Show Navigation

  • HOME
  • SUBMIT A BRIEF
  • CONTACT
  • PAST ASSIGNMENTS

Search Results

152 images

  • Facebook
  • Twitter
x
Refine Search
Match all words
Match any word
Prints
Personal Use
Royalty-Free
Rights-Managed
(leave unchecked to
search all images)
Next

Loading ()...

  • CAPTION: The lessons Florence has learnt have helped her at the women’s group that she’s a member of. During meetings, she is now able to count the money that the the women have collected. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Unknown, Florence Agabo, unknown and unknown.
    Worldrenew_kaberamaido-2926.jpg
  • CAPTION: The lessons Florence has learnt have helped her at the women’s group that she’s a member of. During meetings, she is now able to count the money that the the women have collected. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Florence Agabo.
    Worldrenew_kaberamaido-2940.jpg
  • 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.
    IMG44718.jpg
  • CAPTION: Community COPE members come to ask a householder about what her expectations of the health system are and what she feels ought to be done to get more people into the Government-run Community Health Centre (CHC). The men and women have teamed up here; mostly the men talk with the male heads of households. This lady has been living in this community for around 40 years since marriage. She has observed many changes in health service provision. She says that the panchayati raj system has brought significant health service changes for her, which she’s very happy about. She says that people hear from the newspapers and TV what they can access. The newly-elected female panchayati raj members, reserved 50% of the positions as part of women’s empowerment efforts, have been very active in changing how the government system works and serves people. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Daya Nidhi Shit, Damodar Shit, Shruti Deogam, Punta Hansda and Parwati Murmu.
    IMG44705.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: 70% of rural Uganda’s women are illiterate, which frequently renders them powerless. 39-year-old Florence enrolled onto an adult literacy program run by World Renew’s partner organization, the Kaberamaido Development Mission. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Florence Agabo.
    Worldrenew_kaberamaido-2890.jpg
  • CAPTION: Nirmala Shukla, wearing white, is another member of the panchayati raj system. She is also very active in Community COPE as a part of the information system, bringing its work to the public's attention and serving as a bridge to the press. Shruti Deogam, to her left in orange, is the pramud, the elected head of Ghatshila Block (meaning the highest rank in the panchayati raj system), and is also an important representative of the community to the outside in that she links the block to those higher up at the district level. She is the leader of the Community COPE exercise, and helps to bring in high-level officials to address issues being experienced at the block level. In this line of women (from right to left) we see the pramud (working at the block level), mukhya (village level), Vandana Maitry who is a ward member (village level), and a new Community COPE member. They are discussing what the work plan has addressed so far and what is still to be addressed. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Bisu Murmu, Vandana Maitry, Parwati Murmu, Shruti Deogam, Nirmala Shukla and Shyam Bahadur Sonar.
    IMG44633.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: Raj Kumari Sinha.
    IMG45366.jpg
  • CAPTION: These are sahiyas attached to Ghatshila CHC who've been trained on adolescent reproductive and sexual health, and in how to communicate with adolescent girls on these issues. At the beginning of the sessions they conduct at the anganwadi center (literally: 'courtyard shelter' in Hindi), they start with a song about the importance of young women taking care of their health as they grow up and how important adolescents are in bringing change in their society in the long run. The song includes mention of how everyone has the power to take decisions on their own health, and to change both themselves and society as a whole (which includes the importance of completing Higher Secondary education). LOCATION: Pawra Anganwadi Centre (AWC), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Dipali Baskey, Rupali Shit, Bhasa Sharma, Anupma Soren and Sombari Tudu.
    IMG44917.jpg
  • 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.
    IMG45169.jpg
  • 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.
    IMG45266.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: Doddamma is almost completely blind. Her local self-help group (SHG) helped her come together with a small number of other blind women to form an income-generating group. After each contributed an upfront investment to enable them to buy the raw materials they needed, they started making banana leaf bowls to satisfy the demand of street food vendors. LOCATION: Hullepura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Doddamma.
    022_IMG32255.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-2828.jpg
  • CAPTION: Catherine washes the dishes, following a meal. She used to have multiple sexual partners, something that made her vulnerable to HIV/AIDS. That was until the intervention of a program run by World Renew’s partner, the Kaberamaido Mission Development Program. She now makes sure that her only partner is her husband David, who is himself a health champion in the area. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Catherine Anaso.
    Worldrenew_kaberamaido-2690.jpg
  • CAPTION: Catherine used to have multiple sexual partners, something that made her vulnerable to HIV/AIDS. That was until the intervention of a program run by World Renew’s partner, the Kaberamaido Mission Development Program. She now makes sure that her only partner is her husband David, who is himself a health champion in the area. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Catherine Anaso.
