Dr. Taru Jindal On Experiments In Bihar Amidst The Nation’s Neglect Of Women’s Health
- IWB Post
- March 17, 2020
“‘I am only one, but still, I am one. I cannot do everything, but I can do something and I will not let what I cannot do interfere with what I can,” Dr. Taru Jindal shares with me her favorite quote.
This quote might in many ways summarize her life story so far. Yet, brushed under this beautiful message, lies a plethora of stories, inspirations, and determination that touch upon a range of issues. These issues are about women and child healthcare, medical infrastructure in rural India and social work at the community level. But they are also as much about women’s empowerment, gathering forces to bring about a change and starting out young in selfless service.
Dr. Taru Jindal is a gynecologist who had not been lured by urban corporate healthcare establishments. These, she thought, were already overcrowded with specialists and so she decided to venture into rural Bihar where her expertise and skill were needed the most.
‘A Doctor’s Experiments in Bihar’, published by Speaking Tiger, is Dr. Taru’s documentation of her two-year-long work in rural Bihar; the book, which acts as a ‘road map’ for those trying to make an impact in the system, is also about the ardent service at a time when her health made it impossible for her to even walk. The book gives a detailed insight not only into rural healthcare but also the village society, the position of its women, and the various innovative ways that Dr. Taru embarked upon to ensure that she turned around the condition of the district hospital to such that it won the 2015 Kayakalp award by the Government of India for being the best district hospital in Bihar.
A story of grit and compassion, Dr. Taru Jindal’s life, also like her days in Bihar, has gone through various ups and downs. And, what remains most fascinating are her positive approach and her unflinching resilience in the face of adversities. Yes, she may be ‘only one’ who ‘cannot do everything’, but there is no doubt that her work in Bihar’s rural healthcare, as well as her contribution to the larger society through her book (and TED talk), makes her voice and experience counted. It goes without saying that this book is worth a read for those rooting for a positive change and looking for true inspiration.
Your life story is so inspiring. When most doctors want to establish themselves in private practice and look at public hospital services just as a means of gaining some experience, you chose to go to a rural area of Bihar. What motivated you to make this choice?
Dr. Taru Jindal: The motivation did not come in a day or a month. I did my MBBS and MD from Mumbai. A student organization in our college during my MBBS years used to take us to a lot of service-based set-ups in Maharashtra; some of these include Anandwan where Baba Amte worked, Hemalkasa where Prakash Amte lives, and Gadchiroli where Dr. Abhay and Rani Bang had done great work. So these were all high performing doctors who had aced their medical exams and yet, they chose to give up their city practice and go and settle in remote tribal areas. And in the 20-25 years that they were there, they had managed to turn around their villages and localities. For example, I came to know that in Gadchiroli that was a Naxalite area, the infant mortality rate of children was just about 12, whereas Maharashtra is still struggling at 40-60. They managed to create an amazing amount of change, and thanks to organizations such as in our college, I got exposed to it very early.
We read you had met your husband, Dr. Dharam Shah, in college.
Dr. Taru Jindal: Yes, through the same organization. He was my senior in college and he used to ask me if we should crowd the nook and corners of Mumbai where there are already so many specialists or should we go where we are required, should we go rural? That appealed to me and we decided that we would move to somewhere after our MD, where we were needed. I found a project in Bihar that was started by Melinda Gates Foundation and the mandate was to get doctors outside of Bihar into the district hospitals and train the gynecologists. So I couldn’t think of a better opportunity, it seemed God sent.
Did it ever occur to you that your efforts might go in vain? You had mentioned how the first time you visited the hospital you wanted to leave Bihar and get back. Did that thought ever occur again?
Dr. Taru Jindal: The reason why I felt like leaving initially was because of the condition that I saw in Bihar. No matter how much you hear about it, when you go there the impact of seeing what you see is big. I found myself so helpless. I realized I had the skills and I could teach, but skills and teaching were not what was required at that point. I felt there was a need for an activist to shake up the system, but I was only a doctor. After the first two weeks, I started feeling very impotent; I felt as if the thing for which I had come was not happening and what was required here was not there in me. I couldn’t see children dying every day, so the first thought was to run away. Every single day was a challenge.
How many of those challenges can you attribute to gender, just because a woman dared to challenge the patriarchal institutions of corruption?
