Remember ME - You Me and Dementia

Saturday, October 27, 2007

RTI is development you can see


The villagers of Boru in Gujarat, under the stewardship of Gulambhai, decided they would no longer tolerate the lack of healthcare facilities in their village. Using the right to information, they fired off a series of questions to the PIO. And things began to change.

India is marching ahead with RTI.............

Boru is a small village in Kalol taluka, Gujarat. It is home to approximately 2,500 people belonging to Hindu, Muslim, adivasi and other communities. Like most other villages, Boru has its own problems. The roads are in bad shape, electricity is scarce, and healthcare non-existent. The road to the taluka headquarters at Kalol, around 5 km away, has long ago had the metalling washed away; perhaps it was never there at all. Built under the prime minister’s village road construction scheme, only the first kilometre of the road is properly tarred, the rest resembles a dust bowl. That first kilometre seems to have been enough to please the inspectors who okayed the expenditure.

Health is another serious problem in Boru. There is no primary health centre (PHC) in the village. Government policies allow one PHC for a population of every 30,000 people. It is usually placed in the largest village in the cluster. Boru’s inhabitants can only avail of free medical services at the designated centre 8 km away, rather than in Kalol which is closer. If the road to Kalol is a dubious ‘facility’, the 8 km road to Jantral is a figment of someone’s imagination. When ill, the villagers have little option but to pay Rs 15 to get to Jantral by public transport and be treated for minor ailments. There is absolutely no provision for more serious, sudden and life-threatening emergencies, and none for childbirth. Most deliveries are done at home by local midwives. If complications set in and professional help or a caesarean is needed, it is almost impossible to quickly transport the woman to the PHC. Women have been known to deliver and die on the way to the healthcare centre, and it is not unusual to see four or five men carrying a woman in labour on foot all the way to the centre.

In these circumstances, the government-provided health worker becomes vital. She is supposed to visit the village three times a week, provide immunisation and supplements, and look after the needs of TB patients, children and pregnant women.

Boru is lucky if the health worker visits three times a month. When she does make an appearance, she sits in one place. If people approach her, well and good; if no one comes, she leaves in around an hour.

The villagers have been complaining about lack of medical facilities for the past four years. At the very least they want a sub-centre that will make childbirth less risky. Complaints to the PHC, to the MLA and several other authorities elicited the standard response: “We will try our level best to do something and find a solution.”But after four years the village is still waiting for that ‘best effort’. Nothing has changed. No sub-centre has been sanctioned and the people continue to suffer.

Then along came the Right to Information (RTI). Gulambhai, a concerned citizen of Boru, decided he had had enough. It was time to ask a few questions and at least find out what the healthcare provisions for his village were. He applied to the local health centre doctor who doubles as its public information officer (PIO), asking specifically what assistance could be provided to patients and what facilities were available for pregnant women; the number of health workers assigned to Boru, how often they were required to visit, and what their responsibilities were.

Under the Right to Information Act, this information must be routinely provided by government departments to the public without specific requests being made. Disclosure of names, designations and other particulars of PIOs who are responsible for processing applications for information, and details of their functions and duties along with the powers of all officers and employees associated with the Act is part of every department’s statutory duties. But since the information was nowhere to be found, Gulambhai submitted his ‘request in writing’.

Almost immediately -- and certainly before any response was forthcoming -- things on the ground began to change. The villagers were pleasantly surprised and pleased at the makeover of the health worker. She started visiting regularly (almost everyday), provided basic healthcare, and made sure to visit every mohalla. The visits had an immediate impact on general health in the village. Meanwhile a month went by with no response to Gulambhai’s inquiry.

Pleased with the outcome of their small foray, many villagers didn’t seem to care much that the information asked for was still not forthcoming. Change had come about; their problems were being addressed and there seemed little point in wasting time or energy going into appeal against the PHC doctor and chasing up the information.

But Gulambhai and a few others were convinced this was not the end of the story. They felt it was just as important to get the information. The sudden change in behaviour of the health worker could be temporary. To ensure its permanence it was necessary to make norms related to the provision of healthcare visible and widely known to all. So Gulambhai decided to change his strategy.

He sent the doctor a reminder asking about the status of his application. Three days later, the PHC doctor landed up on Gulambhai’s doorstep (some villagers joked that he must have lost his way; a home visit by a government doctor was unheard of!). Aware of the honour being bestowed upon him, Gulambhai brought out the tea and biscuits.

The doctor asked where Gulambhai had he learnt about the RTI Act, who had taught him to make an application, and how he was going to use the information. Gulambhai explained that a lot of people like him in the village had attended trainings and were well aware of the new law. He himself now devoted a large part of his time raising awareness about laws and rights and procedures among his fellow villagers. He had learnt that it was only when people knew their rights that there would be real change in society. All that said, he heaved a sigh of relief and sat back proudly.

The doctor was surprised. He assured Gulambhai that he would personally ensure that the health worker came regularly. He also suggested that Gulambhai or any other villager visit him at the PHC and draw his attention to any problems they had. But there was no mention of the information Gulambhai had asked for.

The visit from the doctor earned Gulambhai new respect and status in his village. Most of all, it indicated the subtle shift in power that having information and using the law allows in the unequal relationships between bureaucracies and the people whom they are meant to serve.

A week after the doctor’s visit, Gulambhai received the information by post. The villagers were thrilled. The replies were by no means as detailed as had been asked for, and it had taken almost twice as long to get them as is required by statute. Much of the information was what the health centre PIO was required to provide anyway, without request. Logical pursuit of the inquiry would have thrown up questions about events of the previous years: Where had the medicines to be distributed gone? What were the finances allocated to healthcare in the villages, and how had they been spent? Who was supervising the errant health worker? How was their performance assessed?

But for now these lines of inquiry were not going to be pursued. Nor was the system going to change radically. The villagers believed that the provision of regular services and the personal visit by the doctor were in themselves a huge success that more than made up for any technical lapses in the provision of information.

This is what the right to information is. It is power, it is democracy in action. It is development you can see. It is participation you can hold in your hand. It is accountability that comes to your house. It is transparency you can witness in your village.

By Navaz Kotwal

Source: InfoChange News & Features


Forget yourself for others, and others will never forget you.

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