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  • CAPTION: Jyothi has multiple disabilities, including cerebral palsy. Her parents are in the process of constructing a new home, so Mobility India representative Ramesh has come to advise them on the modifications they will need to build in so as to make the house as accessibe to her as possible. He suggests wall bars and foot steps (moulds in the floor) to help her get around the house, and also a specially adapted toilet. LOCATION: Yangahalli (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Doreswamy, Ramesh, Jyothi and Lakshmamma.
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  • CAPTION: Basavanna can see only partially with one eye. He has taken a dairy-related livelihoods training course arranged by Mobility India, specially targeted at people with disabilities. This included several aspects of caring for cows that were unfamiliar to him before. LOCATION: Mudnakudu (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Basavanna (left) and Gowramma (right).
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  • CAPTION: Nirmala Shukla, wearing white, is another member of the panchayati raj system. She is also very active in Community COPE as a part of the information system, bringing its work to the public's attention and serving as a bridge to the press. Shruti Deogam, to her left in orange, is the pramud, the elected head of Ghatshila Block (meaning the highest rank in the panchayati raj system), and is also an important representative of the community to the outside in that she links the block to those higher up at the district level. She is the leader of the Community COPE exercise, and helps to bring in high-level officials to address issues being experienced at the block level. In this line of women (from right to left) we see the pramud (working at the block level), mukhya (village level), Vandana Maitry who is a ward member (village level), and a new Community COPE member. They are discussing what the work plan has addressed so far and what is still to be addressed. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Bisu Murmu, Vandana Maitry, Parwati Murmu, Shruti Deogam, Nirmala Shukla and Shyam Bahadur Sonar.
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  • CAPTION: Community COPE members come to ask a householder about what her expectations of the health system are and what she feels ought to be done to get more people into the Government-run Community Health Centre (CHC). She says she’s happy with what she’s been accessing, but reveals a lack of awareness of what she is actually entitled to. Shyam Bahadur Sonar is therefore suggesting that she should discuss her needs with knowledgeable community members. Kalicharan Namata (second from left) is one of the two adolescent representatives in Community COPE, and has an important role in bringing adolescent voices into the community dialogue. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Shyam Bahadur Sonar (left) and Rupa Namata (right).
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  • CAPTION: The final group is listing out the various mental and social changes experienced by adolescents. One of these is the development of attraction to the opposite sex. It is impressed upon participants that this is something natural that happens to everyone, and that it should not be condemned as something 'bad'. Another is that girls start wanting to make themselves appear as beautiful as possible to others. Boys, meanwhile, might like to drive very fast in front of others, or smoke and take drugs. The group is considering the consequences of these things and how they may be addressed. After discussing these things, the groups join together and discuss what they have each found. This then leads to the enactment of role-plays. LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Kalpana Mahato, Savita Horo, Dr Jagannath Hembrom, Krishna Chakrabarty and Shobha Kumari Nirali.
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  • CAPTION: Shanti Toppo is married. She would like there to be a gap before she has her second child. Health worker Dr Kusum Kumari Bara suggests two options for her, firstly the Copper T, which allows the user to delay pregnancy for a longer period, and secondly the condom, which must be used by her husband. It is stressed that the condom is the only thing that also prevents spread of reproductive tract infections (RTIs) and sexually transmitted infections (STIs). The service provider then suggests that it is a good idea to come back along with her husband, so that he can also understand these things. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Kusum Kumari Bara (left) and Shanti Toppo (right).
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  • CAPTION: The Chamkol programme supports the government's response to the health and wellbeing of individuals with or at disk of disability. For Village Rehabilitation Workers (VRWs) like Rekha (who herself has polio) - pictured here visiting a boy with a learning disability who she recently supported in entering the formal education system - informal support to service delivery means provision of tailored quarterly training. LOCATION: Meghalahundi (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Rekha H.B. (woman), Mahesh (boy) and Mahadevaswamy (man).
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  • CAPTION: While Cluster Resource Person (CRP) Basavaraju observes, Sunithamma leads her primary school class in enacting a skit called 'Grandmother’s Pride'. This group work exercise taught by The Teacher Foundation (TTF) is especially useful for including children with special needs. Roopa (left), for example, loves acting. She has a learning disability and used to come to class only very irregularly. Now that these activities are included in the lesson plan, she's happy to come much more often. LOCATION: Mariallahundi (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Roopa S., Kavya P., Kavya M.P., Mamatha M., Sunithamma, Sunil M.K. and Basavaraju M.
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  • CAPTION: Rajashetty, who contracted polio early in life, is a self-employed blacksmith. He is pictured here working alongside two of his family members. He is a member of his local self-help group (SHG), which has enabled him to draw small loans to invest in his business. LOCATION: Alduru (village), Santhemarahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Rajashetty, Bhagya and Basavashetty.
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  • CAPTION: Mallesh has a severe learning disability. He needs almost constant care. During the earliest days following the birth of a child who has (or develops) a disability, parents often struggle to work out what best they can do for him or her, and could use more information and firmer direction. Under the Chamkol programme, such children aged between zero and five and their mothers, expectant mothers and women of child-bearing age will be able to get this through health, wellbeing, development and pre-school programmes run through Early Years' Clubs. LOCATION: Mahanthalpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Nandini M. (left) and Mallesh M. (right).
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  • CAPTION: Under the Chamkol programme, every disabled member of the community has an Individual Health Plan (IHP). For Rajashekar, who has cerebral palsy, this means following a tailor-made exercise regime. During regular visits to his home, Rehabilitation Therapy Assistant (RTA) Sudha shows his family how to support him with this. LOCATION: Marialla (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Sudhamani R., Rajashekar and Rangaswamy.
