The road less travelled by, that made all the difference
Updated: Sep 21, 2022
Some journeys begin and continue to reach points that were never part of the plan. Tha (as Dr. Lalitha is referred to dearly) says a lot has changed, but some things have remained that were a part of her then and even now. There may come many unforeseen hurdles that last for a day and sometimes for weeks, stagnating thoughts that might keep her awake all night. The way forward is to "deal with the difficult things first thing in the morning and the rest of the day will be easy".
When Tha first arrived at Sittilingi in 1993, the route that led to this beautiful valley came around from Kotapatti which was the only road to this small tribal village. This is a single accessible connection Sittilingi along with 22 other villages had with the outside world - a non-motorable road that can accommodate a two-wheeler alone. During the monsoon, when the underlying stream filled to its brim, the bridge on the road came to drown, blocking the passageway and leaving the valley disconnected. When in the initial days Regi and Lalitha (Dr. Regi is fondly known as Gi by everyone) decided to set up the health initiative, it was only a shack with an Out Patient room, for which they came all the way from Kotapatti to work in the morning and went back in the evening.
Eventually in the same space behind the shack within one year they set up a space for themselves which became their first home in Sittilingi. Tha remembers those days as they happened the day before, it was around the time she was pregnant with her second son Abhay and sometimes living alone with her little kid Harsh when Gi had to travel outside for finishing the technicalities of establishing an initiative that can remain sustainable. On those days as the last light of the day faded away around the corner of the road, amidst the Kalvarayan and Sitteri hills, the sounds of the forest were the only company she had, not a human was to be seen until the break of the dawn. There were days when the power went off for 3 continuous days, where life continued with just candle lights, when access seemed to be a privilege that only came to be acknowledged through the experience of living on resources that took an effort to seek. The closest shop again was 10km away, the gas needed to be refilled by carrying the cylinder on a Bajaj M80, the days when that was possible still ended with a backache, but otherwise, the time it took to finish cooking a meal on a kerosene stove gave way for one to think what all goes into fending for a day. And if there was a call to be made, even if it is for 5 minutes, it was a two and half hours journey all the way to Dharmapuri that was the only point of communication to their life before stepping in here. The regular guests they had at the time were snakes that came in without an invitation on most days. The majority of the snakes in the valley are non-venomous, yet they carried all the precautions. They knew the snake bites were less around here but there were other possibilities of allergies, rashes, etc. and with young kids, it was necessary to foresee and speculate the things that may go wrong. Gi was casual and blended well with the circumstance, he enjoyed the interaction with all these species. On days he found the snakes crawling in, he picked them by hand and safely let them out to find their way in the soil. The monsoon brought out huge scorpions bigger than the palm of Tha's hand and centipedes much much thicker than the ones she had ever seen crawling on surfaces everywhere and anywhere. Tha while reliving the experience mentioned what Gi used to say "nature is not just about trees and flowers, it includes all these creatures too", and then they got used to having them around.
One thing that was different in the valley from the other tribal villages, was the people here had some land they owned, that is, they had a feeling of ownership of the land which they tended to produce. The indigenous communities did have a close connection to the forest, by then the forest laws came to be in place restricting the people to seek resources, but the cultural proximity still held its place.
The initial objective with which Tha and Gi came here to the valley was to set up a health centre as there was no hospital within a close radius, for any serious ailment, the nearest hospital was 50km away. The infant mortality rate was the parameter on which they arrived at Sittilingi, which was 147 out of 1000 live births in 1993. They never thought they would cure everything, but there was a belief that little things like pregnancy mishaps, minor injuries, etc. can be mitigated with some caution and treatment. Their idea was to see health as a holistic aspect that includes other socio-cultural features ingrained in the community and they had the faith that every community has the resources needed to help themselves.
The first 4-5 years went towards setting up the Tribal Hospital, Gi was an anaesthetist and Tha was an obstetrician, but they went much beyond that, it was a holistic approach to go beyond the conventional hospital. There weren't many resources around here like a regular hospital so it was necessary for them to go back and forth from Gandhigram to here to learn the crevices more than the surface. Before coming to Sittilingi, Gi and Tha worked as doctors at Gandhigram, which eventually remained to be a support system for them to face the challenges of setting up a hospital in this remote area, to understand and learn medical processes beyond their area of expertise until then. From shaving the abdomen and private parts to performing a surgery entirely by themselves required a lot more knowledge than what a regular doctor might have. This was also the time when they equipped people from the local communities (Malavasi, Lambadi and Dalit) to take care of community health. It was important for them to have the involvement of people, mostly women, to gain autonomy for their own health.
Tha's approach to this was from the humanitarian perspective, she interacted with women, convinced them of their ability, listened to everything they had to say, encouraged them to become health workers. These were women with exposure to the highest standard of education being 8th grade, for Tha formal education being mandatory is a myth, her value-based approach was to demystify medicine, rather than using technical terms that seem like Greek and Latin, to make medicine and health as simple as possible for a common woman to understand. Once the training of health workers has begun to become a reality, there was a functioning team with pharmacists, nurses, and so on assisting the doctors to run the hospital and it also gave them an opportunity to widen their horizons with the experience of working with the community.
