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BIHAR WORKSHOP 2 SYNOPTIC REPORT

Collaborating NGO: Mahila Jagriti Kendra.

Dates: 25-28 September 1997

Venue: Mission Hospital, Mahila Jagriti Kendra, Gomia, Bihar.

Participants: 16 dais (from Bela Tand, Bengali Tola, Karmathiya Basti, Sarochiya)

5 MJS & MS members
3 Matrika members
Also: Interviews with 1 ANM, 1 Compounder & 1 doctor, all practising in Gomia.


Activities

Sessions During Workshop:

Day 1 -- 25.9.97
Introductions, Discussion about previous workshop, Reporting
Role plays on chhati rituals (small groups, sharing in large group).

Day 2 -- 26.9.97
Game and Discussion on Gender
Body Mapping
Birth Atlas
Sharing Matrika Posters on Childbirth
Field Visit -- for Case Study on Maternal Mortality

Day 3 & 4 -- 27.9.97 & 28.9.97
Field Visits
Interviews with dais
Interview with Compounder


  1. Knowledge, Skills & Practices Before Birth
    1. Women often wear amulets during the pregnancy for protection.
    2. When it is time for delivery, the woman's thighs start shivering, she starts to wet and her water-bag bursts.
    3. [See Bihar Workshop - 1 for more data].
  2. Knowledge, Skills and Practices During Birth
    1. [See Bihar Workshop - 1 report]
  3. Knowledge, Skills and Practices After Birth
    1. Soon after birth the dai massages the woman all over her body, does not fomentation on stomach with arandi leaves, and with mud filled with hot ashes.
    2. For the first six days, maalish (massage) is done everyday for about 2 hours each day.
    3. Ajwain is burnt and the woman's pelvic area exposed to the smoke (dhuan dena).
    4. Sonth (ginger), bread and milk is given to the woman.
    5. She needs to rest, because gradually her body will close up.
    6. On chhati, the house is cleaned and decorated, and mother and baby too wear new clothes.
    7. [See Bihar Workshop -1 report for more data on section 3;
    8. See also section 5 below].
  4. Complications Before, During and After Birth
    1. If placenta is retained in uterus, the dai may put in her hand, hold the cord, and pull it out. In one case when the placenta was stuck inside for 12 hours, the woman died. In another case, placenta and cord were out but baby not delivered, so the doctor was called, injection given to induce contractions, and then the baby delivered.
    2. In another case, the woman folded her legs after birth, so the placenta got pushed further in. The dai reports that she opened the woman's legs, slowly put in her hand and managed to take out the placenta.
    3. If the woman has suffered uterus prolapse, the dai inserts a small pouch dipped in mustard oil and roasted ajwain into the vagina. Also, the dai presses the woman's vaginal area with her heels, on which hot oil is first applied.
  5. Understanding of the Body, Health and Disease
    1. Talking about the body in terms of sexuality and fertility is tabooed. In the village group meetings organised by MJK (Mahila Jagriti Kendra) and MS (Mahila Samakhya) sahayoginis, village women have said -- "You talk like prostitutes!" Village women have also said that if their men knew that there is all this talk (about reproduction and childbirth), they would not allow them to attend these meetings.
    2. During the session on Body Mapping, there were inhibitions, and a lot of laughter when the local term for vagina (burr) was mentioned.
    3. Kuan puja (well worship) takes place generally on the third day after childbirth. The dai (also called maharain) massages the new mother with oil. She puts sindwar leaves in water and boils them, bathes baby with this water. She presses a thread under the tongue so the baby's voice is loud and clear, and presses the baby's lips and eyebrows. Saas and nanad clean the room, nanad is given neg. After bath, the new mother touches the feet of elders and ancestors.
    4. From childbirth up to chhati (usually on 6th day after birth, could be 5 or 7 or 9 days) the new mother and new-born baby are believed to be in `narak Kurd'' (literally, `vessel of hell'; it is a period of pollution). From birth upped chhati, the woman is not to touch anything else in the house. The dai is her companion during these days. The new mother and baby are in a separate room -- wherein the birth too had taken place -- and she is given food there itself, on a leaf-plate. She is to do no housework. It is only after chhati ceremonies are performed that the mother and child, and dai, and in fact whole family, are redeemed from a state of pollution.
    5. Chhati day marks the closure of the period of `narak Kurd'. On chhati, the dai checks to see if the cord has fallen; bathes the baby; beats a Thai (metal plate). The mother is bathed, both mother and baby wear new clothes. The dai hands over the baby to the devarani (the mother's younger sister-in-law), who does namaskar (respectful salutation by folding hands) and then hands the baby to the jethani (elder sister-in-law). The dai cleans the room, and she bathes.