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  • CAPTION: Every child with severe disabilities is entitled to enrol at his or her local school and receive education through a Home Based Educator (HBE). Jyothi, an HBE, is pictured here working with her own brother, Siddaraju, who has severe learning disabilities. LOCATION: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: M. Jyothi (left) and Siddaraju (right).
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  • CAPTION: Thanks to The Teacher Foundation (TTF), Prabhuswamy has been trained to lead Quality Circle Time (QCT) sessions in his primary school classrooms. This technique helps him to involve children with special needs in different activities to a much greater extent, as in this instance where he uses a hand puppet to talk to Gowrishankar, who has speech and hearing difficulties. LOCATION: Bedrapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Prabhuswamy, Gowrishankar and Abhi K.
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  • CAPTION: Shilpa, who has cerebral palsy and moves around in a wheelchair, has developed her confidence level dramatically since joining her local After-School Club (ASC). Its sessions are designed to be highly inclusive, so she feels she is able to engage in activities without disadvantage compared with the other children there. LOCATION: Heggotara (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Manasa and Shilpa N. (right).
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  • CAPTION: Parwati Murmu is one of Community COPE's elected members. She is the mukhya (head of four to five villages) of the Pawra area, and is one of the most active Community COPE leaders. Before getting elected, she had 15 years’ experience in the panchayati raj system. The panchayati raj system dictates that 50% of those elected must be female; in this area, 60-70% are. She also used to be a very active anganwadi worker, and because she is very knowledgeable on relevant health matters she now helps a lot with mother and child health services. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Bisu Murmu, Vandana Maitry and Parwati Murmu.
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  • CAPTION: The media is interested in COPE because the Community is all about bringing positive change. This journalist is from GTN News, a local cable channel which broadcasts across several districts of Jharkhand. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: unknown; right: Shruti Deogam.
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  • CAPTION: Community COPE members come to ask a householder about what her expectations of the health system are and what she feels ought to be done to get more people into the Government-run Community Health Centre (CHC). The men and women have teamed up here; mostly the men talk with the male heads of households. This lady has been living in this community for around 40 years since marriage. She has observed many changes in health service provision. She says that the panchayati raj system has brought significant health service changes for her, which she’s very happy about. She says that people hear from the newspapers and TV what they can access. The newly-elected female panchayati raj members, reserved 50% of the positions as part of women’s empowerment efforts, have been very active in changing how the government system works and serves people. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Daya Nidhi Shit, Damodar Shit, Shruti Deogam, Punta Hansda and Parwati Murmu.
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  • CAPTION: ARSH Counselor Sarita Kumari Panna explains the use of iron and folic acid tablets to Atosi Shit. Most of the adolescent girls (perhaps 80-90%) in villages like this are anemic. There is large-scale absence of awareness of how to ensure their diets contain iron and folic acid, especially with the rising popularity of fast food while young people are away at school or college. Girls are especially unaware, after their menstrual cycles start, about when they ought to have particular types of nutrition. This often results in menstrual problems and anemia. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Sarita Kumari Panna (left) and Atosi Shit (right).
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  • CAPTION: Adolescent client Tulika Shit has a lower respiratory tract infection. Many adolescents in this area have tuberculosis (TB) but don’t realize it. So Dr Ram Chandra Soren is checking whether her symptoms add up to this. ARSH clinics provide services that extend far beyond reproductive and sexual health. They are far more accessible to young people than the outpatient department (OPD) at the hospital is, ensuring they can get the services they need quickly. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Sarita Kumari Panna (left) and Sujata Shit (right).
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  • CAPTION: Sahiya Anupma Soren takes a monthly session with the 15-19-year olds. The discussion covers delaying the age of marriage, antenatal care, where the ARSH clinic is and what it does, the methods of family planning that the facility can help with, and what their respective pros and cons are. The Government requires these sessions to be conducted monthly. Sahiyas are given an incentive of ₹ 75 per session they lead. The girls are asked to come on a regular basis, as the knowledge imparted builds over time. LOCATION: Pawra Anganwadi Centre (AWC), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Anupma Soren, Pritilata Giope, Sarshati Hansda, Maya Namata and Kajal Namata.
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  • CAPTION: This group is considering sexual changes, such as the start of the menstrual cycle. Girls tend not to be aware that this is coming up, as parents and even the health system tend not to orient them on it. Then, when bleeding happens for the first time and it shows through a girl’s clothes, she may feel very embarrassed. So adolescents, schools, parents, and other family members all need to be sensitized. A similar example in the case of boys is night emissions after 'wet dreams'. The first time this happens, the boy may be very startled. In the rural Indian cultural context, boys are unlikely to want to talk about it with parents or healthcare professionals, nor are these people likely to want to talk about what's happening for them. Often, boys will consult 'quacks' or low-cost books available in local markets, and may get information that's far from the truth. Again, ways to tackle this must be considered. LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Sunita Patra, Jayashree Sawayan, Dr Jagannath Hembrom, Suhagini Kisku and Sefali Dandapat.
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  • CAPTION: Mahila Samakhya students act out a role-play. In the play, the old lady’s granddaughter has just started menstruating. She is worrying about what’s happening her, so goes to her grandmother and asks why this is suddenly happening to her. The old lady reassures her that it happens to every woman; that it also happened to her, and that there’s nothing to worry about, everything will be alright. The girl who then comes along is playing the role of a sahiya. She is visiting the household, and reassures the girl that it’s a natural process for all young girls, and goes on to explain how to take care of nutritional intake including supplementation during this period, and also how to be clean and hygienic. She then assures her that if she experiences very bad pain, she can come to her for some medicines. LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Foreground, from left to right: Shobha Pareya, Sita Kujur, Ganga Purti and Salomi Horo; background: multiple people.
