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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: 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 Kumara Naika, pictured here helping Govinda reach his local anganwadi, informal support to service delivery means provision of tailored quarterly training. LOCATION: Badanaguppe (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Kumara Naika (man), Govinda K. (disabled boy) and Puttbassamma (woman).
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  • CAPTION: Until the age of five, Naveen - who has cerebral palsy - was confined to his bed. That was the point at which he got his first life-changing surgery, after which he started to receive training from Mobility India. Rehabilitation Therapy Assistant (RTA) Kavitha patiently worked with him on a one-to-one basis, teaching him how to stand, balance and walk. Since then, he has been an enthusiastic participant at his local After-School Club (ASC). In this image, we see him standing on his own two feet at the front of his class, leading his fellow attendees in a Kannada literacy session under the watchful eye of his ASC tutor. LOCATION: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Naveen Kumar N. (boy) and Vathsalakumari (woman).
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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).
    IMG45360.jpg
  • 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.
    IMG45365.jpg
  • 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, Nikhil Tigga, Subhash Gope, Kuldeep Sahu, Ritesh Munda and Raj Kumar Prajpati.
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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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: SignHealth Uganda often uses its volunteers to put on short dramas at events in order to heighten awareness and challenge the stigmas attached to hearing impairment. In this scene, a boy is performing manual labour in the fields. This is a common occurrence among hearing impaired children, whose parents are embarrassed by them and force them to do hard work instead of sending them to school. LOCATION: Kakunyu Inclusive Nursery and Primary School, Kakunyu Village, near Masaka city, Lweongo District, Central Region, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Geoffrey Kalanzi.
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  • CAPTION: SignHealth Uganda often uses its volunteers to put on short dramas at events in order to heighten awareness and challenge the stigmas attached to hearing impairment. In this scene, a son and his mother cower in fear as the boy’s father vents his anger at having a hearing impaired child. LOCATION: Kakunyu Inclusive Nursery and Primary School, Kakunyu Village, near Masaka city, Lweongo District, Central Region, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Left: Geoffrey Kalanzi; right: Prossy Nassolo.
    SignHealth Uganda-11.jpg
  • 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: 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: In Marikina City, everywhere is a potential playground for children. The local government has started to improve the drains under these boys’ feet in order to reduce the impact of flooding. However, Hilda feels that its measures to prevent flooding in their community could be implemented far faster. LOCATION: Ampalaya Street, Barangay Tumana, Marikina City, Philippines. INDIVIDUAL(S) PHOTOGRAPHED: Unknown.
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  • CAPTION: Dr Ram and his colleagues are forming what they call a 'chain of information', so that even if families don’t allow their youth to seek out the services they need in person, friends can pass on the news about what the ARSH clinic can provide. He observes that another problem is that most families think only of educating their boys on what they need, and just think about marrying their girls off. So it’s important to ensure that girls don’t fall through the net. These four girls are part of the discussion group that’s been established in Ghatshila. They have asked Dr Ram to come to the community college where they are studying nearby and take sessions for all the adolescent girls there to ensure they will then access the services they need. They therefore serve as the link between the college and Dr Ram. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Atosi Shit, Rakhi Shit, Sujata Shit and Tulika Shit.
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  • CAPTION: Dr Ram and his colleagues are forming what they call a 'chain of information', so that even if families don’t allow their youth to seek out the services they need in person, friends can pass on the news about what the ARSH clinic can provide. He observes that another problem is that most families think only of educating their boys on what they need, and just think about marrying their girls off. So it’s important to ensure that girls don’t fall through the net. These four girls are part of the discussion group that’s been established in Ghatshila. They have asked Dr Ram to come to the community college where they are studying nearby and take sessions for all the adolescent girls there to ensure they will then access the services they need. They therefore serve as the link between the college and Dr Ram. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Tulika Shit, Sujata Shit, Rakhi Shit and Atosi Shit.
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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: Standing: Dr Jagannath Hembrom; sitting: multiple people.
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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: Raj Kumari Sinha.
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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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  • 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: Standing: Dr Jagannath Hembrom; sitting (far side, from left to right): Kalpana Mahato, Savita Horo, Krishna Chakrabarty and Shobha Kumari Nirali.
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