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Health and Healthcare Systems

Since inception, Anveshi’s work has reflected an abiding commitment to the problems related to women’s health and well-being. This is evidenced in the publication of two handbooks on women’s health: Savaalaksha Sandehaalu: Streelu-Arogyasamasyalu (One Hundred Thousand Doubts: Women’s Health Issues), 2006 (first published in 1991), and Taking Charge of our Bodies: A Health Handbook for Women, 2004. The books use women’s experiences to foreground the mismatch between the health services and women’s lives. Subsequently, our critical investments in the area of mental health have raised questions about care and treatment of mental distress, mental health policy and rights, and the representation of mental distress in the popular domain. Anveshi has recently widened the scope of its research to examine the crises of modern medicine in contemporary India.

Ongoing Projects

Completed Projects

THE CRISIS OF MEDICINE IN INDIA

The crisis of modern medicine in contemporary India looms as a constitutive backdrop to the problems women and their families face today:  indifferent public health policy, failing primary healthcare, overspecialization in tertiary medicine, the insidious challenge of evidence based medicine, difficulties in psychiatry and rehabilitation, and gargantuan industry interest have all become key questions concerning the survival of most of our people.  This birthed a collaborative project with doctors from the Christian Medical College, Vellore, to examine social medicine as it functions in contemporary India and to see the possibilities of heading it another way.  A book, tentatively titled Rewriting Medicine for India, in cross-disciplinary critical studies of medicine and psychiatry, from the perspective of everyday practice, is expected by late 2010. Lakshmi Kutty, Sheela Prasad, R. Srivatsan, Susie Tharu, D. Vasanta and Veena Shatrugna worked on this project.

 

Patients Managing Healthcare: Re-reading Intractability in Illness Scenarios (2006)

 

This ethnographic study, conducted by Lakshmi Kutty, examined the complex location of what is labeled the ‘non-compliant’ patient in medical discourse – considered difficult, intractable, and unmanageable because s/he does not toe the line, obey rules, follow advice, and is dissatisfied with the healthcare being offered. Interviews with residents of the Old City in Hyderabad showed that the intertwined realities of a patient’s life were totally invisibilized in the medical system’s way of looking at them – essentially as individual bodies battling sickness. The study also brought to light the intensive amounts of negotiation that ill persons are made to effect vis-à-vis medical advice or medical institutional spaces; patients are forced to adjust/manage their experiences of pain and distress so that they can derive maximum utility from whatever normativized medical assistance that is being offered. With tools of analysis drawn mostly from the critical humanities, the project looked at the relationship between poor people’s location as economically/socially disadvantaged patients, and expert-based knowledge systems – medical knowledge as well as governmental logics.


Study Group on Mental Health (2002-03)

Coordinated by Jayasree Kalathil, the study group gave a focus for discussions around mental health in Anveshi. The standing membership of the study group included academics and students associated with Anveshi, some of whom had direct experience of mental distress. The study group discussed various issues like narratives about the experience of mental distress, representation of distress in popular culture, depression, care and treatment, and the role of the family in mental health care. The study group also organised film screenings and public talks.  The  group’s work culminated in a workshop on  ‘Family and Mental Health’ in  April  2003.


Defying Frontiers, Defining Possibilities – Part I: Diagnosing Dismissals. A Documentary on Health (2002)

This 36 minute documentary film was produced as a part of collaborative project with the Institute for Research on Women and Gender (IRWG), University of Michigan, Ann Arbor. The project was envisaged in terms of documenting the contemporary Indian women’s movement through the work of some influential feminist thinkers in India, to culminate in a reader along with a visual documentary of various interviews. This first film in the series, made by Shital Morjaria and K. Anita, shows Dr Veena Shatrugna in conversation with Rekha Pappu, discussing the women’s movement’s engagement with questions of health.  The film also includes a group discussion involving about 12 members of Anveshi invested in health issues. It raises a number of significant issues in relation to the feminist perspective on health, including reproductive health, contraception, nutrition, backpain in women, the role of the drug industry, alternative health care systems,  and mental health.


Indigenous Medical Systems: A Study of Herbal Medicines in Telangana Region (1995-97)

This work was undertaken by Uma Maheshwari, as part of a nation-wide action-oriented research project on alternative medicine and women’s health in India, initiated by Rina Nisson from the Geneva Women’s Centre. The goal of the project was to gather information about alternative methods of treatments for women’s health problems and disseminate it widely. The Andhra Pradesh chapter of this project, as part of Shodhini, was housed at Anveshi. The project identified medicinal plants and herbs, conducted clinical trials,interviewed traditional women healers, and trained women health workers in self examination and conducting gynaecological examination. The publication, Touch Me, Touch Me Not: Women, Plants and Healing, is the result of this project.


Women and Health Care System in Zaheerabad: Towards A New Paradigm of Health (1989)

This study, undertaken by Veena Shatrugna, Uma Maheshwari and T. Sujatha, for the Task Force on Health under the National Commission for Self-Employed Women, looked at women’s experiences with the health care set up in the rural and urban hospitals. An important finding of this project was that the modern health care system had very little to offer to the rural poor women. In most instances, it was found that the health care facilities were distant and unsuited to the needs of the women in remote villages.


Back Pain in Women: Possible Relationships to Prolonged  Work, Chronic  Calcium Deficiency and Bone Thinning (1989)

This was another study conducted for the Task Force on Health under the National Commission for Self-Employed Women. While investigating the ‘causes’ of osteoporosis related injuries that women report at a public hospital in Hyderabad, the study raised questions about the ‘treatment’ that women receive, the relation between social roles of women and nutrition and nature of medical solutions that are prescribed for women. An important finding was that women’s vertebrae absorb all the stresses and abuses that go into moulding women. Factors that result in chronic back pain were found to be inadequate consumption of calcium rich food, disapproval of vigorous exercises during youth, emphasis on femininity and postures that result in stooping shoulders, long hours of repetitive work in fixed postures, pregnancies and prolonged breast feeding. By the time the women are in their 40s, back pain becomes so chronic that hormones and pain killers prescribed by doctors serve only as placebos. The medical system does not recognize the social roots of back pain in women’s lives.

Apart from the report, the findings of the project were also published as an article in Economic and Political Weekly and widely disseminated.