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  • CAPTION: The Mahila Samakhya girls have split up into groups to draw the physical changes that occur in male and female bodies during adolescence. This is done pictorially, because this makes it easier for them to memorize. LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Shobha Pareya, Ganga Purti, Sakro Hembrom, Hisee Murmu, Malti Laguri and Shobha Pareya.
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  • CAPTION: 13-year-old Chowdamma could only stand rooted to the spot when she first started attending her local After-School Club (ASC) five years ago. She has a learning disability, and was afraid to communicate with the other children in any way at all. Under her ASC tutor's careful strategic guidance, she has been able to build her confidence levels dramatically. LOCATION: Marialla (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Chowdamma.
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  • CAPTION: Ningarajamma is a flower vendor. Thanks to the Chamkol programme's Revolving Fund Scheme, she has been able to invest in this business and in turn make it easier for her family to support her brother Jawara Naik, who has a severe learning disability. LOCATION: Alduru (village), Santhemarahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Ningarajamma (left) and Jawara Naik (right).
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  • CAPTION: Every self-help group (SHG) has various office-bearing positions, including chairperson (right) and treasurer (left). LOCATION: Doddarayapete (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Suvarna; right: Shobha.
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  • CAPTION: As an elected member of the Karnataka State Children’s Parliament, Sushma Rani recently met the state's Chief Minister. She had been chosen to represent children with disabilities, and thought carefully about what she could say to him that would be most useful for those whose name she was speaking in. She recognises that she’s become a role model for children with disabilities, and says she hopes to motivate others to follow in her footsteps and speak up for their rights. LOCATION: Bogapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Tejaswini; right: Sushma Rani.
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  • CAPTION: Inaccessible toilets in schools prove a tremendous challenge to children with disabilities. Teachers may not always be on hand to help out, nor may they appreciate needing to do so. The Chamkol programme therefore provides for School Inclusion Audits and Plans to be carried out by Pupils' Clubs with a view to correcting these flaws. LOCATION: Bogapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Lingaraju (left) and Shivakumar M. (right).
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  • CAPTION: When her mother is unable to attend, Padma stands in for her at their local self-help group (SHG) meetings. This is made up of people from their locality who either live with a disability or have a close family member who does. In their case, Padma's brother Shesh Naik lives with multiple disabilities, including cerebral palsy. LOCATION: Amchawadi (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Padma, Sakamma, Chikkatayamma and unknown.
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  • CAPTION: Under the Chamkol programme, anganwadi (pre-school) workers like Shashikala will soon start receiving focussed training on ways to minimise the risk of disability during pregnancy, childbirth or infancy, on how to identify and respond to suspected impairments and how to care for, nurture and support children with different impairments. LOCATION: Uttuvalli (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Pavitra, Komala and N. Shashikala.
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  • CAPTION: As After-School Club (ASC) Coordinator Ravikumar observes, Mahadev Swamy - who has speech and hearing difficulties - engages with non-disabled participants in an exercise taught during recent training by The Teacher Foundation (TTF). LOCATION: Bydamudlu (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Ravikumar, Mahadev Swamy, K. Mahesh and Madhulakshmi.
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  • CAPTION: For many years, Mantesh - who has a learning disability - would hardly communicate with other children or even with his parents. His mother Roopa supports him with his Individual Education Plan (IEP), which includes his attendance at his local After-School Club (ASC). This is very important in developing his self-belief. Just ensuring he attends regularly is a challenge, so it helps if his mother drops him there directly herself, and then meets him once the session is over. LOCATION: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Roopa (left) and Mantesh (right).
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  • CAPTION: Over the course of six months, Karthik’s Home-Based Educator (HBE) Honnamma (pictured, right) helped him learn to dress himself, identify his parents, indicate that he’s hungry and eat with assistance. This represents marked progress; when she first started working with Karthik, who has cerebral palsy, he could not even feel sensations or react to stimuli. LOCATION: Mudnakudu (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Manjula, Karthik and Honnamma.
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  • CAPTION: Nirmala has speech problems owing to jaw disfigurement. Thanks to Mobility India, she has benefited from surgery, and now works as a tamarind de-seeder. Soon, she will be taking up livelihood training for other income-earning activities. LOCATION: Doddarayapete (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Nirmala.
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  • CAPTION: Gathering PIMMS data. Mobility India and CBM have partnered with Aptivate to develop a simple means of collecting key project-relevant data using relatively unsophisticated mobile phones. LOCATION: Sappayyanapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Sudhamani R.; right: Doddamma.
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  • CAPTION: Madhushree has a profound learning disability. Chinnaswamy and his family are determined that in spite of this, she should be able to enjoy a gradually improving quality of life. To assist with making this a reality, Mobility India have helped to draw up an Individual Education Plan (IEP) that is tailored to Madhushree’s specific needs. Together with her local After-School Club (ASC) coordinators, her family have resolved to work with her to meet each goal that’s been set in this plan in turn. Activities in Madhushree’s plan include brushing her teeth, eating and bathing without support and identifying colours. LOCATION: Heggotara (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Chinnaswamy, Madhushree and Asha.
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  • CAPTION: Pallavi, who is unable to speak, was recently assisted by Mobility India to enrol in vocational training courses to develop computing, tailoring and beautician skills. Now that she has had a taste for the sorts of work she could do, she is keen to redouble her efforts and get a good job that will draw on the skills she’s gained. LOCATION: Naviluru (village), Santhemarahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Pallavi.
