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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: Catherine Anaso is seen here playing with her last-born child, after his morning bath. Catherine's husband is David Alele, a Pentecostal Assemblies of God (PAG) health champion. The family live together in Kaberamaido, where they are subsistence farmers. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Catherine Anaso (left) and Silas Oper (right).
    Worldrenew_kaberamaido-2550.jpg
  • 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).
    058_IMG43934.jpg
  • CAPTION: Catherine is all smiles as she serves food to her first-born child Innocent and her husband David. In Uganda, it is traditional for women to kneel down when serving their menfolk. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Catherine Anaso, Innocent Jacob Okot and David Alele.
    Worldrenew_kaberamaido-2652.jpg
  • 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: 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: 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: 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.
    042_IMG44403.jpg
  • 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: 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).
    IMG44747.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: 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.
    IMG45352.jpg
  • CAPTION: Aishwarya's legs are so weak, she cannot stand without support. She also goes through long periods of constant 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 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: Mallianpura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Nagamma H.S. (left) and Aishwarya (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: 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: 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.
    049_IMG43662.jpg
  • 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.
    046_IMG44330.jpg
  • 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: 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.
    050_IMG43472.jpg
  • 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: 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: 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: 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: Christopher Onyimo has a large family. He and his wife (not pictured here because she has gone away to study) have seven children. In this picture, Christopher poses with his daughter-in-law, some of his children and grandchildren. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Unknown, Anthony Oryokot, Christopher Onyimo, Kenneth Onyimo, Rebecca Aniko, unknown, unknown, unknown and Vicky Atimo.
    Worldrenew_kaberamaido-2828.jpg
  • CAPTION: Florence Agabo with her husband Dominic Ekaju and their children. Dominic is a primary school teacher, but the family also farm in order to supplement their income. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Damali Ilimu, John Ekaju, Abraham Ekeju, Dominic Ekaju, Francis Eyunu, Innocent Emalu, Florence Agabo, Pekula Adiao, Sarah Amwodo and Pascal Akora.
    Worldrenew_kaberamaido-2859.jpg
  • CAPTION: Catherine Anaso together with her husband and their children: a family portrait. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: David Alele, Catherine Anaso, Silas Oper, Daniel Owange, Innocent Jacob Okot, Cecilia Acwichi and Nancy Acen.
    Worldrenew_kaberamaido-2555.jpg
  • CAPTION: Onlookers on the shore of Lake Kyoga, at different levels of excitement and anxiety, as they support their favorites in the Kaberamaido Boat Race. LOCATION: Lake Kyoga, Abrepoli, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Multiple people.
    Worldrenew_kaberamaido-9637.jpg
  • CAPTION: Since starting adult education, Florence has enjoyed studying alongside her children at home. Sometimes she is even able to assist them with their homework. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Florence Agabo, Francis Eyunu and Sarah Amwodo.
    Worldrenew_kaberamaido-2896.jpg
  • CAPTION: Florence Agabo with her husband Dominic Ekaju and their children. Dominic is a primary school teacher, but the family also farm in order to supplement their income. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Damali Ilimu, John Ekaju, Abraham Ekeju, Dominic Ekaju, Francis Eyunu, Innocent Emalu, Florence Agabo, Pekula Adiao, Sarah Amwodo and Pascal Akora.
    Worldrenew_kaberamaido-2857.jpg
  • CAPTION: Christopher Onyimo has a large family. He and his wife (not pictured here because she has gone away to study) have seven children. In this picture, Christopher poses with his daughter-in-law, some of his children and grandchildren. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Unknown, Anthony Oryokot, Christopher Onyimo, Kenneth Onyimo, Rebecca Aniko, unknown, unknown, unknown and Vicky Atimo.
    Worldrenew_kaberamaido-2832.jpg
  • CAPTION: Catherine eats a meal of boiled sweet potatoes and bean stew with four of her five children. Sweet potatoes are a staple food for the people of Kaberamaido; their other staples are cassava and corn. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Catherine Anaso, Silas Oper, Cecilia Acwichi, Nancy Acen and Daniel Owange.
    Worldrenew_kaberamaido-2664.jpg
  • CAPTION: Catherine Anaso and her family having lunch together. In this culture, the father sits together with his first-born son, while the rest of the children eat to one side with their mother. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Catherine Anaso, Cecilia Acwichi, Nancy Acen, Daniel Owange, Innocent Jacob Okot and David Alele.
