By Frank Vogl
In the State of Orissa in India, the government claims to provide for not only free delivery to women giving birth, but also an incentive payment for choosing institutional delivery instead of having the baby at home. When Paharia, an Orissa resident, was admitted in 2010 to a local health service center for the birth of her child, the staff demanded Rs.800 (US$15). Her husband was forced to pawn some of the meager family possessions to pay the bribe and meet the cost of drugs. PTF is committed to work with citizens groups to end human rights abuse.
Bhuje Chinda is a landless widow living in a mud house in a village in the Khariar block of Orissa State with her two sons and five daughters, one of whom is mentally handicapped. She is entitled to a range of free public services and benefits, yet she has been a victim of corruption, where her rights have been trashed and public officials have secured the benefits for themselves.
PTF joined with the Policy Affairs Centre in Bangalore to launch a Citizens Against Corruption program to help poor people access the benefits of governmental social security programs without paying bribes (see the project report and learn about PTF’s Jaipur Workshop). The program concentrated on the states of Karnataka, Kerala, Orissa, Rajasthan and Uttarakhand and no sooner were local civil society organizations (CSOs) alerted to it than project proposals flooded in – because of funding constraints, only 15 out of 180 submissions were accepted.
Let us just look briefly at just one of the 15 projects that highlights the work that PTF supports: the melding of human rights and anti-corruption issues and the ability to produce outstanding results by partnering locally and accompanying very small grants with expert volunteer technical assistance. The implementation of the 15 projects covered over 1000 villages and helped some 88,000 very poor families—around 250,000 people.
PTF supported a project by Orissa-based CSO Ayauskam whose focus was on healthcare corruption. An initial survey of 64 villages found that people paid more than $11,000 collectively each year in “corruption taxes” to government health service providers. For example, the government hospital was charging US$55 for delivering a child when the service was supposed to be free.
Ayauskam organized a workshop to discuss the survey findings with journalists which raised public awareness and stimulated ongoing media cove rage. Then villagers were trained on how to use the Indian Right to Information Act to obtain evidence of abuse and how to build protest groups and network with other village groups into a regional district protest movement. At the same time, Ayauskam persuaded all the key people involved—women activists, elected local officials, community based organizations, youth clubs, government officials and service providers—to participate in group sessions at which the weaknesses and failures in the health services were explained and solutions were discussed. The project sought to build cooperation between citizens and officials, meetings were held to identify and discuss problems in each village followed by public hearings attended by local government officials.
Under the Citizens Against Corruption project Bhuje Chinda was included in the public food distribution scheme and thereafter received 10 kg of free rice each month free of cost; she also received Rs.10,000 (roughly $190) under the family benefit scheme and became eligible for a widow’s pension. To help the landless, the project’s managers called on officials to participate in a social audit, who ordered the demarcation of the land; a task that had been delayed for 25 years was completed in one day.
The outcome was just one product of a new sense in the region of strong grass roots organized action. Indeed, Ayauskam’s project completion survey showed a reduction of corrupt practices in government hospitals: 80 percent of those surveyed said that they are not paying fees for hospital births; payment of bribes to other public service providers has been reduced by a half; expenditures on medical services during pregnancy and delivery have been reduced by 82 percent; village health committees have been formed, free medicines are available at the village level, and the countersigning of checks for financial support to mothers after hospital delivery is now done immediately.
Most of the 11,000 households in the project area serviced by Ayauskam are now able to get their entitlement of free medicines and services without paying a bribe. The value of such services is estimated at $30-55 per family per year— a significant improvement.