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  • CAPTION: For a long time, Madhushree's mother Bhagya thought that her daughter was a bit of a slow learner, and she had no idea why. Nobody told her that her daughter had autism, and how autistic children could be helped to develop and thrive. During the earliest days following the birth of a child who has (or develops) a disability, parents often struggle to work out what best they can do for him or her, and could use more information and firmer direction. Under the Chamkol programme, such children aged between zero and five and their mothers, expectant mothers and women of child-bearing age will be able to get this through health, wellbeing, development and pre-school programmes run through Early Years' Clubs. LOCATION: Masagapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Bhagya, Megha and Madhushree.
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  • CAPTION: Geetha's daughter Priyanka tends to vomit up what she is fed, and Geetha had to experiment a lot to find ways to feed her so that this doesn't happen. Priyanka also goes through regular periods of almost non-stop crying. During the earliest days following the birth of a child who has (or develops) a disability or special needs, parents often struggle to work out what they can do for him or her, and would find more information and direction useful. Under the Chamkol programme, children aged between zero and five and their mothers, expectant mothers and women of child-bearing age will be able to get this through health, wellbeing, development and pre-school programmes run through Early Years' Clubs. LOCATION: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Geetha (mother) and Priyanka (daughter).
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  • CAPTION: Anaganwadi (pre-school) Supervisor Jayalakshmi observes anganwadi feeding. Under the Chamkol programme, anganwadi workers will soon start receiving focussed training on ways to minimise the risk of disability during pregnancy, childbirth or infancy, on how to identify and respond to suspected impairments and how to care for, nurture and support children with different impairments. LOCATION: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Jayalakshmi, Nagamma H.S., Aishwarya, Mahadevamma, Bhavani and Mahadevprasad.
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  • CAPTION: Accredited Social Health Activist (ASHA) Supervisor Lakshmi meets with Taluk Health Officer Dr Mallika to discuss ASHA incentives. Under the Chamkol programme, ASHAs will soon start receiving focussed training on ways to minimise the risk of disability during pregnancy, childbirth or infancy, on how to identify and respond to suspected impairments and how to care for, nurture and support children with different impairments. LOCATION: Chamarajanagar (town), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Mallika B. (left) and Lakshmi C. (right).
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  • CAPTION: Mobility India's Sudhamani R. trains Drakshayani in the skills she'll need as an After-School Club (ASC) Coordinator. LOCATION: Handrakalli Mole (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Sudhamani R., Chinnu and Drakshayani.
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  • CAPTION: After-School Club (ASC) Coordinator Asha, who herself has scoliosis, leads children in a card game. The game is very visual, designed to be inclusive for those children who struggle to recognise words. LOCATION: Heggotara (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Megha M., Chennanjamma and Asha.
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  • CAPTION: Visually impaired self-help group (SHG) member Shivaraju proudly displays the bus pass that his membership of the group has helped him to secure. LOCATION: Amchawadi (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Shivaraju; right: Madamma.
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  • CAPTION: Daya Nidhi Shit is a retired government worker who is very active in the community. He says he is especially keen on COPE because it is ensuring access to much in healthcare that was previously unavailable in this block. Here, he is raising the issue of non-availability of appropriate medicines for snake and dog bites. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Damodar Shit.
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  • CAPTION: . LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Nirmala Shukla, Panchami Namta and Susmita Mardi.
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  • CAPTION: Dr Ram Chandra Soren is the Medical Officer-in-Charge in this area. Here, he is training Community COPE members on how efficiency can be improved. This involves consideration of how best to draw up a work plan, how to gather knowledge, how work can then be done, how follow-ups can be done, how analysis of what’s been done should happen, how information gathering should again happen, and so on. The cycle aims for quality improvement, and is continuous, not a one-time thing. Benchmarks are regularly set and reviewed. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Ram Chandra Soren.
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  • CAPTION: Shyam Bahadur Sonar has been engaged with the Community COPE initiative for the past six months. In the community, he is a cricket coach and talent scout, and he's also politically active. He has been a particularly active COPE member, providing a great deal of insight during the scoping phase. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Shyam Bahadur Sonar.
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  • CAPTION: Community COPE is promoting institutional delivery, and is raising awareness that the Government has set aside money to facilitate this through the Janani Suraksha Yojana (JSY) scheme. This roughly translates as 'New Mother’, and provides ₹ 1,400 for the mother and newborn child. This lady has received this money directly to her bank account, yet it turns out she’s unaware of this. Here, Vandana Maitry is assuring her that the money is there and she can withdraw it. During the initial days after birth, it’s especially important that the baby should get adequate nutrition. The system was changed to ensure mothers would get the money and it wouldn’t fall into the wrong hands, but the problem is that husbands or heads of households can also appropriate it under the new system. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Sarita Kumari Panna (left) and Atosi Shit (right).
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  • CAPTION: Community COPE members discuss steps being taken by Dr Ram Chandra Soren, the Medical Officer-in-Charge, and the sahiyas to deal with the problem of snake and dog bites. Dr Ram has explained that medicines are on the way, so the members are now discussing how the Community COPE team can assist with ensuring people get the knowledge they need on obtaining the necessary medicines from the hospital. Most of the time, people go for magical solutions through faith healers. Many people have died from these bites (including from rabies) in this area. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Multiple people.
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  • CAPTION: The lady on the right is a sahiya. She serves as a link between the health system and the community, working at the grassroots in villages. Every village has at least one sahiya. They help health service professionals understand what community needs are and what issues community members are facing. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Ram Chandra Soren (left) and Rupali Shit (right).
