Tag Archives: community

SWOT Weakness–>Monthly Meetings

In the spring of 2012, our 2011-2012 AIF Fellow Margy Elliott conducted a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis for Calcutta Kids. Margy carried out long interviews with representatives of all of our stakeholders including all of the staff; beneficiaries; donors; former interns; current interns and volunteers. The management team along with the board of trustees has carefully gone over this detailed document and is implementing changes so as to promote and further reinforce our strengths, fix the weaknesses, take advantage of the opportunities, and close the holes on the potential threats. Over the coming months, we will share ways in which we have used the SWOT analysis to strengthen and protect Calcutta Kids.

One of the discovered internal weaknesses was a lack of communication between the field staff and management. Many staff members commented on the need for regular communication and regular staff meetings. So we started such monthly meetings in July and we’ve been having such fun with them.

October 2012 Monthly Meeting. Staff sitting in front of “jack-o-lanterns” they made.

We follow a simple agenda for these meetings:

  1. Ice-Breaker
    1. At the end of the previous meeting, a staff member is nominated to prepare and conduct the ice-breaking session at the beginning of the next meeting.
  2. Introduction
    1. We start off each meeting with a case study from the field—usually in the form of a PowerPoint presentation with photographs and associated text. The case is often meant to inspire the staff; share a lesson learned; or show how a particular counseling technique worked or didn’t work. As our work is divided into three geographical areas, each area has a chance to present once every three months.
  3. Updates/Announcements
    1. Job openings
    2. Program changes
    3. Data Feedback–we discuss the quantitative accomplishments of the past month
    4. Welcoming of new staff members; bidding farewell to departing staff
    5. Status updates on ongoing projects
    6. General explanation of accomplishments over the last month
    7. General plan for the coming month(s)
  4. Questions & Answers
    1. This is an opportunity for anyone in the organization to ask questions and raise concerns which need to be dealt with as an organization.
  5. Birthday Celebration & Welcomes and Goodbyes
    1. At these meetings we celebrate all the employees who have birthdays that month.
    2. While eating snacks and cake, we toast our departing staff members and welcome our newcomers.
The meetings are events which both management and field-level staff look forward to. They are a time for recommitting to our cause and to celebrate the community that is Calcutta Kids.

Ice-breaking activity

At the October monthly meeting, Noah and Evangeline were in charge of the ice-breaker. The day before the meeting, we told every member of the team to come in to work the following day with a cooking knife (they dubiously obliged) and Halloween and pumpkin carving was introduced. The staff broke up into groups of 2 and made beautiful ‘jack-o-lanterns’. The following day, Area-In-Charge, Barnali took all the pumpkins and cooked them into a delicious pumpkin stew and the whole staff ate it for lunch along with home-made luchis. –Noah Levinson

Chandan and his carved pumpkin

Sumana and her carved pumpkin

AIF Fellow impressions 2012-13 (1 of 2)

I am so impressed and inspired by the motivation you see at Calcutta Kids. Every health worker I have been able to spend time with during my first month here is doing a wholehearted job to be a good resource to the organization and more importantly to the community they are serving. Thanks to our mentor Danya Sarkar, who helped us feel settled down, Pranav and I have been able to explore the community and learn all the various functions of the organization. As we make our visits into the field with the health workers, the community has noticed and recognizes us as new members of Calcutta Kids. We realized this as we looked a little lost while trying to find our way to the community center and two women immediately gave us directions before we even asked them!

The mission of Calcutta Kids can be understood through the manner in which the health workers communicate with the women of the community. Every child is important and can be given adequate care by simply monitoring them. If a child’s weight has not increased during the monthly Growth, Monitoring and Promotion Program, the health worker visits the mother in the following week and counsels her. The health workers express how they are really sad when they see no positive growth in the child. They encourage each mother to take more care of the baby, give her simple tips on how to create a healthy diet and also praise her when she has done a good job. Thus, the health workers have built a great relationship with the mothers of the community. The mothers are always happy to see the didis and welcome them into their houses. They also offer tea or lunch and ask us to spend time with them. When the health worker completes filling up her form and questionnaire, the women thank her for coming and tell her that they felt happy they got to chat with them. The women also trust the health workers as much as they trust a doctor. Even when the health workers are merely on their walk from one house visit to another, many women stop them with their babies and talk about how their child still has a cold or might have developed a skin infection.