    Worldrenew_kaberamaido-2683.jpg
  • CAPTION: Catherine Anaso prepares a meal of sweet potatoes and beans for her husband and children. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Catherine Anaso.
    Worldrenew_kaberamaido-2609.jpg
  • 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: Relying on one of the instructors for local language support, World Renew volunteer Antony Sytsma delivers a speech during the TLT graduation in Kaberamaido. Andrew was trained by the Christian Reformed World Missions (CRWM) for this work. LOCATION: Kaberamaido, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Unknown (left) and Antony Sytsma (right).
    Worldrenew_kaberamaido-9873.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: World Renew Uganda’s Edward Okiror and his wife show just how excited they feel, after Edward receives his TLT Master Trainer Certification certificate. LOCATION: Kaberamaido, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Edward Okiror (left) and unknown (right).
    Worldrenew_kaberamaido-9914.jpg
  • CAPTION: Peter (right) and his wife Josephine (left) came together to attend the boat race, and Josephine delighted in cheering for her husband as he took part. Here, we see them standing together after the race, in which Peter came third. LOCATION: Lake Kyoga, Abrepoli, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Josephine Isapa (left) and Peter Ongem (right).
    Worldrenew_kaberamaido-9689.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: 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: 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 washes an enamel cup by hand. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Catherine Anaso.
    Worldrenew_kaberamaido-2694.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 used to have multiple sexual partners, something that made her vulnerable to HIV/AIDS. That was until the intervention of a program run by World Renew’s partner, the Kaberamaido Mission Development Program. She now makes sure that her only partner is her husband David, who is himself a health champion in the area. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Catherine Anaso.
    Worldrenew_kaberamaido-2682.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: Part of the crowd of friends and family that came to witness the TLT graduation ceremony. LOCATION: Kaberamaido, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Multiple people.
    Worldrenew_kaberamaido-9918.jpg
  • CAPTION: Catherine Anaso prepares a meal of sweet potatoes and beans for her husband and children. LOCATION: Apapai Parish, Otuboi Sub-county, Kalaki County, Kaberamaido District, Uganda. INDIVIDUAL(S) PHOTOGRAPHED: Catherine Anaso.
    Worldrenew_kaberamaido-2600.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.
    028_IMG32765.jpg
  • CAPTION: Basavanna can see only partially with one eye. He has taken a dairy-related livelihoods training course arranged by Mobility India, specially targeted at people with disabilities. This included several aspects of caring for cows that were unfamiliar to him before. LOCATION: Mudnakudu (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Basavanna (left) and Gowramma (right).
    021_IMG33219.jpg
  • 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).
    IMG44723.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.
    IMG45134.jpg
  • CAPTION: Shanti Toppo is married. She would like there to be a gap before she has her second child. Health worker Dr Kusum Kumari Bara suggests two options for her, firstly the Copper T, which allows the user to delay pregnancy for a longer period, and secondly the condom, which must be used by her husband. It is stressed that the condom is the only thing that also prevents spread of reproductive tract infections (RTIs) and sexually transmitted infections (STIs). The service provider then suggests that it is a good idea to come back along with her husband, so that he can also understand these things. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Kusum Kumari Bara (left) and Shanti Toppo (right).
    IMG45324.jpg
  • CAPTION: Rajashetty, who contracted polio early in life, is a self-employed blacksmith. He is pictured here working alongside two of his family members. He is a member of his local self-help group (SHG), which has enabled him to draw small loans to invest in his business. LOCATION: Alduru (village), Santhemarahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Rajashetty, Bhagya and Basavashetty.
    013_IMG32488.jpg
  • 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.
    031_IMG31902.jpg
  • CAPTION: Nirmala has speech problems owing to jaw disfigurement. Thanks to Mobility India, she has benefited from surgery, and now works as a tamarind de-seeder. Soon, she will be taking up livelihood training for other income-earning activities. LOCATION: Doddarayapete (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Nirmala.
    014_IMG32116.jpg
  • CAPTION: Parwati Murmu is one of Community COPE's elected members. She is the mukhya (head of four to five villages) of the Pawra area, and is one of the most active Community COPE leaders. Before getting elected, she had 15 years’ experience in the panchayati raj system. The panchayati raj system dictates that 50% of those elected must be female; in this area, 60-70% are. She also used to be a very active anganwadi worker, and because she is very knowledgeable on relevant health matters she now helps a lot with mother and child health services. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Bisu Murmu, Vandana Maitry and Parwati Murmu.
    IMG44554.jpg
  • CAPTION: The media is interested in COPE because the Community is all about bringing positive change. This journalist is from GTN News, a local cable channel which broadcasts across several districts of Jharkhand. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: unknown; right: Shruti Deogam.
    IMG44665.jpg
  • 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).
    IMG44811.jpg
  • 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).
    IMG44841.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, Kajal Namata and Sunita Murmu .
    IMG44965.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.
