15 Feb REACH India: Empowering Women Through TB Work
[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_separator type=”normal” thickness=”2″ up=”20″ down=”20″][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_gallery type=”nivo” interval=”3″ images=”2455″ img_size=”full”][vc_column_text]REACH – an acronym for Resource Group for Education and Advocacy for Community Health – is a women majority organization right from senior program management to the community health staff level. It was established in 1999 in response to the roll out of the Revised National TB Control Program (RNTCP) in Tamil Nadu and has since been a key partner and leader in the fight against TB in India.
Although TB is a disease that can affect anyone, REACH focuses its energies on providing support to those from poorer economic backgrounds where there are few options to access information and healthcare. Women represent 43% of the symptomatic TB referrals they receive and 37% of confirmed diagnoses.
As an organization, REACH has always attracted more women than men because of its female-friendly work culture; they take into consideration the triple burden women face in terms of earning, household work and child care. Out of the 70 staff members who are involved in program implementation in Chennai, 72% are women.
Some of the staff are also family members of patients who were previously treated for TB and who have approached the organization for a job. REACH believes in empowering women and especially women in those families where TB has wreaked havoc, emotionally and financially.
The following are interviews with two of REACH’s female community health workers.
How has TB impacted your life?
C: My father had TB and his treatment was delayed because there was a delay in diagnosis. Meanwhile, my family was struggling financially. The responsibility to make ends meet and my younger siblings’ education fell on my shoulders. Our family was stigmatized; relatives who used to be close to my father stopped talking to him once they found out he had TB. We didn’t get help during a difficult time and I thought no one would give me a job.
Z: My father lost a lot of weight over a period of a few months. He was initially diagnosed to have cancer and was being treated for close to a year. With no improvement, I took him to a government hospital where he was diagnosed with TB. They gave us a red pill which my father took for a year with little change in his symptoms. In the meantime, I lost my job as a dental assistant. We were also in a lot of debt. My husband has cardiac problems and had stopped working. My parents are dependent on me. I have two children whose education I have to take care of. TB pushed us into poverty. Finally, one of the doctors in the government hospital sent me to one of the REACH centres. The staff there encouraged my father to complete anti–tuberculous treatment. They also found me a job.
How did you get involved with REACH?
C: One day three years ago, staff from REACH along with those from the country’s TB control programme, RNTCP visited us. They were screening family members of people with pulmonary TB. During their visit, one of the RNTCP staff members asked me about my educational qualifications and where I worked. When I told them I wasn’t employed anywhere yet, they helped me get in touch with REACH, who were organizing this contact screening programme under its project IMPACT. After an interview, REACH employed me in a role in the same project through which they found me. My father encouraged me to take up the role, stating if I could help other people living with TB in any way, that would make him happy.
Z: I used to collect medications for my father from one of REACH’s Nakshatra centers. I told the staff there that I was in dire need of a job and to let me know if there were any available jobs in the organization. They informed me when a vacancy came up.
What kind of work do you do as a community health worker?
C: I am involved in holistic care of people with TB, including counselling and treatment adherence.
Z: I transport samples from 3 hospitals to a GeneXpert lab.
What is your favorite part about your job?
C: I like to educate people about TB. Among all my duties, I find the motivating people brings me the most joy. I love to encourage people with TB to complete their treatment and I love boosting their confidence this way.
Z: My father experienced a huge delay in diagnosis, and I don’t want others to go through that. When he was ill, many doctors told me that at his 67 years I shouldn’t do anything to help him live; that he was done living his life anyway. When I transport samples of older people, I feel happy that they are getting the right kind of care.
My father helps me to look after my children, he has gained the weight he lost and he looks very healthy. He also asks me if he could take up a job. I don’t want him to work though; I want him to rest and be in good health. I have huge respect for the private practitioners who refer patients to REACH. I am happy to be a part of this network.
How do you relate to other women who have been affected by TB?
C: Although most people with TB who I work with are men, I also connect with their female family members: their mothers, wives and daughters. When they are in distress, I tell them the story of how my father was affected with TB, how he got over it and how as a family we were able to aid his recovery. Since I can relate to their woes, they listen to me and are able to keep up their strength during a difficult time. Some of the women who are affected by TB don’t even tell their families of their TB status, but they easily open up to me and are able to share with me the problems they face.
Z: Because I have been to many hospitals I know where good care is available. I know some doctors very well over a period of these two years and I am able to direct the women in my community to the practitioners I know. Seeing them get better makes me happy.
How has your own work changed you personally?
C: My knowledge and awareness about TB has increased tremendously. Now, information on how the disease spreads and affects people is at my fingertips. The job has eased my financial struggle and I have become financially independent.
It has also helped me be a humanist and respect others’ preferences. My ability to empathize with others has bettered. I also have a more wholesome understanding of how things happen in our society.
Whenever people in my family or neighborhood need any guidance regarding health, they approach me. People in my community respect me for the work I do, but more importantly, I have learned to respect myself.
Z: I have learnt to be more disciplined with time and economical with my words. I feel confident in the society now. I have understood how to talk to people of various cadres. I also ask my children to write down for me the lessons from every workday, so I go over what I have learnt each day to help me understand how I can get better at work. As a person, I should say I have grown a lot.
When I lost my job, when we were in debt, many of my relatives and neighbors spoke of us condescendingly. They looked at me as an inefficient person. Now, they look up to me. They trust me enough to ask me for favors. They ask me to let them know about employment opportunities. From being an inefficient worker in their eyes, I have become a hard-working and independent woman.
How has your work changed your life?
C: I feel very fortunate each day when I go to work as I believe the same job could have gone to a person who is not from a family affected by TB. Before getting a job here, I felt stigmatized even to be a TB patient’s family member. I had internalized that I wouldn’t get any job ever, let alone from an organisation that knows that my father was affected by TB. And all that has changed due to REACH.
The organization has built my capacity to be whatever I am today and motivate me to perform my duties towards the society. In fact, I feel so close to my work that I don’t address people with TB by their name; I call them amma (mother), appa (father), anna (brother), akka (sister). In this way I am able to connect with them effortlessly.
Z: I am an illiterate. I want my children to receive a good education and have better lives. My son was doing his engineering course when my father fell ill. I knew I had to manage to continue educating him. I was worried about my daughter who was finishing her school then. Thanks to my work, my daughter is doing her Bachelor’s degree in commerce in a self-financing college. I would like to highlight this as a major change; that my financial position has changed enough for me to educate both of my kids.[/vc_column_text][/vc_column][/vc_row]