Meeting for pregnant women lead by Laxmi Gupta

Meeting for pregnant women led by Laxmi Gupta

The success stories from Calcutta Kids are commendable and its establishment in Fakir Bagan is very apparent in the number of people who visit the clinic everyday or the manner in which we are received in each house. However, there is still work to be done. Although the women recognize the messages delivered by the health workers, many women still do not seem to be adopting a change in their habits. They usually quote too much housework and stress in their lives as reasons for not being able to follow the health workers advice. Even when they come to the community meetings, they listen to the messages or watch the videos but whether they are following the key points is something yet to be assessed. This is a project I plan to work on during my time at Calcutta Kids. I will be working out behavior change communication strategies using different methods of delivering messages to the community. I will be working with the health workers and the beneficiaries to find out why they are not able to follow simple, yet key health practices. Through the health counseling sessions, community meetings and discussions groups I hope to understand the needs of the women, analyze existing techniques of delivering health messages and find ways to improve them. Eventually, I hope to create a sustainable structure to monitor and evaluate changes in health behavior as put forth by the health workers.- Sriya Srikrishnan (AIF William J. Clinton Fellow 2012-2013)

C-Section Blog Series (4 of 4)

The third part of our C-section blog series focused on the circumstances leading up to Calcutta Kids’ decision to stop partnering with private clinics for facility based deliveries, and instead (a) offer a Delivery Savings Scheme (DSS) which would provide financial assistance for beneficiaries to deliver wherever they prefer; and (b) up the ante on birth preparedness through a new home counseling curriculum. This week’s blog describes that curriculum, provides data on beneficiaries’ usage rates of the delivery savings scheme, and calls attention to the fact that more community involvement is necessary for the delivery savings program to succeed.

Throughout the pregnancies of our beneficiaries, our CHWs visit their homes at least once a month. During the last few months of pregnancy, the visits have become more standardized and focus on the following themes:

  • Danger signs. What to watch out for—especially pain in the lower abdomen, heavy white discharge or bloody discharge. In such cases, pregnant women are advised to go immediately to the facility with which they are registered, and to call their Area in Charge for support
  • What not to worry about: Many women become worried if the gestational age of their child crosses 37 weeks. The CHW’s counsel the women not to worry about this until around 40 weeks at which time they should visit their facility.
  • Preparation: The family is counseled to assure the availability of transportation to the facility regardless of the time of day or night, and to ensure that money is set aside for transport. They are also told what documentation to have ready to take with them to the facility.
  • To C or not to C: Pregnant women and their families are provided with knowledge about C-sections. They are informed of the recognized and accepted indications for C-sections; the potential risks for the mother after a C-section delivery; the potential risks for the mother during her next pregnancy; the immediate risks for the baby during a C-section delivery; and the potential long term risks for a C-section-delivered child.

The CK staff has gone through an intensive training focusing on these themes. (You can see these materials in the resources section of our website or you can click here for the Labor and Delivery Educational Session and here for the C-Section Education Session.)  They also have received refresher training on the labor and delivery process, fetal development, and complications that can occur during labor. And they are equipped with flip charts and other materials to facilitate their home-based counseling with pregnant women.

Delivery Savings Scheme Data:

  • Scheme began in July 2011
  • Since inception, 68 CK pregnant women out of 162 pregnant women in households registered with CK, have enrolled in DSS
  • Of those 68, 45 remain pregnant
    • Of the 45 who delivered, 2 had miscarriages; 29 had normal deliveries, and 14 had c-sections.
    • Of the 45 who delivered, 24 took place in private facilities and 19 took place in public facilities.
  • Currently (July 2012) there are 55 pregnant women involved with Calcutta Kids and 21 are participating in the DSS.