Dr. Taru Jindal: No, in fact, I would say being a woman made it a little easier. Probably they were in a system where they were not used to seeing women empowered. They were not used to women making their choices or voicing their opinion because most of the women that came to the hospital were from far off villages, who had never stepped out of their homes. So when I came in with my strong voice and wanting to change everything, I think in some way, they liked it. It was a fresh view of womanhood for them and I never faced any discrimination. It didn’t come in my way or my work and I got the support I needed.
Can you tell us about the most persistent challenges in regard to women’s healthcare that plague the medical system of India?
Dr. Taru Jindal: I can speak about those areas where I worked in Bihar, and maybe they are representative of most rural areas of our country. Some of the challenges were very peculiar and we cannot think of those while sitting in cities. For example, family planning is such a big deal in India, but over there an average woman was having four-five children. Later I realized the reason was the high child mortality rate. Very few children were crossing the age of five years. So our concept of family planning of only two completely failed there and that’s where I understood that until and unless we provide delivery care or healthcare system to these women we cannot just force the family planning agenda on them. Also, access to healthcare was very poor. Villages were far removed from where the healthcare centers were located and the health centers in which I worked were very poorly furnished. The infrastructure was just not there. In Motihari district hospital, they delivered 40-50 mothers on average every day, but they had only four instruments to deliver those 40 mothers. So they were just washing those instruments in plain water and using them again and again. Finally, a lot of states allow private practice for government doctors. But if there is not enough monitoring, the spare time becomes full time. When I was in Motihari, I saw often how a mother would be lying in the hospital and her baby’s heart rate would be dropping inside and she would need caesarian in the next ten to fifteen minutes to save the baby, but the lady doctor who was supposed to be on duty was busy in private practice and was not to be traced anywhere.
Tell us a bit about the women you met. Not only the women from your team but also the ordinary women who came to you. What delighted you as well as maybe worried or even angered you?
Dr. Taru Jindal: When I started living in the village, I realized that the women of Bihar were extremely resilient. A lot of our auto-rickshaw walas or sabziwalas are Biharis. They leave their women behind in the villages and they would come home only twice a year, one is during Holi and the other is during Chhat Puja. The women got pregnant during that time and the men would go away again after say 10-15 days. Their entire pregnancy and post-pregnancy time, these women would be alone, probably only with their mothers-in-law. They are emotionally very isolated; they were doing the entire job of the house, taking care of their children and the newborn all on their own. Many of them used to get hysterical in the evening and land up in my hospital with breathlessness which had no solution until and unless they started living their married lives with their husbands. I cannot even imagine the kind of emotional pain they had been going through.
Why did you decide to document your experience in a book? How easy or difficult was it penning down those experiences and then finding an audience for it?
Dr. Taru Jindal: In 2016, I had decided that I was going to spend my life in Bihar but then I was diagnosed with a brain tumor and I had to come back to Mumbai. From a time when I could walk 12km to a village, I was now sitting inside the four walls of my house. It was such a sudden collapse in my life and there was no hope of going back. In fact, it’s been four years since my disease started and I haven’t gone back. I was really sorry and depressed and that’s when my husband and brother, who are my greatest support, told me that I could serve the women and children of Bihar through documenting all that I experienced in Bihar. They told me that for the new doctors, the only source of inspiration comes from people of the generation of Amte and Bangs, and that’s a senior generation. And so documenting became an addiction for me. I could hardly walk because of my treatment and the only things that worked were my fingers, so I would sit on my laptop for hours even when everyone was sleeping and I would just keep typing. In a way, it helped me get through those days of treatment and by a year the book was almost complete. It also has a Marathi version done by Rohan Prakashan. The book getting published by Speaking Tiger was a big dream and is my service of these four years for the women and children of Bihar. I couldn’t go out so I sat here and wrote for them.
How do you think your book can act as a reference point, as well as inspire other doctors to follow your path?
Dr. Taru Jindal: I have written this book as a road map. If someone says I am landing in a village tomorrow, this is the book they can read and get a plan of how to start. People say the book has a medical background, but I would say that only the background is medical, the rest of it is universal. The story could be extrapolated into any other environment. People are the same everywhere, issues are the same, only the premise is different. Also, anyone who wants to do something outside his or her personal life, who wants to influence the architecture and the canvas of the locality of people around him, then this is the book to read. This is because the book has everything about what could be done or the solution, also the changes that are required within the person himself to become the changemaker. It’s not about the outward journey alone, it’s about the inward journey. I was very impulsive and short-tempered, but working in the community forced me to become a more contemplative and patient person. The book will especially help young people who are looking to do something but don’t know-how.
