01/02/2018 Fifth Day
The first lecture of the day was presented by Dr. V. Ramankitty on health and development in Kerala. Dr. Ramankitty’s focus on epidemiology guided the presentation’s general outlook on the state of health issues in the state. Dr. Ramankitty cites multiple reasons propelling advances in health in Kerala. The first is that all childbirth is institutionalized at hospitals. Previously, childbirth did not receive much medical attention. Second, the spread of immunizations successfully combated various diseases, such as smallpox. However, due to India’s diverse cultures, some religions groups, such as some Hindus and Muslims, do not seek out or accept immunizations because of their religious beliefs. Third, education and access to media communications have greatly distributed and disseminated health information. Lastly, the leftist leanings of the state, as through the Communist government, ensures that politically, health is a right to be protected. The basic health challenges faced by Kerala ultimately relate to poverty, but urbanization and modernization have resulted in the double burden of disease where diseases of both poverty and development afflict the population. It was of note to hear Dr. Ramankitty elaborate not only on the general conditions and advances of health in Kerala, but also some of the current issues and challenges. As in the US, the continued commercialization and privatization of health care has resulted in expensive specialized medical attention. While general care remains low-cost, advanced treatments are often out-of-reach for those disadvantaged. The lack of an insurance culture, specifically among the poor, contributes to the unaffordability of higher medical procedures. (What about mandatory health insurance?) One of the most pressing challenge is that Indian medical care has no quality assurance. Additionally, private hospitals are not accredited and proposals are being worked for hospital accreditation. Due to the open market competition and the lack of government regulations, private hospitals have unregulated charges and may be of dubious quality. Perhaps the most surprising, and honest aspect that Dr. Ramankitty revealed about health in Kerala was that although the statistics are impeccable, the health care sector still faces challenges. The good statistics come from a young population, and when the figures are normalized for age, the statistics are not as impressive. (Dr. Ramankitty’s insights indicate there are more to the eye than what are being presented and they should be further researched and addressed to present a more comprehensive picture of Kerala’s development.)
The environmental sustainability movements in Kerala as presented by Jayakumar was the most exciting and engaging presentation thus far, partially because of Jayakumar’s radiant and lively personality. It was evident that Jayakumar continues to embody the protest-spirit of the late 1970s that was formed during his college education. Of the environmental sustainability challenges that Jayakumar presented, the most noticeable one for me was that he sees a failure of the collective system in Kerala. He forwards that the development model in Kerala is individual-centered, as seen through the lens of transportation where everyone has or strives for motorbikes as personal transportation. His observation that the development model in Kerala is too individualistic does not align with previous other presentations highlighting the collectivity and communal actions of the Keralan state. (It would be interesting to ask others if they also see Kerala’s development as individualistic or collective) I raised a question during the question-and-answer section of the presentation pertaining to the price of organics in the Kerala market. Jayakumar confirms that the price of organic products in Kerala is also high. Their costs have partially been lowered by local, peer-organic certification instead of a national, institutionalized one. (Such a system of local certification would greatly reduce the cost of organic products and be interesting to experiment with in the US) Additionally, subsidies from the local and state governments also contribute to reducing the cost of organic products. (Such a system of local and state subsidies for organic foods seem feasible in the United States for experimentation)
After the two presentations, the class and I went to tour Mithraniketan, or a community of friends, aimed at experimenting with a Montessori-influenced style of education and living especially, among the lower castes and scheduled tribes. The organization receives architectural advice from Costford and supports their endeavors with agricultural research and farming, pottery making, and making baked goods among other services. I purchased a plum cake and two clay housewares to assist their mission and their education of those in poor socio-economic standing.
01/03/2018 Sixth Day
The entire day was centered around the Kudumbashree Mission, or the Family Prosperity Mission. Aimed at empowering women in order to bring prosperity to families, the Kudumbashree Mission has roughly three components. The first is the creation of an organizational framework. This frameworks transverses across multiple scales, from the local Neighborhood Group, to the Area Development Society, and up to the Community Development Society. This approach is most aligned with the local government structure in Kerala and establishes a demand plan rooted in the community. One of the many features of the program that I find interesting is that because the organizational framework is locally neighborhood based, the community decides who is in need of the most assistance and prioritizes them first. A group of 10-20 women from each neighborhood would form a Neighborhood Group to represent their family. Of which 5 would be office bearers with a limitation of consecutive terms. The Area Development Society consists of 7 members from the Neighborhood Groups. The Community Development Society, the largest sphere, consists of several Area Development Societies. (A similar organization structure can be explored in the US to improve better local governance and the distribution and allocation of resources) In addition to setting up the organizational framework, the Kudumbashree Mission aims to establish better microfinancing and microenterprises for women. The ability to organize into small groups to contribute weekly savings deposits with the backing of the larger organization ensures a form of collateral and collective bargaining power to the bank for loans to these lower-income groups that would have been traditionally neglected by the financial sector. (Lottery-savings program) From microfinancing, perhaps the main thrust of the Mission is in microenterprises for women to enter farming and nonfarming enterprises. Most of these female run and led enterprises either contribute directly to society, like Animal Birth Control, Female Lodges, Geriatric Care, or Rain Harvesting, or through supporting the Government, like producing Nutrimax infant formula powder. (In the US, can those who are low-income create their own enterprises and receive government contracts to provide and serve more nutritional school lunches?) The Mission is also expanding its focus not only on women, but for those mentally challenged and the LGBTQ and Transgender communities. While the Kudumbashree Mission is so widely success that it has not only received full support from the Government of Kerala, the Government of India, and other states, the forces of advanced education and social improvements with the forces of globalization have resulted in a trend of the new generation striving for wage employment instead of self-employment. This can be partially explained by the lack of an entrepreneurial culture in Kerala, but perhaps even wage employment provides more financial and social freedoms to women from their additional income than previously before.
The end of introductions to Kudumbashree and was supported with a tour of a Nutrimax production facility where a group of ten women supplies the Government with infant formula powder. Is this Communism at work when the workers manage and own their own means of production? If so, it is quite a promising result as the women are not only empowered but even contributing the larger em-betterment of society.
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