With a DSS user rate of around 40%, the scheme is not working as well as we would like. And the DSS is not working as a replacement for the services being provided earlier through private facilities.

Next week, Calcutta Kids will be holding a number of focus group discussions to try and figure out why it is that more pregnant women are not taking advantage of this scheme. The discussions will be held separately with those who have used the DSS and those who have not. We look forward to sharing what we learn from these discussions in a future blog.

From this data, however, some questions arise: Does this experience coupled with the micro insurance experience indicate that families (a) don’t have surplus cash on hand or (b) aren’t willing to use surplus cash for such a purpose or (c) that the men in the family are not willing to set such money aside for this or (d) there a is basic fear (based on the reality that there is a lot of huckstering that goes on in the slum) that they might never see their money again?

Clearly we have more work to do in facilitating a good option for safe facility-based delivery among our beneficiaries. We are confident that we will be able to find a solution which benefits our beneficiaries while at the same time protecting them—and also Calcutta Kids. -Sumana Ghosh, Danya Sarkar and Noah Levinson

New Child Development Corner

Despite the sweltering heat in the last couple months, and the impending torrential rains of monsoon, there is a lot going on at Calcutta Kids this summer. In the midst of all the new activities, in mid-May, Calcutta Kids received the wonderful news that we will be receiving a small grant to set up a child development corner in our new community center, from the J. Kirby Simon Foreign Service Trust. We are very excited about this prospect, because a child development corner will allow us to provide a more holistic approach to child growth and development within the larger young child health initiative. In the past six years, we have made remarkable improvements in the nutrition and growth of young children in Fakir Bagan. The average birth weight has increased from a dismal 1.8 kg in 2005 to 2.8 kg in 2011. Indicators of children’s nutritional status have improved greatly– in the past three years, the severe malnutrition rate has fallen by more than half, from 12.3% to 5.5%. However, there is still a lot to do to ensure that children in this urban poor community are able to achieve optimum development.

Calcutta Kids became conscious that in Fakir Bagan slum as in most urban poor settings, young children have little or no access to play and stimulation. There are no playgrounds for children, and although there is a maidan (field) nearby, it is frequented by older children and teens, and usually only boys. Young children (under 3 years old) are often seen sitting passively on a cot or in the doorway, while their mothers are doing domestic work such as cleaning, cooking, fetching water, or part-time factory work such as sewing garments or making zippers. In homes, families rarely have any toys available for the young children, a luxury that many cannot afford.

Play is essential to development because it contributes to the physical, cognitive, social, and emotional well-being of children. In fact, play is so important to optimal child development that it has been recognized by the United Nations High Commission for Human Rights as a right of every child. In this light, Calcutta Kids appreciates the need to create a child development component to ensure this basic right, with the goal of improved cognitive growth and overall development for all our young children in Fakir Bagan.

The child development corner in the community center will be a safe, clean, and stimulating environment for young children to simply play – to create and explore the world with toys, with other children, and with their caregivers. The project will also facilitate parents’ and caregivers’ understanding of the importance of play and stimulation in child development. It is anticipated that this type of play will provide the needed stimulation that will help very young children with both gross and fine motor skills that will allow them to reach appropriate developmental milestones, develop new competencies, and improve cognitive development. It is hoped that this unique early childhood stimulation project will serve as a model for other NGOs in Kolkata who are working in child health in the urban slums.

Stay tuned for more updates on the child development corner which should be fully established by early 2013. –Danya Sarkar

Swarathma Brings in the Monsoon

I pegged Swarathma as a small time band from a mile away. It was presumptive, sure, naïve even, but it didn’t occur to me that anyone else would play for an NGO in the dusty heat of a slum for free. Little did I know how wrong I was.