The next five years were then dedicated to engaging and training the health auxiliaries as able as possible to diagnose, treat and prescribe. The health auxiliaries were women, who were to be picked from each village through a process of mutual consensus. It was a challenging journey not only to train the health auxiliaries but to also convince the family members for them to step out of their homes to do something alien yet it was by now understood that it was important to take control and there was a possibility for them to serve their own community. Once this happened THI could function on its own, with the local community members taking care of the day-to-day proceedings. Today these women have had enough experience to treat and take care of their patients on their own with minimal involvement (only when it is absolutely necessary) from Gi or Tha. They began to train more health workers later and also engage with fresh MBBS graduates that come to the Tribal hospital to learn, work and relearn to curate medicine to work within rural spaces with a holistic and intimate approach.
By now the last ten years of engagement within the valley and its ecosystem proved to be insightful and productive to the vision the health initiative began with. The onus for the next five years then shifted towards the community health programme through which Tha and Gi visited the villages in the valley to understand what the issues were if there were any. This was something Tha really connected to, she opined health included all of it, not the ailment, but also the life, lifestyle and a whole lot of other things that go into living a fulfilled life. She does not call herself a doctor, a small part of her may have been, but rather believes that she is a health worker, working on all the aspects of health and wellbeing. She is involved deeply in different things, to be able to hand it over to someone, to give that sense of authority that she has over herself also to somebody for themselves. This involvement and a deeper understanding of the villages and the people led to getting a gist of all the concerns that take roots within a community. The community health programme included having meetings with different villages to raise issues which were also unrelated to health, the importance of livelihood came, which was also an integral part of health. In the next few years many conversations regarding food and the nutritional value that was associated with traditional farm crops such as millets seemed to have a logical correlation between livelihood and health.
With the introduction of the Green Revolution in the 1960’s the farmers largely converted to growing rice, leaving behind their traditional way of farming crops and the lack of variety in production affected the soil as well the lifestyle losing nutritional value. Another disadvantage came financially with increased utilisation of fertilisers, lack of damage protection, and irregularity in the yield creating debt trap cycles which began to cause even more concern. Through destructuring the concerns that came out of these meetings within different villages, it is evident that the approach towards holistic development had a codependent relation with livelihood and lifestyle. And it was also necessary to find an alternative to the existing agricultural practices while ensuring the producers (farmers) benefit physically (nutrition), and mentally (financial crisis) and to return to their natural processes of cropping which was sustainable for them individually and also for the soil, planet and ecosystem they live in.
In 2008, Sittilingi Organic Farmers Association (SOFA) came into existence to ensure a healthy way of living and ensure a stable income and a fair price for their produce. It initially took a lot of time and energy to demystify the myths of modern agriculture and revive the organic practices as the farmers were sceptical if this could be a possible solution, for the mere simplicity of the process and to walk back in time. Before the formation of SOFA, it took almost two years to engage and convince four farmers to make the shift towards organic farming. The effort paid off with SOFA working with almost or more than 800 farmers in the valley today, with quality produce and market connections to support their resilience.
The difficulty of women in any community is much different from how men experience a certain condition of living, and even truer within the marginalised. Tha has an association with these issues and belonging to the identity herself, she is empathetic to the condition. Though she has no authority to intervene personally in local affairs, there is a lending ear she always provides and supports in ways that are possible. When it comes to the dignity of women in circumstances unjust to her, she reacts and it is a natural instinct. Porgai was formed in 2006 with a similar vision, the term Porgai means pride and dignity in Lambadi. Sittilingi Valley has two conglomerates of the Lambadi tribe that have their origin in Afghanistan and migrated to different parts of India centuries ago. Porgai is a women's collective founded by Neela and Gami with the support of Tha to revive their traditional Lambadi embroidery craft that fell out of place for the past two generations having no relevance. With the knowledge that the two nonagenarians have regarding the craft it was revived and now serves as a livelihood opportunity for the women of this community.
Tha sees it as a collective formed based on integrity to give autonomy and financial independence to women. She makes sure the money received through their craft goes directly in cash rather than a bank transfer, so the men can never know the income and women can choose to spend wisely. Tha believes it makes a difference to her if she can support bringing a quality change in the life of five women rather than changing the whole structure, in her words, “there is so much of effort to be put into a human being and it is a lifelong commitment”.
The journey of this couple who came here to Sittilingi to work among people that needed them is one filled with ideas, visions and living the life of a dream. It is a long story to write about but an even longer one to live in, the last 30 years were a part of Tha’s and Gi’s life that was to be consistent and responsible for. As the saying goes ‘It has not always been rosy’ there were challenges to overcome, and many more for the coming times also as change is a constant occurrence that has its own course to deal with and grow with. But the takeaway for the people coming here is to envision the route from centralisation to localisation. Here it began with health and it is not just about medicine - farming, art, and livelihood, all of these are also essential elements for physical, mental and social wellbeing that are necessary for the holistic and healthy development of the individual and the community.
Humanity does not exist in isolation, it is the codependent ecosystem that nurtures growth towards its fullest potential. Sittilingi is an ecosystem that shows a conscious pathway to live in the present, understand the resources that the communities possess and their ability to resolve concerns within themselves and showcase resilience in their own natural form (the way it is meant to be). It is an example to redefine development and sustainability to show the contributing factors to growth that may come from within. Rather than being a success story alone, it is a representation of small efforts that can make a big difference with a value-based approach that caters toward living a just and fulfilled life for the coming times.
Watch the film made on the 25 years of Tribal Health Initiative:
Watch the film made on the revival of Lambadi art through Porgai:
Also check out: