in Mangalpur village, one the poorest of the region.  Jhum Bai replied, “Before I married, my family was better off. We had more to eat. When my parents decided that the time had come for me to marry, they considered three suitors. Two came from families with greater wealth. The third, Kunwar, came from a poorer family.  My mother said: “This will be a better marriage.  The richer suitors will treat you with little respect. The poorer suitor is more likely to treat you well.”  So it came to pass.

Jhum Bai is driven with a determination to improve her lot in life. After she married Kunwar, she nevertheless managed to save over the years, so that they now have pots and pans. Think of it: pots and pans – but not enough food to avoid hunger! She told us that the other girls in the village used to make fun of her for marrying into such a poor family but her tireless basket weaving brings in two dollars weekly. Not even her husband knows, but she is keeping these savings in secret for hard times ahead.

Update on Dasrath: On the way to JSS today, Dasrath suffered a seizure and, while with us, still another while playing outside on the grounds. Yogesh Jain is once again adjusting his anti-seizure medications. 

February 1, 2010

Dasrath's Story, Part II: The Harshness of Village Life

For background, see Dasrath's Story, Part I: Initial Presentation and Surgery


Since writing Dasrath’s Story, Part I, I have visited Dasrath and Jhum Bai in Mangalpur, their forest village, and have interviewed Jhum Bai once again in Ganiyari at the JSS health center and hospital complex. Their story, like the road itself into the village, twists and turns, down narrow, rutted paths. But one conclusion is clear. In the end, their greatest suffering is the sense of helplessness to find a brighter future, free of the deprivations of poverty. Dasrath, perhaps, lives from day to day, seizure to seizure.  Jhum Bai, married close to the onset of puberty, six years later remains childless and faces the most bleak of all possible outcomes: abandonment.  This is the fate of perhaps the majority of childless, village women.  Let’s hope that I’ve got it all wrong.

The winding, dirt road to the Village of Mangalpu

Visit to Dasrath and Jhum Bai in Mangalpur Village
Mangalpur is a remote village of 28 families and 150 individuals. Most single family dwellings have but one room; few have tile roofs; all are constructed of mud and have dirt floors. None have latrines nor running water. The primary school is housed in a tiny one-room building adjacent to a newer facility that has never been finished. 

The unfinished village school house, center, and the temporary, inadequate school building at the far left.

Arriving at the village, active electioneering for the first panchayat (local governing body) election in sixty years was underway.

Entering the village, the panchayat election poster is prominently displayed.

Several hundred meters on, we came to another cluster of huts including Jhum Bai’s and Dasrath’s.

Jhum Bai stand in front of her home shared with her husband, Kunwar Singh, Dasrath and others.  

Our visit to Dasrath and Jhum Bai’s one-room hut was brief.  Her husband, Kunwar Singh, and JSS’s volunteer Senior Village Health Worker, Aghaniya Bai, were present.

Left to right: Jhum Bai, Aghaniya Bai, Kunwar Singh, and JSS Village staff specialist, Prafull

I presented Jhum Bai, with Aghaniya Bai as witness, Rs. 3,000, the balance required to pay off the moneylender and reclaim the family’s small plot of land on which a single crop of paddy is harvested each September. Earlier, I had gained clearance from Yogesh Jain and other physicians of JSS to provide such assistance. Thus, with a total donation of Rs. 5,000, or about $100, the family was able to regain their land on which they grow rice. Jhum Bai told us that Kunwar cried when he heard the news. (See Dasrath’s Story, Part I.)

The electrical connection, to provide illumination from a single bulb inside the home, had been out of order for several months.  Jhum Bai related that the leader of the panchayat demanded Rs.100 to get the responsible government official based in Kota, the block headquarters, to fix it. She could not pay. Hence it remains a useless relic.

The broken electrical connection, many months out-of-order

At night, the family depends on the dim light from a single bulb attached to the exterior of the hovel.  At times, a kerosine lantern is available. The battery of a torch, which sits on top of on of three bags of paddy, has long ago expired.

Bags of paddy from the September harvest, stored in the family's hut with the useless torch

 Three large sacks of paddy from the September harvest are stored in the room, only about one-third the normal yield due to the failure of monsoon rains in 2009.  The family plans to extract the seed for planting of their plot of land at the onset of the monsoon season in July.  Hence, there will be no rice from their own crop. The family itself depends on the government-subsidized rice purchased with ration cards but this only lasts for a portion of each month.

On the back wall of the hut hang everyone’s garments, mosquito nets, dried corn brought by Jhum Bai’s parents, who live 40 kms. away and, heaped on the floor, assorted light, threadbare blankets and ground coverings. Jhum Bai owns three saris. There are no beds.

The back wall of the hut with clothing.  Jhum Bai holding mosquito netting. Piled on the floor, flimsy blankets. Dried corn on upper right.

Soon, the family hopes to finish construction of a second room, adjacent. When completed, Jhum Bai, her husband and Dasrath will live there. The current hut will be converted into an animal keep for the family’s two remaining oxen and for storage.

The partial wall of the adjacent, new one-room home under construction. The current home will accommodate two oxen in the future.

Daily life 
We asked Jhum Bai to return to Ganiyari a day after the elections for further discussion. This is the story that emerged.

Life is unimaginably hard.  During these winter months, November – February, despite keeping a fire burning inside their hut at night, they shiver from the cold.  All garments available are not sufficient for protection. Sleep is fitful. Often, Jhum Bai, her husband and Dasrath awaken by 2 AM and sit around the fire to warm up before lying down once more, trying to sleep. They have no woolen clothes and only the thinnest of blankets.  I felt compelled to provide wool sweaters and blankets but colleagues advised the cold would penetrate even those.  I also brought Jhum Bai a food basket of sorts, including a few oranges.  Only once previously in her whole life had she ever eaten an orange.  

When in need, neighbors can’t be counted on. Nor can the government. The bore well, the source of drinking water near their home, has been out-of-order for a month. Two weeks ago, each villager paid Rs. 10 to the Panchayat but, since, there’s been no repair.

The government has failed to install any latrines in this or other villages in the forest preserve.

The government is now beginning to force villagers out of their homes to resettlement areas outside of the forest on the order of New Delhi. Four villages already have been moved and, as yet, the government has failed to provide amenities or compensation. A weak protest is growing against overwhelming odds. These villagers are mostly of the Baiga tribe, officially protected, but in fact scorned by officialdom as illiterate and too few in numbers to be taken seriously.

The roof leaks badly; the best solution, tile, is beyond their grasp.  Even a new sheet of heavy plastic, to be covered with leaves from the forest is unaffordable. Broken and old tiles hauled from another village may be used on the adjacent roof but the quantity and quality is grossly insufficient.  

For personal hygiene, washing up takes place at the bore well pump – when functioning.  But poverty dictates that soap be used only every other day.

No one in the family owns a bicycle.  Those seen in the photo belong to two of Kumar Singh’s cousins that live elsewhere.

My final question this day to Jhum Bai: "If you were granted three wishes, what would they be?" Without hesitation, she replied: "I would not have three wishes, only one, to have children." Her survival may depend on this wish coming true.

Final interview to follow: Jhum Bai's Dream