When Noah divulged the details to me, I found out that the band is actually something of an Indian phenomenon. Their first album won them Best Band, Best Album, and Song of the Year at India’s most prestigious annual rock awards show. They were on the iconic TV series The Dewarists. They have toured Australia, Britian, and Morocco. And now they were playing for Calcutta Kids.

Back in the old days, for every paid gig they played one for free. They’ve since run out of enough time to keep up the one to one ratio, but when they can they still try to play for those who would not see them otherwise. Thanks to their bassist and spokesman Jishnu’s old friendship with Evangeline, the final concert on the tour to mark the launch of their second album would be in Fakir Bagan.

Weaving around piles of sand and through patches of the road lost in mud, Evangeline and I eventually led their van to Howrah and the impromptu stage that had been miraculously constructed for them. I think the band was almost so impressed as we were, and the juxtaposition of big-band electronics and crumbling-wall school grounds was immensely pleasing.

I picked out a spot in the sea of rickety plastic chairs that bulged at the edges of the colorful canopy above it, and the band sound checked as the crowd filtered in. Chandan and Kalyan lugged some wooden benches out from the school to augment the periphery as it became clear that spectators would outnumber chairs. When all was said and done, a floor of women and children—often balanced on laps or sitting together two to a chair—gazed up at the first bandstand of their lives.

Just before the band went backstage to change into performance attire, their lead singer arrived. No one was going to disappoint the crowd by admitting that he had been missing—the doctors had to knock him out cold at the hospital the night before to put a dislocated shoulder back in—and the band assured us that they could play without him. But after we left him at the hotel and told him to lie low, he just couldn’t. So with a piece of cloth to support his arm (to everyone’s amazement, he even replaced that with a guitar strap when the concert began, strumming away as though nothing had happened), he made it just in time. Security—a graying old man with a stoop and a hard stick—almost wouldn’t let him in. He didn’t have a ticket, after all.

When the band took the stage and plunged into their first song, it seemed to me that an almost tangible incredulousness emanated from the audience. The end of the first number and no more than a sparse acknowledgement of applause underlined the pristine newness of the occasion: the crowd did not know how to react simply because they had never reacted to such a thing before.

Slowly but surely, though, the audience grew less self-conscious and more absorbed by the music. Jishnu has a way of connecting with the floor before him, and in between songs he lightheartedly instructed the crowd in performance manners—when to clap, when to cheer—and introduced the songs that followed, explaining their significance and meaning. On the second song there was little cooperation when he tried to stimulate a clap, but when he motioned for the mothers to lift up their babies in front of them with the chorus of the fourth, there wasn’t a moment’s hesitation. He even seamlessly promoted Calcutta Kids’ new and critical mantra: “A child gaining weight cannot be very sick. A child not gaining weight cannot be very well.”

As the concert went on, the clouds around us darkened, rumbling closer. Just as the mood was reaching unabashed exuberance, the thunder clapped above us and the rain began to fall. At first, no one seemed to know what to do. As soon as it became clear that an inundation was in store, however, the crowd lurched into motion, fleeing either home or into the schoolhouse next door. The band and their helpers scurried to protect the equipment from the blowing rain.

Perhaps unexpectedly to the westerners among us, the deluge did not bring with it a downhearted regret that the concert had been called off before its due course. Instead, the cooling blessing of storm and rain stimulated the same energetic exuberance that had radiated up moments before at Swarathma. As we huddled inside to wait out the downpour, we figured that nature could have given us fifteen more minutes of music. But we agreed that no one could have planned so powerful a coda to the slum’s first concert.—Evan Mullen

Celebrating Women

Around the world, International Women’s Day is marked every year on March 8 to celebrate the participation, contribution, and achievements of women in society. In Fakir Bagan, women live day-to-day taking care of their children and husbands, and have little time to think about themselves. They live in a male dominated environment where alcohol abuse, verbal abuse, and domestic violence is considered a norm that they must accept. Women who earn an income to support the family not only face the same issues, but also face the problem of having their hard earned money taken away by their husbands to spend on alcohol or cigarettes. It is still a struggle for women in this community to make their own voices heard and to be aware of their rights and needs as women.

