Text of a speech delivered by Dr. Abraham George at the conference
on empowerment of women in developing countries, hosted by the Action
Alliance on Women's Health, Santa Fe, New Mexico, USA, on 26-27 April,
The realities of rural life in India are difficult to comprehend. While
a small minority of people in major cities have benefited from the information
revolution of the past decade, the lives of most people in rural India
(over 650 million) have hardly improved. There is a lot of talk about
the "digital divide;" the government is planning to bring
the Internet to villages, but it is difficult to see how this project
will help when the basic necessities of life are absent.
A majority of villages do not have sustainable economies, and only
through oppression of women and lower castes can the landlords, upper
castes, and government officials support a better life for themselves.
The social injustice that underlines this perennial problem cannot be
addressed by a frontal attack on women's issues by targeting women alone,
but it requires a comprehensive effort in which communities develop
through sustainable and integrated programs that impact everyone.
Issues of rural poverty and health have traditionally been the concern
of governments. In the past, and even today, most programs designed
to benefit rural India are funded and managed exclusively by the government.
Private initiatives are lacking as the government, to preserve its power,
has placed obstacles and disincentives at every step. For example, modern
healthcare for all of rural India is a free government service, but
the reality is that the delivery of primary health care has failed miserably.
A number of charitable institutions and non-governmental organizations
(NGOs) have played a positive role, often assisted by government grants
and foreign donations.
The World Bank has been the major source of external funding through
loans to governments (never directly to private institutions) for specific
projects. Very few projects have ever met their goals; in fact, most
rural projects have been dismal failures. Unbearable bureaucracy, terrible
inefficiency, and corruption at all levels of the government have wasted
much of the money allocated to rural development. Furthermore, the local
officials who manage projects that target women do not themselves believe
in the potential of women. Yet the process continues, without an alternative.
International agencies continue to pour money into these programs, only
to benefit the middlemen. Clearly, a new approach is required to have
an impact on the lives of women in rural India, and to ultimately help
stabilize population growth.
Empowerment of women involves many things - economic opportunity, social
equality, and personal rights. Women are deprived of these human rights,
often as a matter of tradition. In rural areas, women are generally
not perceived to have any meaningful income generation capacity, and
hence, they are relegated mainly to household duties and cheap labor.
Without the power to work and earn a good income, their voices are silenced.
Even in matters of sex and child bearing, women often do not have the
ability to oppose the wishes of their men.
In a society where men control the destiny of women, how is it possible
to empower women? Simply encouraging women to resist the wishes of men
would not only fail, but would create mistrust of any goodwill attempts
from "the outside" to help rural communities. Women will gain
power only when both men and women begin to respect and accept the contribution
of women. Developing women's capacity for income generation without
threatening men is key.
Past experience has taught us that attempts to control the number of
children through behavioral changes in men have failed because families
do not see the benefit of fewer children. Children, especially boys,
are viewed as extra hands that can provide income and help with family
chores. The poorer the family, the more children they seek. Hence, it
is evident that the economic status of the family plays a major role
in family planning. Birth control and reproductive health of women are
behavioral issues affected mostly by economics, access to health care,
and education. Until this reality is accepted, the desired changes may
not be attainable in the foreseeable future.
Education plays an important role in bringing about awareness on women's
rights. When both boys and girls grow up with mutual respect and understanding
of their capabilities and roles in the society, women are more likely
to find their rightful place within the family and the community. But,
sadly enough, rural education perpetuates the myth that boys are inherently
superior to girls. This is further reinforced by the family, where even
mothers tend to give more attention and opportunities to their boys.
The George Foundation based in Bangalore, India and founded in 1995,
was established to help alleviate poverty, promote health and a clean
environment, and to strengthen democratic institutions and values in
India. We have come to know of the following two events, among many
others, in the course of our work with the families of the children
in our boarding school, Shanti Bhavan. The first case involves a young
pretty mother who was living with her son in a small hut. Her husband
had earlier abandoned her, and she was not able to return to her parents
as they considered her "unworthy." One morning, she accompanied
two men from the city who promised employment for her in the Middle
East following an interview at an office somewhere, only to be gang
raped and then returned to her village after a few days. Her absence
was noticed by her neighbors, who blamed her for the outcome and accused
her for the separation from her husband. Feeling shame, and finding
that she could no longer live in the community, she set herself on fire
The second story is about a middle-aged woman whose husband had more
than one "wife," a common practice in rural India though not
officially allowed. One of his wives contracted AIDS somehow, and while
her illness had become generally known, he continued to have sexual
relationship with his other wives. He made no effort to medically test
or to take adequate protection measures for himself or his other women,
and soon all involved contracted the disease.
