Friday, February 01, 2008

An Easter Garden

My part in the evaluation, which involved doing a review medical on all the eldery, data entry of all the questonnaire data (feedback and WHO BREF) and holding a focus group discussion with all the members and staff, is complete. It took, unsurprisingly, longer than expected, mainly because cordinating people who have lots of other jobs to do, is difficult. Especially in India.

The results have not been analysed but, despite my slightly pessimistic posting a few days ago, I feel very positive about its future. Although there was definitely less progress than I was hoping for, again this should not have been a surprise, and, as mentioned before, the elderly have only marginally increased their quality of life from bloody awful to partially bearable, after the final focus group discussion with all the participants and the key team members, all of us went away with big beaming smiles on our faces. I was very keen that the beneficiaries of the centre - which, let's face it, doesn't amount to even a whole drop in the ocean at a measly 23 people - should not continue to feel that the centre was simply there to hand out to them and meet their needs unchallenged. That is part of the story admittedly, but other aspects must include bringing benefit to the wider community, empowering the current beneficiaries to generate more change in their own lives and that of others and attempt some kind of self-sustainability.

During the medicals, I was pleased to note that, although no-one had written in their files since I last did regarding their medical needs, those who had been identified as having COPD, diabetes, hypertension, visual difficulties, hearing difficulties, a hernia and various other bits and bobs falling off or broken, had for the most part had those needs met at a minimial, in some cases no, cost. As last time, I noticed that there was an importance in telling me their story. Even though they knew I had no medicines or treatment I could give them, everyone wanted their time telling me about their health issues. Most now, luckily, were relatively minor but the telling of the tale seemed to have a therapeutic benefit beyond its worth. Its about being valued. Interestingly, as has been the case all the way through my involvement with this project, events in India have mirrored topics taught in the MSc. Currently, I am doing Narrative in Health and Illness. How wierd is that.

On one of the days I was at the centre, when I had finished the medicals for the day and about to leave them enjoy their lunch (which smelt delicious), they stopped me leaving and all gathered round me. One of the more eloquent gentleman, who reads the papers out loud to the others as he is one of the few literate members and who always greets me in his three words of English, stood and made a short speech (which I didn't understand). Then from nowhere, one of the ladies produced a marigold and jasmine garland and a shawl which they had all clubbed together to buy me to say thank you. It was nearly another nose bubble moment.

So back to the exciting outcome of the focus group discussion. We went to try and find out what the elderly felt they could contribute back to the centre. During the feedback questionnaire, the themes emerging were that they, still feeling old and frail, felt the answer would be not much, but they would do whatever we asked if they could. I wanted to move away from starting with the possibly herculean task of making the project financially self-sustainable. The reason these people were there is because they were unable to make ends meet. We have redressed some of their health problems, but we haven't given them younger bodies or new skills. As all marketing gurus know, goals must be SMART (the A of which stand for achievable) and it is important to try and make these people feel more rather than less capable. One tiny step at a time.

Consequently, we focused the discussion on trying to identify exactly what they could contribute, however small to the centre or the community. The discussion moved slowly to start with. We need new saris, can we have a veg or non-veg side dish, can you cut through the corruption we face and get us our pension, they said. No, no, what can you give for others. We have nothing, not even land to grow vegetables. Someone looked out to the backyard - what about out there? Breakthrough. Suddenly, the whole dynamic of the discussion changed. The possiblity of starting a small garden grew in their minds. They could grow their own vegetables, they might be able to sell some, feed other needy elderly in the community. They would work co-operatively. Suddenly, their individual helplessness changed to collective hopefullness. I am going back in March over the Easter holidays with the analysis of the evaluation data to develop a plan for the next year. We told them this and asked if they could make a garden to show me on my return.
Multiple head noddings. Madam, we will do.

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