On the afternoon of March 7, Calcutta Kids held an early celebration of International Women’s Day in our Maa o Shishu Shiksha Kendra (Mother and Child Learning Center) in Fakir Bagan. Members of our women’s support group and their friends from the community joined in the celebration. We celebrated the immense strength women exhibit in their day to day lives throughout the year, recognizing the unlimited sacrifices made by women in this community.

During the event, our program coordinator Sumana helped the community reflect on the status of women in society, how to create awareness about women’s rights, and to think about approaches to empower women in Fakir Bagan. One beneficiary Hira Poddar, said, “These forums allow us the opportunity to get together and share our problems and gain strength from each other.” Another beneficiary, Mira Shaw, a single mother and sole income earner whose husband left her with two young children said, “I am very happy with my life because I can take responsibility for my own life and take good care of my children.”

After the staff members and women spoke, we stood in a circle and sang We Shall Overcome. The then danced to Bollywood music and played with Holi colors! It was a wonderful celebration and a reminder to all of us at Calcutta Kids to continue striving to create a space where women’s voices can be heard. –Danya Sarkar

Mothers Find Strength in Support Group

Mothers share best practices for preparing complementary foods

Although Calcutta Kids has a very close relationship with the women and children of Fakir Bagan, our efforts in community mobilization have been limited. Community meetings are held for pregnant women and mothers of young children, but these meetings are largely lecture style with information being given by our health workers. Our goal in organizing a women’s support group was to create a completely different type of forum, where women would come together as friends to support each other and discuss issues that are relevant to them in their daily lives. They would lead the direction of the group and decide what activities they would like to carry out for themselves and within the community. When we started our first women’s support group in mid-November, we had no idea what to expect as we sat on the mat and waited for the women to appear. One by one they came- Rekha, Santi, Sakuntala, Fulo, Rakhi, Priyanka, Sova, and Urmila, their young children in tow. As they sat on the mat, we offered tea and biscuits and asked mothers to introduce themselves to each other. Sumana, the program coordinator, explained about support groups and asked them to think about whether they were interested in forming such a group.

The women were hesitant at first, but with some encouragement from Sumana, they began chatting with each other about themselves and where they had come from. The discussion then turned to their opinions about Fakir Bagan. A few positives were mentioned: “We like being close to a school and close to shops.” One woman mentioned that she enjoyed celebrations like Durga Puja in Fakir Bagan. The majority of discussion centered on negative views: “We don’t like the water here. We don’t like the filth. Every time it rains it floods and water comes into our homes. It makes life very difficult. When this happens, the children get sick- diarrhea and vomiting. The toilets are disgusting and no one cleans after they use. It makes us feel sick to use the toilet.” Most of their concerns related to health, hygiene, and sanitation, but they all perceived a lack of community feeling in Fakir Bagan: “People only think about themselves. In our area people don’t help each other out.”

At the end of our meeting, the women told us that they enjoyed getting together and learning from each other, but most importantly they liked the idea of becoming a support group and becoming friends. Our senior health workers were very excited by this ‘different kind of meeting’, where women were able to speak and get to know each other instead of only sharing information with the health workers. As women were able to express their feelings, health workers were able to learn how they feel. At Calcutta Kids, these meetings are the first step in our community mobilization effort, and we hope that the group will encourage community-based initiatives that will help improve the quality of life in Fakir Bagan. – Danya Sarkar

Our New Community Center is Open!

 

On January 11, 2012, Calcutta Kids opened a new community center – called Maa o Shishu Siksha Kendra (Mother and Child Learning Center) in the community of Fakir Bagan.Although the other Calcutta Kids facilities are extremely close to the slum neighborhood, this is the first center located directly within the community. Calcutta Kids plans to utilize the space for the monthly Growth Monitoring and Promotion program, for community meetings, and for mothers’ support groups, among other things.