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  • CAPTION: Dr Ram Chandra Soren, the area’s Medical Officer-in-Charge, notes that adolescents tend to be reluctant to visit their CHCs, preferring private clinics and 'quacks', because they assume that they will not get what they need there, or that there will be insufficient privacy. He assures them that they can get what they need from the ARSH clinic with full privacy and confidentiality. Changing awareness about this has resulted in significant positive changes, such as a marked reduction in septic abortions. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Ram Chandra Soren.
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  • CAPTION: This is the Adolescent Reproductive and Sexual Health (ARSH) clinic at Ghatshila Community Health Centre (CHC). Atosi Shit (right) is an adolescent client, and Sarita Kumari Panna (left) is an ARSH Counselor. Here, Kumari is giving information on hygienic practices during the menstrual cycle in order to guard against infection and possible infertility. The ARSH clinics have been designed to provide health-related services to young people aged between 10 and 19 at a time when they are going through a lot of changes, both physically and mentally. This can mean anything from getting a small wound dressed to getting an abortion. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Sarita Kumari Panna (left) and Atosi Shit (right).
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  • CAPTION: Dr Ram Chandra Soren is the area’s Medical Officer-in-Charge. He oversees the ARSH clinic here. He says that they’ve seen a lot of changes since the clinic opened. At first there were around 20 clients; this has grown to approximately 250. Though he studied and started his career in Orissa, Dr Ram is originally from this community and this gives him a great level of acceptance among the community members, which makes it very easy for him to communicate with them. People also know that he’s approachable outside of the regular office hours. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Ram Chandra Soren.
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  • CAPTION: Sahiya Anupma Soren quizzes the girls on such subjects as the legal age of marriage, their daily nutritional needs and the foods that can provide these, the sort of medical advice that’s available for them, etc. There are two groups in the room. One is made up of married adolescents, aged 15-19, which discusses delaying the age of marriage, the different methods of family planning that are available, and antenatal care; the other consists of 10 to 14-year olds, with some school-going girls and some school dropouts, and this group focuses in a big way on nutrition, menstrual hygiene, and developmental changes. LOCATION: Pawra Anganwadi Centre (AWC), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Anupma Soren (standing, left) and multiple others.
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  • CAPTION: Sahiya Anupma Soren takes a monthly session with the 15-19-year olds. The discussion covers delaying the age of marriage, antenatal care, where the ARSH clinic is and what it does, the methods of family planning that the facility can help with, and what their respective pros and cons are. The Government requires these sessions to be conducted monthly. Sahiyas are given an incentive of ₹ 75 per session they lead. The girls are asked to come on a regular basis, as the knowledge imparted builds over time. LOCATION: Pawra Anganwadi Centre (AWC), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Anupma Soren, Pritilata Giope, Sarshati Hansda, Maya Namata, Kajal Namata and Sunita Murmu .
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  • CAPTION: Sahiya Anupma Soren takes a monthly session with the 15-19-year olds. The discussion covers delaying the age of marriage, antenatal care, where the ARSH clinic is and what it does, the methods of family planning that the facility can help with, and what their respective pros and cons are. The Government requires these sessions to be conducted monthly. Sahiyas are given an incentive of ₹ 75 per session they lead. The girls are asked to come on a regular basis, as the knowledge imparted builds over time. LOCATION: Pawra Anganwadi Centre (AWC), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Anupma Soren, Pritilata Giope, Sarshati Hansda, Maya Namata and Kajal Namata.
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  • CAPTION: This is a training of frontline workers (FLWs): auxiliary nurse midwives (ANMs) and lady health visitors (LHVs). The latter supervise ANMs. Across the state, there are more than 2,000 FLWs. The Government-approved plan states that these individuals must have five days of training on adolescent reproductive and sexual health matters. It is being conducted by Dr Jagannath Hembrom, a ‘Master Trainer’. His role is more as a facilitator than a teacher. There is a pool of 67 such master trainers in Jharkhand, and Dr Jagannath is recognized as one of the best of these.  LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Dr Jagannath Hembrom; right: multiple people.
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  • CAPTION: This group is considering sexual changes that adolescents go through. The idea that these things should even be discussed is often resisted by the trainees, and this often comes up in a big way during the first day of training. However, as the days unfold, they are encouraged to open up and relax, and generally a much more positive attitude to such discussion evolves by the end of the program. LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Suhagini Kisku, Sefali Dandapat and Sarojini Mahato.
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  • CAPTION: The final group is listing out the various mental and social changes experienced by adolescents. One of these is the development of attraction to the opposite sex. It is impressed upon participants that this is something natural that happens to everyone, and that it should not be condemned as something 'bad'. Another is that girls start wanting to make themselves appear as beautiful as possible to others. Boys, meanwhile, might like to drive very fast in front of others, or smoke and take drugs. The group is considering the consequences of these things and how they may be addressed. After discussing these things, the groups join together and discuss what they have each found. This then leads to the enactment of role-plays. LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Ratna Das Banerjee, Kalpana Mahato, Savita Horo and Krishna Chakrabarty.
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  • CAPTION: Mahila Samakhya students act out a role-play. In the play, the old lady’s granddaughter has just started menstruating. She is worrying about what’s happening her, so goes to her grandmother and asks why this is suddenly happening to her. The old lady reassures her that it happens to every woman; that it also happened to her, and that there’s nothing to worry about, everything will be alright. The girl who then comes along is playing the role of a sahiya. She is visiting the household, and reassures the girl that it’s a natural process for all young girls, and goes on to explain how to take care of nutritional intake including supplementation during this period, and also how to be clean and hygienic. She then assures her that if she experiences very bad pain, she can come to her for some medicines. LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Ganga Purti (sitting in front), Salomi Horo (lying down) and Shobha Pareya (sitting behind).