    IMG44960.jpg
  • 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.
    IMG45117.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: Ratna Das Banerjee, Kalpana Mahato, Savita Horo and Krishna Chakrabarty.
    IMG45153.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.
    IMG45245.jpg
  • 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).
    018_IMG32435.jpg
  • CAPTION: Every self-help group (SHG) has various office-bearing positions, including chairperson (right) and treasurer (left). LOCATION: Doddarayapete (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Suvarna; right: Shobha.
    006_IMG32151.jpg
  • 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.
    012_IMG32318.jpg
  • 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.
    003_IMG32935.jpg
  • 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.
    008_IMG32723.jpg
  • 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).
    070_IMG32041.jpg
  • CAPTION: Under the Chamkol programme, every disabled member of the community has an Individual Health Plan (IHP). For Doddamma, this includes basket weaving as an exercise to help address her rheumatoid arthritis. This has the added benefit of being an income-generating activity. LOCATION: Doddarayapete (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Doddamma M.
    030_IMG32220.jpg
  • 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.
    059_IMG33151.jpg
  • CAPTION: Inclusive Education Resource Teachers (IERTs) such as Kiran are one of the government's primary resources for inclusive education, and great allies for the Chamkol programme. They are responsible for identifying those children who have special educational needs and assessing what should be provided for them. Here, Kiran is leading a training session of parents and siblings of people with learning disabilities. LOCATION: Haradanahalli (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Kiran.
    057_IMG32583.jpg
  • CAPTION: Gathering PIMMS data. Mobility India and CBM have partnered with Aptivate to develop a simple means of collecting key project-relevant data using relatively unsophisticated mobile phones. LOCATION: Sappayyanapura (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Sudhamani R.; right: Doddamma.
    002_IMG32984.jpg
  • 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.
    069_IMG33077.jpg
  • 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.
    024_IMG32423.jpg
  • 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.
    063_IMG31955.jpg
  • 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.
    027_IMG32704.jpg
  • 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.
    066_IMG33059.jpg
  • CAPTION: Visually impaired self-help group (SHG) member Shivaraju proudly displays the bus pass that his membership of the group has helped him to secure. LOCATION: Amchawadi (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Shivaraju; right: Madamma.
    005_IMG32740.jpg
  • CAPTION: Vandana Maitry, center, is again a very active member of Community COPE and a part of the panchayati raj system. She also works as a trainer of sahiyas at the block level. Accredited Social Health Activists (ASHAs) work at the grassroots level in the health system; they are called sahiyas in Jharkhand, which means 'people’s helping hand'. Vandana is particularly active in helping to keep hospital premises clean. She serves an educative role, working to ensure trashcan usage increases, spitting is prevented, and people use toilets properly, especially as many are reluctant not to use open spaces for defecation. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Bisu Murmu, Vandana Maitry and Parwati Murmu.
    IMG44634.jpg
  • CAPTION: . LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Nirmala Shukla, Panchami Namta and Susmita Mardi.
    IMG44697.jpg
  • 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: Community COPE members discuss steps being taken by Dr Ram Chandra Soren, the Medical Officer-in-Charge, and the sahiyas to deal with the problem of snake and dog bites. Dr Ram has explained that medicines are on the way, so the members are now discussing how the Community COPE team can assist with ensuring people get the knowledge they need on obtaining the necessary medicines from the hospital. Most of the time, people go for magical solutions through faith healers. Many people have died from these bites (including from rabies) in this area. LOCATION: Pawra (village), Ghatshila (block), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Multiple people.
    IMG44644.jpg
  • CAPTION: The lady on the right is a sahiya. She serves as a link between the health system and the community, working at the grassroots in villages. Every village has at least one sahiya. They help health service professionals understand what community needs are and what issues community members are facing. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Ram Chandra Soren (left) and Rupali Shit (right).
    IMG44844.jpg
  • 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).
    IMG44753.jpg
  • 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.
    IMG44891.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.
    IMG44923.jpg
  • 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.
    IMG44870.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, Kajal Namata, Anjana Hembrom and Sunita Murmu.
    IMG44959.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.
    IMG44982.jpg
  • CAPTION: Training of frontline workers (FLWs) is being rolled out in phases. Topics include developmental changes among adolescents and their consequences; nutritional requirements and how to meet them, plus what happens if they are not met; family planning; reproductive tract infections (RTIs) and sexually transmitted infections (STIs); menstrual hygiene; non-communicable diseases; and how to counsel on all of these things. Of these, counseling takes the major focus. LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Dr Jagannath Hembrom; right: multiple people.