      1. Before chhati, sasural (marital home) people visit the maika (natal home) people, and invite them by offering lota for `samadhi milan'''. The maika people come at chhati and are welcomed. When the maika people arrive, first a curtain is put between the two sets of parents (of the new-born's mother, and the new-born's father), the sasural people sprinkle water on the maika people, both sides give paan (betel leaves) to one another, feet are washed, beard shaved, and the samadhis (parents of the young couple, from both sides) embrace each other. There is chhati bharna -- the woman's mother (baby's nani) gives oil and new clothes for the new-born. She lights a diya, rice is kept in a plate, and arti is performed for the baby. Five children are fed kheer. The woman's mother also brings new clothes for her son-in-law and others. The woman herself (i.e. the new-born's mother) is adorned with sindur and kajal. Special foods are cooked. From this day, she can eat everything. The entire family, and dai eat together on chhati day. If the baby is a boy, food and books are kept for him; if it is a girl, utensils are kept. The dai takes leave the next day. The saas puts sindur and kajal for her, and gives her a new sari, rice, sometimes money. The dai should leave happy. It is believed that if the dai is happy, the baby too will be happy.
    6. The dais seem to share a wide cultural understanding in which the upper part of the body is associated with `swarg'' (heaven) and also with the upper castes; the middle part of the body is associated with `dharti' (earth) and also with the middle castes; and the lower part of the body is associated with `narak' (hell) and also with the lower castes. The genital area is included in the lower part of the body. One dai questioned this arrangement, by asking, during the workshop, "The whole body is one, then why is there this division, with one part considered untouchable?" [The corollary was also implied in her question, i.e. if all of society is one, then why is there this division, with one part of society considered untouchable?]
      1. The dais also commented that before puberty girls are considered to be holy, but not so after puberty. After birth also, a woman is considered to be polluted and unholy.
  6. Health Delivery and Referral Networks
    1. The compounder (CB Sharma) when interviewed said he has done a diploma in pharmacy, and works in his brother-in-law's chemist shop in Gomia. He goes to homes and administers injections if prescribed by a doctor (to whom a dai may have referred a case). For injections he uses disposable syringes. Each compounder has a prescribed area. Sometimes the dai may come directly to him to ask for pitocin or oxytocin injections if there is dilatation without labour pains: then too he goes and administers an injection; sometimes he puts a drip too. An injection is needed in 2% of cases, while 95% are normal deliveries; 2% deliveries are conducted by private doctors and 1% taken to the hospital in Hazaribagh. CB Sharma considers the rituals practiced by people, by dais, and by ojhas or majhis to be useless and a waste of money. He says that after administering pitocin birth takes place within 5 or 7 minutes; but in case the first dose is not effective then after 3 hours a second dose is given. At times the compounder may refer a dai to Dr. Madhuri or Dr. Horo (private practitioners in Gomia). He says that people do not on the whole like to take injections. He is critical of dais’ work because he says women can get infected; but sees it as necessary because not everybody can go to doctors.
    2. Sr. Mary, of the MJK Mission Hospital, notes that the private doctors do not accept poor patients; they charge 600-700 per normal delivery. The compounder CB Sharma said that "Poor people are dying as your hospital is not taking delivery cases."
    3. There are now 16 chemists shops in Gomia, although (according to the Compounder) there is not much increase in sale. Increase in the number of shops is more a consequence of unemployment.
    4. [dais seem to have accepted the medical model, most have contact with doctors and ANMs. But it is a question how far they are able to procure appropriate medical interventions. Doctors and other health professionals seem to have a biased approach, they think the dais’ methods are wrong, without examination.]
  7. Identity and Status ofdais
    1. The dais of Gomia come across as situated at the lower end of various power-arrangements -- in terms of caste, class as well as gender.
    2. In terms of caste, the dais are all `Chamar'' (or Ravidas). Being a polluted caste, associations of pollution with the work of midwifery get integrated into the overall understanding of dais as untouchable.
    3. A caste-class nexus is at work here. In Gomia, a feudal jajmani (patron-client) system is in operation.
    4. Over the past 3 or 4 months, one dai, Razia, had performed 10 deliveries in the homes of kisans (literally, farmers -- landed middle-caste -- her jajmans or patrons). Another dai Phoolkumari had conducted 2 deliveries in the homes of gawalas (owners of milch cattle -- middle caste).
