Armed with the objective of empowering people to take care of themselves, the institute undertook a Knowledge, Attitude and Practices (KAP) study to understand better the mortality pattern of the population. Nearly 29,184 people were surveyed and the results were alarming. Of the 14 notified slums in Delhi, Zakhira had all the indicators of a health expert’s nightmare—malnutrition, poor awareness on key health issues and bad eye care. Between eight and 16 per cent of children under the age of five suffered from severe malnutrition and diarrhoea—both factors responsible for the high mortality rate in children.
The study also found that though the slum-dwellers had knowledge of breast-feeding, the practice was low largely because of the pressure on both parents to make a living. "We realised an isolated eye care programme would not yield good results as a qualitative health system was not in place and the population was totally dependent on non-qualified health practitioners or quacks. Therefore, there was a need to provide a general health package. Also, for the health package to be effective, it was important to create awareness amongst the population," says Bhanot.
An intensive training programme was framed to include personal and environmental hygiene, regular health check-ups, general eye care, AIDS and STD awareness, vitamin deficiency and monitoring nutrition. Colleges like the Lady Irwin College were roped in to impart tips on nutrition and gradually Venu went beyond their core competence.
Besides this, vocational training was also included. About 38 women’s groups were formed to act as pressure groups to enrol girls in trades like tailoring, beautician courses, toy and candle-making, television and radio repair etc to make them self-reliant. "We realised that slums by their very nature have a huge floating population. Migrants keep coming and move on in their lives but we hope they will carry with them what we have taught," notes Bhanot. Of course, there is no way of knowing whether the learning is being transmitted forward, but hope keeps Venu afloat.
When ‘Operation Zakhira’ started, the slum-dwellers were sceptical about the intentions of the surveyors and health activists. An NGO had been working in the place but obviously with little success. The scepticism was understandable. "We had to prove ourselves first and gain the confidence of the people," recalls a project worker. A group of local women were selected to break the ice and explain the project. It was after this that the project took off. Simultaneously, Venu also set up hand-pumps since there was a shortage of these in the slum. This went down well with the local population and the little resistance and scepticism vanished.
A year after it went into Zakhira, Venu decided to levy a fee of Rs 5 on patients coming for check-up to their health camps. "The idea was to make them realise the services also come with a fee—albeit fixed at moderate and affordable rates," says Bhanot. The medicines were made available free of cost.
Zakhira is not the same place anymore. A lot of changes have taken place in the last two years. The public response has been so overwhelming that Venu is looking forward to adopting more ghettos in the future. They’re confident now since they have a working model to replicate. "This is just the beginning. Zakhira has given us hope," says Bhanot.
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