[caption id="attachment_3824" align="aligncenter" width="560"] ASHA gave me the opportunity to give a talk to their community health volunteers about rabies[/caption] I've spent my final day in the slum and it's time to draw it all together and reach some conclusions. What's it all been about, what have I achieved, and what's going to happen next? First, to explain: the rationale behind my work has primarily been human health. It's shocking that rabies is still a major killer in India, despite the fact that it's completely preventable. If 70% of the street dogs in an area are vaccinated, the disease dwindles and disappears to insignificant levels. Surely this is a goal that is achievable? The current estimated incidence in India of around 3 deaths per 100000 people per year means that over 20000 people, mostly children, die unnecessarily every year. In a slum like Mayapuri, with a population of 12000, there's probably around one death every three years. Feedback from my questionnaire suggested that this may be close to the truth. Rabies is common enough to be a constant threat, but rare enough that it's easy for people to forget about it. Yet it is such an horrific, unnecessary death that everything possible must be done to prevent even one fatality. ASHA deals effectively with many health and welfare issues in the slums, vaccinating children with BCG, MMR, Hepatitis, Tetanus and Polio: before ASHA arrived 15 years ago, no babies were being vaccinated – the uptake is now 100%. ASHA also treats adults for TB under the DOTS programme, and offers a range of birth control methods. There's no doubt that the charity's work has transformed the lives of the slum dwellers. But what about rabies? When I asked this question last year, it seemed that it was a bit of a grey area: ASHA is so busy with other priorities that it's easy for rabies to slip under the radar. When I discovered this, I felt that there was an opportunity for me to use my background as a vet to look into the issue when visiting the slum with a group of volunteers from my local church. Mission Rabies – who are already in the process of vaccinating millions of dogs around India – do not have an immediate plan to focus on the Delhi area, but they were exceptionally helpful in assisting me with this project. They drafted a questionnaire for me to use while here, and they advised me on important aspects such as informed consent and male/female interpreters. So what did I discover? Well, I found out how difficult it is to do social research. I had thought I might gather several hundred questionnaires over 3 days, but the process took longer than I had expected: up to 15 minutes for each interview via an interpreter, then time spent seeking out the next candidate. I ended up with just 40 completed questionnaires: not as many as I'd have liked, not enough to be significant in a formal sense, but still perhaps enough to gather valuable feedback about the subject. What did I learn? First, I discovered some interesting socioeconomic facts.
- 75% of households live in just one room, shared between an average of four people: no kitchen, no bathroom, no hot water
- 95% of slum dwellers own a mobile phone
- 90% own a television
- 65% own a bicycle.