    Worldrenew_kaberamaido-2663.jpg
  • CAPTION: Innocent, pictured left, is one of five children born to David (right) and his wife Catherine. What they farm is enough for home use; a little is also taken to the market for sale. David is a health champion through the Kaberamaido Mission Program of the PAG church, a partner of World Renew. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Innocent Jacob Okot (left) and David Alele (right).
    Worldrenew_kaberamaido-2653.jpg
  • CAPTION: Catherine’s children, immersed in their studies at home in Kaberamaido. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Nancy Acen, Innocent Jacob Okot and Cecilia Acwichi.
    Worldrenew_kaberamaido-2626.jpg
  • CAPTION: A spectator beams with delight as a crowd watched the spectacle that is the Kaberamaido Boat Race. LOCATION: Lake Kyoga, Abrepoli, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Unknown; multiple people in the background.
    Worldrenew_kaberamaido-9632.jpg
  • 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: 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: 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: 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: 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, 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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, Anjana Hembrom 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: The trainer is teaching the girls about the menstrual cycle, what it means for them, and how they can take care of their needs after it begins. LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Adult: Rajni Lakra; children: multiple people.
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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: 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: Salomi Horo, Shobha Pareya, Sita Kujur and Ganga Purti; background: multiple people.
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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: Class photo at Mahila Samakhya's residential school in Ratu, Ranchi. Mahila Samakhya takes on young women who’ve been abandoned or sexually abused, and teaches them with a view to mainstreaming them back into society, including the area of sexual and reproductive rights. It is a national-level NGO, and is working in 11 districts in Jharkhand. Last year, EngenderHealth worked with the Government to bring Mahila Samakhya into the Rashtriya Kishor Swasthya Karyakram (RKSK) (National Adolescent Health Program). LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Adults: Malti Laguri (left) and Rajni Lakra (right); children: 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: Moni Suren, Rajni Lakra, Tara Among and Roshni Hembrom.
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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: 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: 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: 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: 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 Shilpa - seen here addressing a meeting of anganwadi workers - this means informal support during disability screenings, vaccination and immunisation outreaches. LOCATION: Benderwadi (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Shilpa K.N.
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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: 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: 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: 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: 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: 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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  • 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: 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.
    IMG44939.jpg
  • 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 and Kajal Namata.
    IMG44972.jpg
  • CAPTION: This is the group aged 10-14. The song the sahiya is leading is about the nutritional requirements of the adolescent age group, and how nutrition affects their mental, physical, and social development, as well as how important it is for future generations. They are singing in Santhal, the local tribal language. LOCATION: Pawra Anganwadi Centre (AWC), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Multiple people.
    IMG45034.jpg
  • CAPTION: This is the group aged 10-14. The song the sahiya is leading is about the nutritional requirements of the adolescent age group, and how nutrition affects their mental, physical, and social development, as well as how important it is for future generations. They are singing in Santhal, the local tribal language. LOCATION: Pawra Anganwadi Centre (AWC), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Multiple people.
    IMG45015.jpg
  • 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.
    IMG44987.jpg
  • 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: The trainer is teaching the girls about the menstrual cycle, what it means for them, and how they can take care of their needs after it begins. LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Adult: Rajni Lakra; children: Salomi Horo (standing front), Holika Lakraand (standing back) and multiple other people.
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  • CAPTION: Mahila Samakhya takes on young women who’ve been abandoned or sexually abused, and teaches them with a view to mainstreaming them back into society, including the area of sexual and reproductive rights. It is a national-level NGO, and is working in 11 districts in Jharkhand. Last year, EngenderHealth worked with the Government to bring Mahila Samakhya into the Rashtriya Kishor Swasthya Karyakram (RKSK) (National Adolescent Health Program). They have since trained 27 Sayogini and district-level trainers on adolescent issues. From these, they identified 14 to train outreach and frontline workers in facilitation. They are now organizing trainings in the field, contributing to demand generation for adolescent health services. In this image, Aditi Ranjan has arrived at Mahila Samakhya's residential school in Ratu, Ranchi with Dr Satya Mohapatra. The latter is the Program Manager of the Tarunya ARSH India programme; Aditi is the Senior Program Officer with responsibility for four districts in Jharkhand, including Ranchi. LOCATION: Mahila Samakhya, Ratu (block), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Adults, from left to right: Aditi Ranjan, Dr Satya Mohapatra and Rajni Lakra; children: 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: Tara Among, Rajni Lakra, Roshni Hembrom, Birsi Mundu, Moni Suren.
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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.
    IMG45264.jpg
  • 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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