THE PERIOD PEOPLE for public health

Up until today, where I stand as the co-founder of a social enterprise, I have followed and carved a path for myself with the single, consistent vision of changing the lives of women in my country through healthcare. With this goal in mind, I have developed a rich foundation of experience in healthcare through academic training in epidemiology and biostatistics for twelve months as part of my medical studies, working as an intern doctor in a rural hospital with postings in primary health centres, volunteering in emergency flood relief camps, treating patients as a ‘home visiting doctor’ and finally starting a social health enterprise aimed at creating multidimensional improvement in women’s health in India.

Driven by my ambition to become a doctor, I graduated high school with excellent academic records standing school second in Biological sciences and was granted admission into a renowned medical University through a merit based ranking system. In my third year of medical college, as part of our training in social and preventive medicine, we visited villages to survey their living conditions, cultural health practices and overall health status. Through these visits I realized menstrual health management was one of the most difficult health issues that women from underprivileged backgrounds faced. I observed women re-using old rags, saw dust, ash and even toilet sponge as a means to manage menstruation. After a dialogue with my professors, I was guided to read on health policies in India for women and also understand the cultural and religious context of menstrual management practices. We held awareness programs on menstrual health and hygiene practices and distributed sanitary napkins in the households. The gratitude the women conveyed on receiving the napkins was astounding and hugely rewarding. This was when my interest in public health and policy studies was inspired.

With my career plans still evolving, I began working as an intern in the rural hospital attached to my medical institute which is where, what began as a stirring sentiment, became the centre of my professional goals. Almost all our patients came from underprivileged backgrounds and in spite of the hospital offering free and subsidized medical care, most patients, especially the womenfolk, came to us only as a last resort. They suffered through illness and disease as long as they possibly could, being unable to forego daily wages, abandoning their fields and homes, to travel distances and access our medical care. As a young female doctor, the most heart-wrenching experience for me was having to prematurely discharge women with reproductive tract injuries and illnesses owing to their families forcing them to return to their gender-specified duties. I decided then, to commit myself professionally, towards bettering the health of women in my country.

In July 2013, while I was working in the rural health-centre, news filtered through the radio that the northern state of Uttarakhand had been struck by devastating floods levelling the already threadbare medical infrastructure. Eager to start on my path in public health, I immediately contacted the non-for-profit organization 'Save The Children', offering my services as a volunteer doctor. Three interviews and a week later, with limited funds in my pocket, I was en route to Uttarakhand to liaise with my team. We hit the ground running, with the first week spent working in chaotic and overcrowded medical camps. In order to better manage the situation, the project coordinator asked one of us to lead the volunteer team. Although I was the youngest doctor on board, my teammates insisted I take on the responsibility based on the drive I displayed by working extra hours in the camps, my willingness to visit villages in remote regions and the positive reactions from the villagers, patients and staff. Through our work I came to understand the women were uncomfortable consulting at our campsites, in the open. I discussed the issue with our project coordinator and offered to visit them in their homes with help from the Accredited Social Health Activists (ASHAs), village mid-wives and Anganwadi workers. During my visits I handed out sanitary napkins and Iron supplements personally addressing the need for hygienic menstrual health practices based on my experience in medical college. The whole exercise proved very successful in winning their trust which allowed us to address issues on menstrual health, contraception, institutional deliveries and breastfeeding. This gave me huge insight into the potential health impact of providing healthcare services for women in the privacy of their homes.

Following my internship, eager to improve my understanding of this service and the possibility of it’s implementation in public health particularly for women, I joined PORTEA home healthcare services as a resident doctor. During my year’s tenure in Portea, I treated more than 200 patients in their homes, understood daily nuances in operations, patient health patterns and the problem solving possibilities of the service. The response and satisfaction expressed, particularly by women, after being examined and treated in the privacy of their homes was remarkable and has encouraged me to begin exploring the possibilities of its implementation in public health. Under the direct guidance of the Medical Director of Portea, I am now developing an ‘at-home rehabilitation protocol’ post-hospitalization with an outcome assessment proposal in order to substantiate the need and possible impact of this healthcare provision.

In October 2014, when the Indian state of Kashmir was struck by floods, I received a call from ‘Save the Children’ enquiring about my immediate availability. A message from the CEO conveyed a specific request for my services based on my associations and familiarity with the team. I instantly departed for Srinagar, working with both known and unknown faces to plan, execute and oversee medical relief efforts. Helped in great measure by my previous experience in Uttarakhand, in addition to medical aid I ensured distribution of sanitary napkins in the villages and slums and spoke to groups of women regarding sanitary waste disposal. Rewardingly, before I left Kashmir, I was offered the position of Health Program Manager in Jharkhand, but my prior commitment with Portea meant that I had to decline their generous offer.

With the knowledge and experience that I acquired in health care over the past seven years, I have now co-founded a social enterprise named “The Period People” aimed at creating multidimensional improvement in women’s health, in India. My co-founder and I quit our jobs and lived off our savings for four months preparing a proposal to promote the use of the ‘menstrual cup’ as a safe, economically sustainable menstrual management product for women across the country. During this period I came across a research publication by Dr. Belen Torondel, from LSHTM, regarding menstrual hygiene practices and urogenital infections among women in Odisha, India. We used several findings from this study to substantiate our ideas and propositions, make a hugely successful pitch, raising $75,000 in seed funds to kick-start our first menstrual health project. We aim to create paradigmatic improvement in women’s health in India addressing cultural, lingual, educational and geographical barriers through our work. In order to efficiently execute the organization’s plans and achieve our social impact goals I require academic and research knowledge in public health issues, statistics, health economics, health service evaluation & management. The Public health – Health services management course curriculum in LSHTM has modules in these precise topics, making it the best academic step for me to take.

As a public health practitioner I envision undertaking the task of bringing together a consortia of professionals to introduce the novel facility of ‘healthcare at home for women’ as a Public Private Partnership project of ‘The Period People’. I intend to utilize evidence based work modules and engage with the government for implementation, broadly following the UK’s existing PPP model. My organization’s 5 year goal is to propose a policy to the Government health ministry for provision of menstrual cups through Wash programs and public facility plans for safe menstrual health management spaces in schools, universities, bus and train stations, etc. backed by statistics and evidence synthesized from our own field work.

By blazing this trail outside the security of structured, hospital-based work routines, I intend to lead by example and inspire doctors to step out of their comfort zones and expand their horizons. With more than 39 million people being forced into poverty through medical bills alone and with one of the highest maternal mortality rates in the world, India is in dire need of huge change in primary healthcare and health delivery systems. I intend to ignite this change through my entrepreneurial platform once I establish myself academically and professionally as a public health specialist.