    5. The dai shares a low status alongwith other women, be they high-caste or low-caste. However, through a game on gender, we found that approximately half the participants would prefer to be a man in their next birth. The reasons why they would prefer mailed indicate the down-side of their experience of being women -- one said if she is a boy, she can play, have fun and relax at home; others said women have to work too hard and moreover they are taken for granted; oner said that she is tired of this life; the reason given by another was that her husband had left her so in her next birth she would leave someone -- men can keep more than one wife; one participant expressed that as a man "I will be able to earn, will not get `married off' [i.e. go at a young age into a new, marital, household], and I will have a wife to press my feet!"; another commented that women have many health problems, and are not cared for by anyone."
    6. However, approximately half the participants said they would like to be reborn as females. The reasons given indicate, partly, a certain pride in themselves as women. One said she would like to be a woman in her next birth too because "a woman makes a home, and ensures survival of the world"; another said the world is perpetuated by women, and if women have problems, so do men; another said she would like to do something for the next generation of girls. Others said -- they would prefer being reborn as women simply because that is what they are right now; they will continue to have many problems which they will attempt to solve; they would work on the land....
    7. Of course, dais are repositories of certain quintessentially female knowledge -- the knowledge of the female body, and of childbirth. Thus, they partake in a very special way of both the down-side and the up-side of the general status of women. dais are women who know about womanhood -- about femaleness -- in a more special way than do other women. In other words, dais in a unique way embody in themselves both the pollution and the power that attaches to womanhood.
    8. dais are highly respected at the time of birth, but at the same time it is a period of untouchability so they, being caste-untouchables, can be the companions of the mother, who, by nature of her birth-giving, is in a state of pollution. Therefore the dai's status is full of contradictions. At chhati, the dai is traditionally honoured by the family in which the baby has been born. They put sindur on her, give her gifts and money. They want her to be happy, and believe that the baby will be happy if the dai is happy.
    9. dais customarily do not assist in the deliveries of their own daughter-in-law. It is done by gotni or devarani, or a neighbouring dai. Sometimes, rather than call in a neighbouring dai which will mean an expense, the mother-in-law may do it herself. But it is considered a matter of sharam.
    10. [See also section 9 below].
  8. Stories, Songs
  9. Socio-Economic Profile of the Area
    1. Located in S. Bihar, Ranchi and Dhanbad being the adjacent towns, Gomia is in the coal mining belt. Only 1/4th of the total land area is cultivable. Agriculture and coal are the major sources of livelihood for the original inhabitants of the area. Employment in the Indian Explosives Limited is largely restricted to people who have migrated here. The original inhabitants of the area, which was earlier forested, were Santhali tribals. They got displaced when forests were cut, fields carved out and factories and mines set up. Staple crops in the area are rice and corn.
    2. Most land is owned now by Yadavs, Telis and Kumhars, while Santhalis work as agricultural labourers, constructions workers and petty coal business like selling small quantities of coal (usually illegally). Santhalis keep goats, hens and pigs too; and brew rice beer. Oraons are more educated than Santhalis, most have adopted Christianity and are economically better off. Non-tribals include outcastes like Dushadh, Chamar, Ravidas; other caste groups are Baniya, Teli, Yadav, Kumhar, Lohar etc.
    3. The jajmani system is prevalent, with the upper castes acting as patrons of the lower castes in a complex network of duties and obligations. The lower caste provide services (including that of midwifery) to the upper castes, for which they are paid in various forms, on various occasions. The clients are fixed, neither side can change allegiance. It is not a free market situation. A particular dai will be associated with a particular family of `Kisans' (here, a generic term for the middle and upper castes i.e. the jajmans). This is an obligatory relationship. In the jajmani system, there is security of work and no conflict or competition as in a market.
    4. Overall there is a mixed economy. Market economy and market values are entering the area, and men are more prone to break away from the jajmani bonds. But women are by and large ensconced within these bonds, and have also in fact taken over some labour that was traditionally men's, in agriculture. Income from jajmani work is insufficient and families look for additional work in the market. Agricultural work is available for only two months in a year, they are paid 1.5 kg daily (i.e. Rs. 15-16). Construction work may fetch Rs 25-30 daily, and coal-selling up to Rs 50-100 per day.