    IMG45066.jpg
  • CAPTION: This is a training of frontline workers (FLWs): auxiliary nurse midwives (ANMs) and lady health visitors (LHVs). The latter supervise ANMs. Across the state, there are more than 2,000 FLWs. The Government-approved plan states that these individuals must have five days of training on adolescent reproductive and sexual health matters. It is being conducted by Dr Jagannath Hembrom, a ‘Master Trainer’. His role is more as a facilitator than a teacher. There is a pool of 67 such master trainers in Jharkhand, and Dr Jagannath is recognized as one of the best of these.  LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Left: Dr Jagannath Hembrom; right: multiple people.
    IMG45046.jpg
  • CAPTION: This group is considering sexual changes that adolescents go through. The idea that these things should even be discussed is often resisted by the trainees, and this often comes up in a big way during the first day of training. However, as the days unfold, they are encouraged to open up and relax, and generally a much more positive attitude to such discussion evolves by the end of the program. LOCATION: Ghatshila Community Health Centre (CHC), Purbi Singhbhum (district), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Suhagini Kisku, Sefali Dandapat and Sarojini Mahato.
    IMG45126.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: Standing: Dr Jagannath Hembrom; sitting: multiple people.
    IMG45129.jpg
  • 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.
    IMG45186.jpg
  • 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.
    IMG45174.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: Tara Among, Rajni Lakra, Roshni Hembrom, Birsi Mundu, Moni Suren.
    IMG45238.jpg
  • 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.
    IMG45234.jpg
  • 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).
    IMG45294.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: Moni Suren, Rajni Lakra, Tara Among and Roshni Hembrom.
    IMG45262.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: Moni Suren, Rajni Lakra, Tara Among and Roshni Hembrom.
    IMG45264.jpg
  • CAPTION: Health worker Dr Kusum Kumari Bara demonstrates the use of a mala chakra, a necklace made of red and white beads, to her client. It will help her know when it’s safer to have sex if she does not want to conceive. It is provided by the ARSH clinic free of cost. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Dr Kusum Kumari Bara, Sabita Devi and Najmain Parveen.
    IMG45306.jpg
  • CAPTION: Shanti Toppo is married. She would like there to be a gap before she has her second child. Health worker Dr Kusum Kumari Bara suggests two options for her, firstly the Copper T, which allows the user to delay pregnancy for a longer period, and secondly the condom, which must be used by her husband. It is stressed that the condom is the only thing that also prevents spread of reproductive tract infections (RTIs) and sexually transmitted infections (STIs). The service provider then suggests that it is a good idea to come back along with her husband, so that he can also understand these things. LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Dr Kusum Kumari Bara (left) and Shanti Toppo (right).
    IMG45322.jpg
  • CAPTION: This is Ratu CHC’s ARSH clinic. The sahiyas, sitting to the left, have accompanied some of the girls from their respective areas to the facility so that they can discuss issues that sahiyas can’t handle themselves. This has not yet been incorporated into the sahiya incentive system, yet some have already willingly started doing it. At the clinic, the girls meet with Multi-Purpose Health Worker (Female) staff, formerly (and often still, unofficially) known as 'ANMs' (auxiliary nurse midwives). LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Adults, from left to right: Kanti Devi, Yasmin Kahtun, Rina Devi and Raj Kumari Sinha; children: Ayesha Khatun (entering the room) and multiple other people.
    IMG45275.jpg
  • CAPTION: While Shanti Toppo discusses contraceptive options with the health worker, another ANM checks her blood pressure. This is because she has been complaining of a spinning head and pains in her abdomen. The cause of this might be anemia, though there are other possibilities as well.<br />
LOCATION: Adolescent Reproductive and Sexual Health (ARSH) clinic, Ratu Community Health Centre (CHC), Ranchi (city), Jharkhand (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Dr Kusum Kumari Bara, Raj Kumari Sinha and Shanti Toppo.
    IMG45331.jpg
  • 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.
    032_IMG32075.jpg
  • CAPTION: Rajamma, who has severe rheumatoid arthritis, gets around her home by crawling. She has a new wheelchair, but her mother Mahadevamma will not be able to wheel her into and out of her house in this until construction of the ramp up to the doorway has been completed. LOCATION: Amchawadi (village), Haradanahalli (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: Rajamma (left) and Mahadevamma (right).
    026_IMG32685.jpg
  • CAPTION: Shobha has taken up a job as a sweeper at Vijaya Bank in order to help support her two brothers, Siddaraju and Shivaraju, who both have severe learning disabilities. Through the Chamkol programme, families like hers are able to get support in devising Individual Livelihood Plans to build pathways out of poverty. LOCATION: Mudlumole (village), Kasaba (hobli), Chamrajnagar (district), Karnataka (state), India. INDIVIDUAL(S) PHOTOGRAPHED: From left to right: Siddaraju, Jayamma, Shivaraju and Shobha.
    023_IMG32243.jpg
  • 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).
    071_IMG32010.jpg
  • 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).
    020_IMG32513.jpg
  • 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).
    016_IMG32391.jpg
Next