These two real life stories represent the endless number of lives lost
from ignorance, the low status of women and their inability to control
What If? Potential Solutions
There is no easy or quick fix to the problems related to women's empowerment
and reproductive health in rural India. The real solution lies in a
holistic approach that deals with all the major interrelated issues
of economic welfare, social justice, education, health, and traditions/spirituality.
The three key ingredients of success are trust, infrastructure for
delivery, and financial incentives.
Behavioral change can be initiated and promoted only by those who have
earned the trust of the people they claim to serve; government officials
are amongst the least trusted, and hence, they are the most ill-suited
for the task. People listen to those whom they trust, but still may
not act without financial incentives that are offered through economic
opportunities, and without actually seeing the infrastructure for delivery
of services. Hence, projects run exclusively by private and non-governmental
institutions (funded directly by government, international agencies
and private donors), without unwanted governmental interference, have
a better chance of success.
Private initiatives in rural areas need not always be charitable or
non-profit. In fact, products and services, including education and
health services, paid for through fees based on income levels can be
very effective in stimulating a village's economy. Private companies
need to be encouraged to deliver products and services for profit, but
at affordable costs. When non-profit institutions work with profit-oriented
private companies in a competitive environment, products and services
are delivered at an economic cost that even most rural people can afford.
When villagers realize that they are indeed the beneficiaries of projects
(as opposed to government officials and few others), they begin to trust
and have confidence in those providing the services. This then opens
up the opportunity to educate people on delicate topics such as sexual
behavior, use of condoms, family planning, alcoholism, abuse of women
and children, and others. Institutions that are best suited for communicating
these messages are the villages' health clinics, schools, community
centers, and religious institutions. When project leaders become part
of these institutions, they come closer to the people they serve.
In most rural areas, the primary symbol of wealth and respect is in
owning cultivable land and/or cattle. When a woman earns and saves enough
to buy either one on her own, she automatically gains immense respect
and voice in her family and within the community.
Many of the traditional barriers that have kept her silent begin to
break down. Her husband and other elder members of the larger family
are now prepared to listen to her and accede to her personal needs.
She then has a bigger voice in how she brings up her children and in
how the family is run.
It is important to note that men are more likely to support approaches
to women's empowerment if they are also beneficiaries of those programs.
Without the involvement of men, women are unlikely to gain new rights.
It takes a concerted effort to break age-old traditions and what men
perceive to be in their self-interest.
Dharmapuri District in Tamil Nadu State, India, has been identified
as one of the most backward districts in the nation in terms of health
and development. This District is remote and the project described below
is carried out in an area about 24 kilometers from the nearest city,
Hosur. Infrequent and irregular public transport hinders quick access
to government emergency health services. Education facilities are limited
to government primary schools of poor quality, and the nearest high
school is located 10-15 kilometers from many of the villages served
by The George Foundation's projects.
Large sections of the communities in this area belong to "lower
castes" and backward groups, some of those often-called "untouchables."
These people are largely landless laborers who have no fixed assets.
There are very few non-farming occupations in this area. Communicable
diseases including HIV/AIDS and Hepatitis, respiratory infections, tuberculosis
and leprosy are widely prevalent. More than 75% of women and children
suffer from anemia or malnutrition. Chronic diseases often result in
loss of precious man-hours and income. Sociological problems such as
alcoholism, wife and child abuse, and discrimination of lower castes
are consequences of poverty and ignorance.
A tragic and widely documented feature of this District is the prevalence
of female infanticide practices. Despite some government efforts, there
has been little impact in curtailing this practice. Women have very
little voice in matters of human reproduction and reproductive health.
