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Improving Health and Living Conditions in the Gilbert Hill Slum

1998-07-10

[Photo: Gilbert Hill slum, Mumbai.]

Changing attitudes are helping residents of a Mumbai (formerly Bombay) slum transform their health and living conditions. Yet, in 1992, when a local university first approached the people of Gilbert Hill to help develop their community, they had very different priorities.

"The women wanted income-generation schemes and saw their health and education as the least of their priorities," says Mariamina Varghese, Vice-Chancellor of SNDT Women's University. The residents did not understand that health problems such as diarrhea were related to open gutters, garbage strewn outside their homes, and the overflow of human waste in public toilets. They did not feel a sense of ownership for their environment, she explains, but viewed environmental quality as the responsibility of the municipal corporation serving their area.

Participatory approach

In this Muslim slum of about 150,000 people, families are large while literacy levels, the status of women, and family income are very low. When the project began, Gilbert Hill was isolated from other development projects, which residents had refused to participate in. But attitudes started to change when the SNDT Women's University not only agreed to share the results of research on the health and nutrition status of local women and children, but also to involve the people in gathering data, planning, and implementing the study.

This participatory research project, which was funded by the International Development Research Centre (IDRC), arose from an IDRC/UNICEF-funded national seminar on urban nutrition that Dr Varghese organized in 1989. Although the initial goals were modest, the research team's methods for identifying and addressing women's health issues have proven useful to other agencies such as UNICEF.

Community discussions

The work began with discussions involving university staff and residents. Since most women were housebound and had little decision-making authority, Dr Varghese and her colleagues included men and other family members, who became supportive when they realized the possibility of increasing family income. One man, who operates a cable television station, agreed to broadcast videos on the status of girls and the need for education. (In Gilbert Hill, groups of women generally watch television together in the afternoons.) Dr Varghese says these videos helped to motivate women to participate in the project.

Based on their outspokenness — or in rare cases, their political activism — eight women were selected to help organize communities within the slum. The university gave them each a small salary of 300 rupees a month to visit peoples' homes and recruit information gatherers for the health and nutrition study. The baseline study revealed a need to increase immunization rates, as well as a high prevalence of dehydration and malnutrition. The findings surprised Gilbert Hill residents, who did not regard nutrition as a priority, says Shobha Udipi, Head of SNDT's Department of Food Science and Nutrition.

Broad agenda

After further discussions, Gilbert Hill residents and university staff agreed on a broad agenda of activities involving health, education, income generation, and the environment. For example, university students gave presentations on nutrition. A doctor visited each part of the slum to discuss diarrhea and prevention. Over a seven month period, 800 women had their blood tested and 90% were anemic. University staff explained anemia and its treatment, and distributed a nutritional supplement containing iron, salt, and vitamin C. The university also began to purchase higher quality grains and rice for distribution throughout the slum, charging the same price or slightly less than what the women were paying in local markets.

During the project, teenage girls with some education were paid to hold literacy classes. For residents who agreed to attend them, the university helped launch income-generating projects, such as production of artificial flowers. It also set up sewing classes, acquired three sewing machines, and secured contracts for slum women to sew lab coats for college students. Some girls also began teaching each other henna painting so they could earn money from this skill.

Optimistic

"Before, I had no confidence that I could do anything," says 18-year old Shenaz Sheith. "Now I have finished high school, plan to [attend] SNDT Women's University, and am teaching henna painting and pre-school." Like Sheith, many girls and women throughout the Gilbert Hill slum seem optimistic about their future.

Since 1993, the university has been working through local development committees set up under the Indian government's Urban Basic Services Plan, which calls for one women representative per 10-40 families. But the project has not yet caught on in all parts of Gilbert Hill, admits project officer, Meenaxi Kamath. "It takes a long time to convince everyone of the benefits. The women leaders continue to visit homes and discuss possibilities."

Marked differences

One incentive to join are the marked differences in the cleanliness of alleys and streets, as well as the appearance of homes, between the 80% of living areas reached by the project and the remaining 20%. (A few community centres and schools have also been built in project areas.) The focus is now on further improving sanitation and quality of life. So far, the university has helped people write letters to the municipal corporation and has facilitated negotiations so slum residents can appoint their own people to maintain toilets and collect garbage. These workers received some financial incentives from project funds until May 1998, but it's now up to the community to help pay the cleaners and collectors.

"In the first phase, people saw their work as part of our university's project," concludes Dr Varghese. "Now they see it as their own development."

Jennifer Goldstone is the communications coordinator for the international division of the Association of Universities and Colleges of Canada. She visited this project while in India in April 1998. (Photo: J. Goldstone)

Resource Person:

M.A. Varghese, Vice-Chancellor, SNDT (Shreemati Nathibai Damodar Thackersey) Women's University, 1, N. Thackersey Road, Mumbai - 400 020, India; Tel: (91-22) 203-1881; Fax: (91-22) 201-8226; E-mail: sndt@bom2.vsnl.net.in

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