by Shaikh Maaz Tanveer, Head of Communication & Natural Resource Management at HANDS Pakistan
These are two stories about empowerment and determination and how women are powerful change agents in the communities of rural Pakistan. Shamshad Begum from rural Punjab province and Najma Rahu from Sindh province in Pakistan are part of the “Marvi” program, a brainchild of HANDS Pakistan. In Pakistan, the maternal mortality rate is high, so this program has been a game changer.
Marvi workers are change agents in their local communities who are trained to create awareness about mother and child health, family planning and reproductive health. In Pakistani folklore, Marvi was a village girl who refused to marry a king but preferred to live a simple life in the village. In Sindh province the term Noor (light) is used for these women champions. Over 8000 Marvis or Noor workers are currently active in their villages, to bring prosperity back into their communities.
Shamshad Begum in her family's vegetable garden @HANDS
Shamshad Begum had a close call with death after she suffered from health complications caused by giving birth at home without a skilled birth attendant. After the ordeal, she vowed never to let any other woman in her village suffer the way she did.
“The villagers told my husband to let me die. They discouraged him from taking me to the hospital because they thought that he would be wasting his money on me. To the villagers, I was just a child-producing machine, who had served her purpose. But fortunately, my husband didn't pay any heed to them and got me the healthcare that I needed. The sad part is, not all men in my village care about their women. Not all women in my community are as fortunate as me. This is why when the HANDS team approached me to create awareness about mother and child health in my village, my husband and I agreed wholeheartedly.
The three-day training program with HANDS prepared me to convince the villagers to give a gap between the births of children, and to use contraceptives. I have gone house to house to educate the villagers about the health issues that mothers face because of their young age, and because they are not allowed to recover from childbirth before bearing another child.
To the villagers, I was just a child-producing machine,
who had served her purpose.
The villagers constantly argue with me and blame me for trying to finish off their generations. But I firmly tell them that we are only asking them to give some gap for the betterment of their women and children. We are not stopping them from having children. Something I said must have resonated with them because today, more and more women are being taken to the hospital to deliver their children. Where there is some resistance, I intervene. I am adamant that no more mothers will suffer. This is why in critical cases; I accompany some of the women to hospitals as well.
Not all women in my community are as fortunate as me. The pandemic may have stopped many things, but it has not been able to stop our work. HANDS gave me additional training regarding SOPs to follow when visiting women in the village. I also make sure that I guide these women on measures to take to prevent the spread of COVID-19 in their households.
My life has changed drastically since I joined HANDS as a Community Health Worker (Marvi/Noor). From being a simple homemaker, I am now helping my community be healthier and saving the lives of women and children."
Najma Rahu is determined that women should give birth safely @HANDS
“I was sitting idly at home and wanted to start a job to support my family. The conditions at home were poor with a meagre income to survive on. I also wanted to make a difference in my village which is in the district of Sujawal.
I realised that quite a few women in our village are facing complications or losing their lives during childbirth due to the lack of a gap between the births of children and deliveries being done at home, which distressed me. My dreams were big, but I did not have a way to fulfill them until HANDS came to our village four years back and showed me the way.
After the flood devastation in 2011 our village was assessed by HANDS and during the large community meeting, I was selected as a community health worker also known as Marvi. Soon after, I was trained in basic health services, especially in mother and child health. Since then, I am known more as a Marvi than by my own name.
Four years down the road I have 100 clients, all deliveries are done in the hospitals, the quality of life of the people in the village has become better, and the average woman’s health has improved. On a personal level, my financial condition has improved, my 7-year-old son goes to school, I am able to look after my disabled mother properly and have a supportive husband who is by my side in all that I do. I also own a buffalo, do sewing and embroidery, and grow vegetables in my kitchen garden with the help of seeds provided by HANDS.
One part of my dream has been realised, but the other part of having a hospital in the village in front of our Marvi Center is yet to be fulfilled."
HANDS Pakistan is one of the largest non-profit organisations in the country, working since 1979, to approach development in a holistic way. Their programmes range from healthcare, education, livelihood, water & sanitation to community infrastructure and disaster management.