Mothers, children, and community leaders supported Calcutta Kids at the ribbon cutting ceremony. At the event, numerous mothers spoke about their appreciation for and success because of Calcutta Kids’ services. Noah Levinson, Calcutta Kids’ Director, said that this was the beginning of a new era for Calcutta Kids, an era where the community would play an important role in defining and directing our programs.

A Mother’s Story

Rekha with Rani at the start of YChiNG and shortly after the birth of Madhu

Rekha Shaw is an out-going, energetic woman who participated actively in the YChiNG trial. Her two youngest children were malnourished and were in a terrible condition when we enrolled them in the program. Rani, at 29 months, weighed 7.31 kg (a little over 16 pounds) with a weight for age z-score (WAZ) of -4.296. Rani was stunted and developmentally delayed—she could not stand up, let alone walk. Her younger sister Madhu was faring slightly better but was still severely underweight: at 16 months, she weighed 6.58 kg (about 14.5 pounds) with a WAZ of -3.3. Both girls were very anemic, had high worm loads, and suffered from frequent acute infections.

Their mother, Rekha, has six daughters, a result of repeated pregnancies in an attempt to have a son. Tragically, she did have a son (born after the first four daughters), but he died just after birth for reasons she does not know. She lives with a mother-in-law who is not supportive and pressures her to bear a son. She also lives with a husband, who drinks and does not care for her or the children. She says, ‘There is nothing good about that man. He does nothing. He beats me.’ As her husband’s income was not sufficient, she began working outside of the home as caretaker (for an ill person) in order to provide for her children.

Rani and Madhu with mother Rekha at the YChiNG graduation

Despite all odds, Rekha was determined to give her youngest daughters a chance to succeed…. and we were determined to help her. After six months in YChiNG, the two girls have made significant gains in growth and development. Rani is still in the severe underweight category but her WAZ has improved to -3.207. Most importantly, she has learned to stand up and now she walks! Madhu’s weight has increased tremendously and she moved from severe to moderate to mild underweight in the past six months, a remarkable achievement. They have both improved in anemia status, have increased appetites, and learned to feed themselves with a spoon. We are so proud of Rekha for her courage, and so pleased to see Rani and Madhu now running, drawing, and playing in our center! -Danya Sarkar

YChinG Graduation Event

Recently Calcutta Kids held a graduation program for children who participated in a 6 month trial to address severe malnutrition in Fakir Bagan. The thirty-three children enrolled in YChiNG (Young Child Nutrition Group) were invited to a weekly feeding and GMP session at the DTC. They had access to the Calcutta Kids pediatrician, free medications and micronutrient supplements, and free routine and follow-up pathological tests. Read more about the YChiNG trial here.

Mothers listen to program coordinator Sumana Ghosh and mother Rekha Shaw

The graduation program marked the close of the YChiNG trial and was an opportunity to celebrate with the mothers and children who had participated in the program. Some children made remarkable strides in weight gain and growth, while those who did not fare as well (mainly due to lack of attendance) were given encouragement and asked to return for weekly meeting sessions.

The graduation program was a fun event that mothers and children enjoyed thoroughly. The MYCHI Program Coordinator, Sumana, talked about the YChiNG program and its impact. She thanked the mothers for participating and working hard to better the nutritional status of their children. Three mothers shared their stories and experiences with YChiNG. Rekha Shaw, whose youngest daughters Rani and Madhu participated, spoke about the improvements she had seen in her girls because of the program. Shanti Shaw, whose son Sujay had been hospitalized a year earlier due to severe malnutrition, described his recovery and how they were assisted by Calcutta Kids. Sabitri Prajapati spoke about her son Ayush who was born with low birth weight and was not growing well until he participated in the YChiNG program.

Mothers and children had lunch together, with mishti (sweets) and tea afterwards. We listened to Hindi music, and watched the children dance. At the end of the program, Calcutta Kids gave each child a colorful melamine bowl and spoon to encourage enjoyable, active feeding at home. -Danya Sarkar