    5. A number of illegal systems are in operation and have become a normal way of life; these include -- illegal coal business; illegal liquor refineries; illegal prostitution; illegal medical practices such as compounders injecting oxytocin. Lots of middle-men have emerged, including petty contractors who act as a link between coal sellers, policemen and coal mafia; and compounders, who act as a link between dais, doctors and ANMs.
    6. Women bear the burden of household tasks (including fetching water from long distances, in a situation of acute water shortage), as well as earning a living. Men as well as women who go to the town or city to work have to walk long distances from the villages -- as much as 8 to 10 kms one way. Buses seem an unnecessary expense, they charge 3-4 Rs.
    7. Eating habits have changed, with less green leafy vegetables and fruits like mahua, and more items bought from the (weekly) market such as brinjals, tomatos, ladies finger, white peas and besan.
    8. Standard of education is low, hardly anybody studies beyond middle school. Girls study less than boys. Mission schools are preferred to government schools.
    9. Dowry is a problem. Educated boys ask for 20-25,000 Rs as dowry, and lots is spent on pomp and show. Bigamy is still prevalent. Violence against women -- wife-beating -- is a big problem in the colonies. It is worse in families where men are employed in CCL or IEL -- have secure jobs. A number of men have abandoned their wives.
    10. Festivals are celebrated round the year. `Karma'' is a major festival, it is for brother-sister unit, and the `Karam' tree is worshipped, and women sing and dance. `Jitya' is a festival for the well-being of sons; and `Teej' for husbands. Women fast on these days.
    11. Birth and death rituals differ for tribals and non-tribals.
    12. Tribals and non-tribals do not intermix much. Santhalis are apprehensive about outsiders, and retain strong faith in traditional healers.
    13. Khamra Basti is located near Gomia town, most men from here work in CCL (Central Coalfields Ltd) and IEL. Some women are dais, some agricultural labourers. It is a Harijan basti with pace houses. We saw some young men playing cards, women said they are unemployed and therefore loiter around. Local alcohol is brewed from mahua. Men from town come and drink, and also there is prostitution.
    14. Karmatiya is near a colliery and almost everyone earns by selling coal. It is 12 km from Gomia town, roads are in bad shape. The inhabitants buy coal illegally from the colliery, carry it home, sell it to contractors at godowns or local consumers. There are a large number of dais. In all there are about 100 kacha houses, they are big and open, with pits in separate pig-houses. Here too there are water problems. The government has cut down local forests and have planted protected forests, there is no land left even for use as toilets. Most people have moved out to Khamra basti and the people are afraid the area may be declared a coal mine area and they may all be displaced.
    15. Bela Tand village -- Land adjoining this village belongs to Yadavs, some to Dushadhs. The Dushadhs work as dais and agricultural labourers. Men too work as agricultural labour and go for construction work. dais' jajmans stay far off.
  10. Relevant Background about the Collaborating NGO
    1. MJK and MS workers are called sahayoginis. They are a core resource group. Each sahayogini holds weekly meetings in 10 fixed villages. She shares information with the village women about training programmes, does surveys on women's health, runs savings accounts, and supervises the educational centres. The sahayoginis have a deep relationship with the women.
    2. There is no clear division between MJK and MS, but source of funds and payment are different. The disparity in salary does not seem to be a source of conflict. On the whole there is dissatisfaction with salaries, they are on the low side. This is a reason for some tension in the organisation.
    3. Sahayoginis are extremely hard-working, and diligent. Each bears a lot of responsibilities. The work is directed by Pilar. The workers are well informed about their basic work i.e. violence against women.
    4. They are busy in their routine work and do not get much time to follow up workshops like this one.
    5. After this workshop sahayoginis said it would be good if they learnt birthing work. They developed a critique of the routinised medical practice of giving injections and episiotomies. Some said they would like to learn from dais, and assist them in childbirth. The dais would not like to share their jajmani work, but may want to give over work in poor houses.
    6. Sahayoginis will share the knowledge that food should be given to a woman after delivery (jaggery, black grams, chura, and tonics of mahua, anwala, berries etc).
    7. Sahayoginis will do some field research on maternal death.
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