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  • CAPTION: Packs of enough sanitary pads for five days are available from the ARSH clinic at the cost of just ₹ 6 (US$ 0.10). Out of this, ₹ 1 goes towards sahiyas’ incentives. Here, the medical officer is explaining the use of sanitary napkins, the cost and where more can be bought (for around ₹ 20) within the community. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Kusum Kumari Bara (left) and Pritee Kashep (right).
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  • CAPTION: The Mahila Samakhya girls have split up into groups to draw the physical changes that occur in male and female bodies during adolescence. This is done pictorially, because this makes it easier for them to memorize. LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Moni Suren, Rajni Lakra, Tara Among and Roshni Hembrom.
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  • CAPTION: Shanti Toppo is married. She would like there to be a gap before she has her second child. Health worker Dr Kusum Kumari Bara suggests two options for her, firstly the Copper T, which allows the user to delay pregnancy for a longer period, and secondly the condom, which must be used by her husband. It is stressed that the condom is the only thing that also prevents spread of reproductive tract infections (RTIs) and sexually transmitted infections (STIs). The service provider then suggests that it is a good idea to come back along with her husband, so that he can also understand these things. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Kusum Kumari Bara (left) and Shanti Toppo (right).
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  • CAPTION: A trained ANM visits Bethany Convent School in Ratu, Ranchi, and teaches them on sexual and reproductive health through a game. The cards state the physical changes that occur for both boys and girls, and the boys are asked to segregate them by gender and put them in order. This is followed by a discussion. These sessions happen at the school biannually when the school health team visits. A lot more of this work is being done with girls as compared with boys. The reason is that for boys, suitable forums are not so readily accessible. For girls, there are the Mahila Samakhya schools and anganwadi centers. The latter come under the Government’s Ministry of Women and Child Development. The School Health Program, however, is a component of the Adolescent Health Program, which gives importance to both boys and girls. Rashtriya Kishor Swasthya Karyakram (RKSK) (National Adolescent Health Program) was launched this year, doing peer interventions with both boys and girls. LOCATION: Bethany Convent School, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Adult: Raj Kumari Sinha; boys in the foreground: Ritesh Munda (left) and Nikhil Tigga (right).
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  • CAPTION: A trained ANM visits Bethany Convent School in Ratu, Ranchi, and teaches them on sexual and reproductive health through a game. The cards state the physical changes that occur for both boys and girls, and the boys are asked to segregate them by gender and put them in order. This is followed by a discussion. These sessions happen at the school biannually when the school health team visits. A lot more of this work is being done with girls as compared with boys. The reason is that for boys, suitable forums are not so readily accessible. For girls, there are the Mahila Samakhya schools and anganwadi centers. The latter come under the Government’s Ministry of Women and Child Development. The School Health Program, however, is a component of the Adolescent Health Program, which gives importance to both boys and girls. Rashtriya Kishor Swasthya Karyakram (RKSK) (National Adolescent Health Program) was launched this year, doing peer interventions with both boys and girls. LOCATION: Bethany Convent School, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Raj Kumari Sinha, Subhash Gope, Ritesh Munda, Nikhil Tigga, Kuldeep Sahu and Raj Kumar Prajpati.
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  • CAPTION: Under the Chamkol programme, every disabled member of the community has an Individual Health Plan (IHP). For Netrawati, who has scoliosis, this means following a tailor-made exercise regime. During regular visits to her home, Rehabilitation Therapy Assistant (RTA) Kavitha shows both her and her mother Nagamma what they need to do. LOCATION: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Netrawati, Kavitha M.L. and Nagamma.
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  • CAPTION: All schools in Kasaba hobli have ramps for wheelchair users, though few were built for the benefit of disabled students; rather, they were put in place for election purposes, to enable disabled voters to attend polling booths during elections. Many, like this one, lie unused and in deteriorating conditions where there may not even be any wheelchair users. Meanwhile, other aspects of school accessibility - such as signs with text that's too small for the visually impaired - go unaddressed. The Chamkol programme therefore provides for School Inclusion Audits and Plans to be carried out by Pupils' Clubs with a view to correcting these flaws. LOCATION: Budhitittu (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Sanjana (above), Pradeep S. (below), Rajeshwari R., Kavya R.S., Nagendra and Rajesh.
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  • CAPTION: Jayamala keeps an eye on Madhushree while leading a game at her anganwadi (pre-school). Through the Chamkol programme's Early Years' Clubs, anganwadi workers like Jayamala will play more of a role in the lives of the youngest children with special needs, like Madhushree, who has autism. LOCATION: Masagapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right (visible faces only): Madhushree, Jayamala, Chamdama M., Radhika B., Chamdama M. and Aishwarya S.
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  • CAPTION: Fortunately for Shilpa, ramps are one aspect of school accessibility that Kasaba's schools have in place. However, many are too steep, while many other aspects of accessibility - such as toilets and signage - also need urgent attention. The Chamkol programme therefore provides for School Inclusion Audits and Plans to be carried out by Pupils' Clubs with a view to correcting these flaws. LOCATION: Heggotara (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Shilpa N. (in wheelchair) and Revanna K. (teacher).
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  • CAPTION: Encouraging and facilitating disabled people's participation in local governance is a very important part of the Chamkol project, something that Shashikumar - who is blind in one eye - is taking the lead in. Today, he’s come to meet the Development Officer at his local gram panchayat (village assembly) to talk about the fact that his self-help group (SHG) doesn’t have a place where it can meet regularly. LOCATION: Hullepura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: K. Nagarajappa; right: Shashikumar.
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  • CAPTION: Steps prove a significant challenge for Ashwin, who has diplegia and can only get around unassisted if on his hands and knees. The Chamkol programme therefore provides for School Inclusion Audits and Plans with a view to correcting these flaws. LOCATION: Mangala Hosuru (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Nagamma (left) and Ashwin (right).