Are there any anecdotes or stories of determination that you would like to share with us from your book or personal experiences?
Dr. Taru Jindal: Let me share a funny incident. In the initial days of my work in Motihari, when I would enter the OT, the relatives would pull me out. When I asked one of the nurses, she said it’s because of my hair. I had a boy cut and so they thought I was a man. Though I was wearing a salwar kurta and bindi, they still thought I was a male and were not allowing me inside. So from that day, I started putting sindoor just like them, a long orange sindoor to identify myself. But that goes to show that their exposure to the outside areas was so less that they had never seen a woman with short hair.
The Supreme Court has upheld that students taking up PG and specialty courses in government medical colleges should serve in rural areas, also known as the bond. What are your thoughts on this? Also, do you think that a strict law around it will be formulated any time soon?
Dr. Taru Jindal: Through the book, I have given the message that everyone should spend at least one year in rural areas. However, whenever something is imposed versus when it is voluntary, there is a lot of difference in the emotion of the person. The bond is extremely important because it is the first time a recently passed out postgraduate or graduate gets exposed to the realities of rural areas. If the bond is not there, they will just go to their corporate lives, without ever knowing what a rural area looks like and what the challenges are. A bond is the only time rural areas also get some good doctors coming into their hospitals. Also, no one is asking for a five-year bond, it’s just one year. The only problem is that the bond has not been sold properly. The idea of serving a bond almost sounds like bonded labor as if we are bonded laborers of the government. It has a very poor connotation to it. It has not been packaged or advertised in a lucrative way by the government. I think all those who want to do the bond should read my book and that’s when you will realize that in just two years I had so much fun and had the greatest experience of my life.
You did touch upon a lot of points during your TED talk. And I loved the part where you narrate that someone painted the OT table with words, ‘My hospital’. This sense of ownership is what you have highlighted even in your work in Masarhi where trained locals now handle the malnutrition program. Hence, according to you, what is the biggest leap of faith that one needs to cross to get a sense of ownership?
Dr. Taru Jindal: Inspiration is really important. A lot of people, who work in the government system, start off with a lot of hope and energy but somewhere along the way their energies get sapped because of lethargies in the system. I realized that skills and training would come much later. The people working in the hospital needed to be inspired and made to believe that they were doing something very significant.
So, I realized I was in East Champaran. Champaran was the land of India’s first satyagrah or Gandhiji’s Indigo revolution, and Motihari was where Gandhiji started it. So I thought that I should also begin with Gandhiji. I picked up the broom and I told the OT team to have a day of cleaning. I spoke to them of Shram Daan to do something for the sake of someone else. And that day for five hours we had been just cleaning every corner. The next morning when I came I saw that the OT assistant had already painted the rusted tables with fresh white paint he had purchased on his own. He said this was the least he could do for his hospital and I felt that it was the first time that anyone had addressed the hospital as ‘his’ own. And so that was the first act of inspiration in that hospital and people were slowly getting inspired. Of course, all don’t get inspired and you continue to have roadblocks and challenges but there will always be those five-six people in the system who will respond to your attempts of inspiration. They will get inspired and will come and join. And yes, you lead by example and that’s another way of inspiring people.
You have done commendable work even if we look at sheer stats. But do you think that people like you, who do real selfless service, are often never brought in the limelight as much as desired? Do you think the recognition of your work is much less than deserved?
Dr. Taru Jindal: I think I have got so much more attention than I deserve. When I got the awards, such as the Karamveer Chakra and the ‘Most Inspiring Woman of the Year Award’ in 2019, it was the cause that got awarded.
How do you cope up with your personal medical condition? What pushes you to not succumb to negativity and move on?
Dr. Taru Jindal: I knew a lot had been invested in me. There are very few doctors in our country, on top of that, there are even fewer lady doctors. Add to that I am a lady doctor who wants to work in a rural area. So I am all the rarer. And so if I am so rare and important for my country then I cannot afford to get lost in my disease. I cannot afford to not get well. So the biggest inspiration is my patients and my work.
You can avail of your copy of the book ‘A Doctor’s Experiments in Bihar’, here.