The government has a primary health center located at Bagalur and there
are no major voluntary agencies working in this district.
In Dharmapuri District the Foundation has attempted to facilitate the
development of a model community consisting of several villages that
prosper from sustainable and integrated economic activities. Health
and education facilities are being renovated, and economic opportunities
are being shared, especially among the socially disadvantaged castes
The project started four years ago with Shanti Bhavan, a world-class
residential school for children from poor backgrounds from some 25 villages
in the District. Educational standards of government schools in the
area are also being improved through other initiatives such as teacher
incentive programs, construction of facilities for higher grades and
a library, merit scholarships, and purchase of reference books. These
programs have brought us closer to many children and their families
in the community, allowing us to communicate our messages clearly.
In the health arena, the Foundation now "co-manages" a government
run Primary Health Center (PHC) that serves nearly 80,000 people. Within
a short period of six months starting in October 2000, the facility
has been completely refurbished, better procedures have been instituted,
and PC based record keeping and diagnostic software that assists in
the delivery of healthcare has been implemented. Additionally, the Foundation
has built a new medical and community center (a 16,000 sq. ft., 10 bed
facility) that focuses on outpatient and emergency care, prevention,
health education, veterinary services, and other community-oriented
programs. These initiatives have earned considerable trust of the people,
especially the women whose children have benefited from the many activities.
Attempts are made to preserve the rich and ancient culture of the people,
while trying to meet their spiritual needs. Toward these ends, an arts
and crafts museum has been built, and an arts village is being created.
Two temples have been renovated, while a third one was newly built,
and an ancient chariot was reconstructed. By associating the Foundation's
work with the communities' social needs, it has become possible to reach
them in many other areas.
All of these activities have generated considerable employment for
the local population. Local labor has been used extensively, and many
non-technical products and services are also being locally procured.
The Foundation has persuaded the government to improve the roads by
partially funding the project, and to bring electricity and telephone
service to the community. All of these changes have occurred in less
than four years, significantly improving their quality of life.
To reach women, especially those from poor families, the Foundation
has recently launched a major project to economically empower them.
To start with, we purchased nearly 150 acres of land that had been previously
left uncultivated. Each woman is assigned approximately ¼ acre
of land, which has already been properly prepared with ploughing by
tractor, grading, soil preparation, drainage and fertilization at commencement
of the program. She is provided at no cost the basic tools for farming,
and is trained in proper cultivation and farming methods - an "earn
while you learn" scheme. The produce of the farm is sold centrally,
and a part of the proceeds is given to each farmer periodically for
daily living, while a major portion is kept in interest bearing savings.
Ten to twenty percent of the sale price is retained for the purchase
of seeds, fertilizers, pesticides and other resources required for the
next crop. While women work in the farm for four to five hours each
day, their children under the age of five years enjoy the facility of
a day-care center that takes care of their educational and nutritional
needs. The expectation is that within four to five years, each woman
will have saved enough from the money retained to buy her own piece
of cultivable land and/or cattle, and will have also learned modern
Despite the difficulties that are likely to be encountered, we believe
it is possible to bring about major improvements to the lives of women
in rural India. Well-planned and properly managed private initiatives
can succeed in empowering women, provided the approach taken is sufficiently
holistic. Effective and sustainable programs can be executed with limited
initial investment, while ensuring that significant benefits flow to
families with low income and socially disadvantaged status.
Government run rural development projects, as practiced today, are
unlikely to significantly improve the social and economic status of
women in the foreseeable future. Hence, privately funded and managed
initiatives on a large scale need to be tried to bring about sustaining
changes. Such undertakings should seek government involvement only as
a facilitator, as opposed that of a "manager" or "partner."
The time has come to go beyond small pilot projects that hardly ever
lead to major undertakings. There has been much needless suffering for
too long by a majority of the world's population. It would be a noble
and worthwhile effort to prove the concept on a large scale, probably
for several million people in an area. That would require considerable
organizational skills and management talent, with a clear focus on accomplishing
set goals in a time-bound fashion. The success of such a program would
be the model that international funding agencies and philanthropic institutions
can build upon, and serve as a departure to the failed policies and
programs of the past.