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  • CAPTION: Gathering community data. Mobility India and CBM have partnered with Aptivate to develop a simple means of collecting key project-relevant data using relatively unsophisticated mobile phones. LOCATION: Sappayyanapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Mariswamy, Manu and Nandini A.C.
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  • CAPTION: Rajamma, who has severe rheumatoid arthritis, gets around her home by crawling. She has a new wheelchair, but her mother Mahadevamma will not be able to wheel her into and out of her house in this until construction of the ramp up to the doorway has been completed. LOCATION: Amchawadi (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Rajamma (left) and Mahadevamma (right).
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  • CAPTION: Shobha has taken up a job as a sweeper at Vijaya Bank in order to help support her two brothers, Siddaraju and Shivaraju, who both have severe learning disabilities. Through the Chamkol programme, families like hers are able to get support in devising Individual Livelihood Plans to build pathways out of poverty. LOCATION: Mudlumole (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Siddaraju, Jayamma, Shivaraju and Shobha.
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  • CAPTION: Mantesh, who has a learning disability, hardly communicates with other children or even with his parents. His family is keen for him to get involved in the local Chamkol programme-supported After School Club (ASC), but feels the challenge lies in getting him to attend and participate. His case worker will therefore be working with him according to his Individual Education Plan (IEP) to help him develop his self-belief, and also with his mother, who needs encouragement to believe in him. LOCATION: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Mantesh (left) and Vathsalakumari (right).
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  • CAPTION: After-School Club (ASC) Coordinator Doddamma, who herself has rheumatoid arthritis, works on an activity designed under a visually impaired child's Individual Education Plan (IEP). LOCATION: Doddarayapete (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Gowtham S. (left) and Doddamma M. (right).
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  • CAPTION: Sushma has a form of cerebral palsy called diplegia. She needs almost constant care. During the earliest days following the birth of a child who has (or develops) a disability, parents often struggle to work out what best they can do for him or her, and could use more information and firmer direction. Under the Chamkol programme, such children aged between zero and five and their mothers, expectant mothers and women of child-bearing age will be able to get this through health, wellbeing, development and pre-school programmes run through Early Years' Clubs. LOCATION: Mangala (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Ambika (left) and Sushma (right).
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  • CAPTION: Sheela has a small business making food and drinks for local schoolchildren. Through this, she is able to support her daughter Nandini, who has a learning disability. She plans to soon take advantage of a loan provided through the Chamkol programme's Revolving Fund Scheme in order to upgrade her shop stock. Here, we see Nandini helping her mother to make tea to sell. LOCATION: Alduru (village), Santhemarahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Nandini (left) and Sheela (right).
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  • CAPTION: The Chamkol programme supports the government's response to the health and wellbeing of individuals with or at disk of disability. For Primary Health Centre (PHC) workers such as Dr Prasad, this means informal support during disability screenings, vaccination and immunisation outreaches. LOCATION: Panyadhundi (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Prasad P.M. (left) and Navida Begum (right).
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  • CAPTION: Under the Chamkol programme, every disabled member of the community has an Individual Health Plan (IHP). For Doddamma, this includes basket weaving as an exercise to help address her rheumatoid arthritis. This has the added benefit of being an income-generating activity. LOCATION: Doddarayapete (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Doddamma M.
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  • CAPTION: At the end of a classroom session, Hemavathi gets the children to do a group work exercise that reviews, in a fun way, what has been taught. This is a particularly inclusive technique, which she learned during training by The Teacher Foundation (TTF). In spite of his locomotor disability, Sidaraju (centre) feels very much a part of the action. LOCATION: Mangala (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right (visible faces only): Mallikarjuna, Sidaraju, D. Mahendra, B.P. Hemavathi, S. Asha and Rachana.
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  • CAPTION: Doddamma is almost completely blind. Her local self-help group (SHG) helped her come together with a small number of other blind women to form an income-generating group. After each contributed an upfront investment to enable them to buy the raw materials they needed, they started making banana leaf bowls to satisfy the demand of street food vendors. LOCATION: Hullepura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Doddamma.
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  • CAPTION: Inclusive Education Resource Teachers (IERTs) such as Kiran are one of the government's primary resources for inclusive education, and great allies for the Chamkol programme. They are responsible for identifying those children who have special educational needs and assessing what should be provided for them. Here, Kiran is leading a training session of parents and siblings of people with learning disabilities. LOCATION: Haradanahalli (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Kiran.
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  • CAPTION: Accredited Social Health Activist (ASHA) Gurushanthi administers the polio vaccine to Mahendra while his mother holds him. Through the Chamkol programme's Early Years' Clubs, ASHAs like Gurushanthi will play more of a role in the lives of the youngest children with disabilities, like Mahendra, who has cerebral palsy. LOCATION: K K Hundi (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Chiktayamma, Mahendra and Gurushanthi.
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  • CAPTION: Partially visually impaired After-School Club (ASC) Coordinator Chethankumar leads 'Cheering Up', a highly inclusive exercise that gets the children enthusiastic about engaging with one another. This is one of the steps in Quality Circle Time (QCT), recently taught to all of Kasaba's ASC Coordinators. LOCATION: Mangala Hosuru (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Santhosh, Nagasundra, Kavitha, Arathi, Chethankumar and Ashi.
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  • CAPTION: Using a loan from her local self-help group (SHG), Shivamma has set up a petty shop to help cover the costs associated with her daughter Saraswathi's learning disability. LOCATION: Mangala Hosuru (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Shivamma (left) and Saraswathi (right).
