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634Challenges for Bioethics from Asia

Health Education for Dalit (“Untouchable”) Mothers in Tamil-Nadu: Report and Evaluation

- Frank (Yeruham) Leavitt, Ph.D. .

The Centre for Asian and International Bioethics, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, ISRAEL

Email: yeruham@bgumail.bgu.ac.il

In January 2000, an international team organized by our bioethics centre conducted Phase I of our Mother and Child Health Education Project, at the Delta Centre, Kadalur (near Kalpakam), Tamil-Nadu, India. Our team consisted of two physicians, one nurse, another nurse who is also a lawyer specializing in human rights, an environmental educator, a medical student, and myself as bioethicist and chairman. We taught healthy pregnancy, healthy midwifery, infant growth and nutrition, infant diseases, sanitation and the healthy use of water, family planning and sexually transmitted diseases, and bioethics. We qualified 30 village women, many of whom were illiterate, as Health Ambassadors, who would return to their villages to teach health-promoting behaviour.  In October 2000, we returned for Phase II and qualified an additional 30 women. We conducted a follow-up survey in August 2001, and another follow-up visit in November 2003.

A final evaluation of the project has not yet been written. In this talk, I shall describe the project in more detail, and share with you my thoughts about evaluation. I hope you will agree that the project was partially successful. But we also made mistakes from which lessons can be learned. I hope to take your feedback into serious consideration when we write our evaluative report.


Macer: Were they happy? Did they learn something?

Leavitt: People who participated, the health ambassadors, yes, I noticed they learned a lot. On the other hand, they were very disappointed when they stopped receiving the stipend.

Konrad: It would be terribly important to do a follow-up study to document what has happened after the project. Also to inform health projects and how this is impacted on communities.

Leavitt: We interviewed over half of the women. We have detailed informal interviews which I still haven’t analysed.  Now , I think I have the retrospect and perspective to analyze it. But yes there shouldn’t be more...

Konrad: How about funding?

Leavitt: Our major funding came from the Ministry of Foreign Affairs of Israel whose policy is not to fund the same project twice.

Konrad: How about the Indian end?

Azariah: An Indian philantropist donated 100,000 rupees.

Leavitt: The Murogovand foundation paid for the stipend at the start. But what happened was that he retired.

Wen:  Did women’s role in the project change their roles in the community? Have you also thought about bringing men into the project?

Leavitt: I was actually thinking about that. But I didn’t have time to bring that up, so thank you for asking. When we teach something about gynecology there should only be women room.  But after 2 weeks, the women were much more relaxed, and during the final review meeting, the men were there. And one of the women asked the woman, how do you know that you have a suspected sexually transmitted disease? One answered, that the sign was the discharge. Then the woman asked, what should you do? The other woman answered, go to the doctor. Then when she was asked about who should go to the doctor, she answered, my husband. The point I wanted to make here is that they were more relaxed. We also invited men to meetings and talked with men of the village less informally. One discussion with the men was on condoms. One man stands up, and

. pp. 634-635 in Macer, DRJ., ed., "Challenges for Bioethics from Asia" (Eubios Ethics Institute, 2004).

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