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  • CAPTION: Manju's son Sagar was born with clubfoot and hands. Thanks to timely interventions, he has been making great progress. During the earliest days following the birth of a child who has (or develops) a disability, parents often struggle to work out what best they can do for him or her, and could use more information and firmer direction. Under the Chamkol programme, such children aged between zero and five and their mothers, expectant mothers and women of child-bearing age will be able to get this through health, wellbeing, development and pre-school programmes run through Early Years' Clubs. LOCATION: Melagipura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Pushpalata, Santosh, Sagar, Manju and Chenajamma.
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  • CAPTION: Using a loan from his local self-help group (SHG), Mariswamy has set up a petty shop to help cover the costs associated with his son Manu's club foot. LOCATION: Sappayyanapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Mariswamy, Manu and Meelamma.
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  • CAPTION: Ningaraju's mother Rajamma has joined her local self-help group (SHG), made up of people from their locality who either live with a disability or have a close family member who does. Borrowing money from the SHG makes meeting the costs associated with Ningaraju's condition (club foot) considerably easier. LOCATION: Sappayyanapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Rajamma; right: Ningaraju S.R.
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  • CAPTION: Basavashetty is totally blind in the left eye and mostly blind in the right. He feels his way around his home, and could greatly benefit from wall bars to help with this. LOCATION: Sagade (village), Harave (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Basavashetty.
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  • CAPTION: Shesh Naik has multiple disabilities, including cerebral palsy. His only mobility comes through wheelchair use, and he's totally dependent on family members to wheel him around. He still needs a ramp to be constructed, so that they will be able to get him into and out of the family home. LOCATION: Amchawadi (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Padma, Shesh Naik, Raghu and Latha.
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  • CAPTION: Following an accident, Pradeep (pictured, front) had to have his hand amputated. In order to ensure he'd be able to meet the costs associated with his special needs over the years, his father Jayanna borrowed from the Chamkol Programme's Revolving Fund Scheme and started a small sheep rearing business. LOCATION: Heggawadi (village), Santhemarahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Jayanna, Kumari, Prathap and Pradeep.
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  • CAPTION: The core activity of Chamkol is the enablement and support of self-help groups (SHGs) in every village and their democratic representation through local Grassroots Federations (GRFs). The overarching body in this structure is the Chiguru Committee, of which inspirational Jayamma H.R. (right) held the presidency until December 2013. LOCATION: Heggotara (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Doddamma M.; right: Jayamma H.R.
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  • CAPTION: Home-Based Educator (HBE) Sakamma has been able to help eight-year-old Sangeetha, who has cerebral palsy, improve her fine motor skills by playing with various teaching and learning materials. Sangeetha has also learned to recognise regular visitors to her home, and to say simple words like amma ('mother'). Over the lifetime of the Chamkol programme, Sakamma says we can expect Sangeetha to start walking, and also to learn to write a little and turn those single words into full sentences. LOCATION: Amchawadi (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Sakamma (left) and Sangeetha (right).
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  • CAPTION: On the right is Damodar Shit, a retired teacher, and a new and instrumental member of Community COPE. He has been very helpful in the education domain, even before joining, working in schools and bridging the gap between schools and the health system. In the center is Daya Nidhi Shit, a retired government worker who is very active in the community. He says he is especially keen on COPE because it is ensuring access to much in healthcare that was previously unavailable in this block. Here, he is raising the issue of non-availability of appropriate medicines for snake and dog bites. On the right is Shiv Shankar Chandra, Community COPE's storekeeper. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Daya Nidhi Shit, Damodar Shit and Shiv Shankar Chandra.
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  • CAPTION: Vandana Maitry, center, is again a very active member of Community COPE and a part of the panchayati raj system. She also works as a trainer of sahiyas at the block level. Accredited Social Health Activists (ASHAs) work at the grassroots level in the health system; they are called sahiyas in Jharkhand, which means 'people’s helping hand'. Vandana is particularly active in helping to keep hospital premises clean. She serves an educative role, working to ensure trashcan usage increases, spitting is prevented, and people use toilets properly, especially as many are reluctant not to use open spaces for defecation. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Bisu Murmu, Vandana Maitry and Parwati Murmu.
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  • CAPTION: Community COPE members come to ask a householder about what her expectations of the health system are and what she feels ought to be done to get more people into the Government-run Community Health Centre (CHC). The men and women have teamed up here; mostly the men talk with the male heads of households. This lady has been living in this community for around 40 years since marriage. She has observed many changes in health service provision. She says that the panchayati raj system has brought significant health service changes for her, which she’s very happy about. She says that people hear from the newspapers and TV what they can access. The newly-elected female panchayati raj members, reserved 50% of the positions as part of women’s empowerment efforts, have been very active in changing how the government system works and serves people. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Vandana Maitry, Kalicharan Namata, Shyam Bahadur Sonar and Rupa Namata.
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  • CAPTION: Adolescent client Sujata Shit is getting her blood pressure checked. She came to the ARSH clinic complaining of weakness and a spinning head. Most of the girls with anemia have low blood pressure. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Sarita Kumari Panna (left) and Sujata Shit (right).
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  • CAPTION: Adolescent Rakhi Shit is being taught about family planning methods. The counselor Sarita Kumari Panna is telling her about the different options available to her. This information is not considered something that should be given only after marriage; it is recognized that sexual activity could happen before as well, even though this is culturally unacceptable. Most of the girls here (and also the boys) are unaware that the condom is something that can be used to prevent STIs - including AIDS - and unwanted pregnancy. Owing to this ignorance, under-age pregnancies are quite common, and abortions - including unsafe illegal ones - are being sought. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Sarita Kumari Panna (left) and Rakhi Shit (right).
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