Boundless energy for the rural woman: the award-winning doctor Banoobai Coyaji has pioneered health care in 300 Indian villages. (Healthcare).

The eminent Indian gynaecologist and hospital director Dr Banoobai Coyaji is Pune's best-known lady--and perhaps the most loved. Coyaji, who won the Ramon Magsaysay Award for public service in 1993, constantly works on fresh projects to benefit rural women, especially adolescent girls.

It all began in the 1970s when Coyaji found that rural people were flooding hospitals in Pune, Maharashtra, for minor ailments. The government had its primary health centres, but as they were regarded as second-rate, few patients went there. Coyaji asked the Chief Minister of Maharashtra to give her one primary health centre to run and to allot her the same amount of funds that the government would spend on it. She insisted she could get her hospital doctors to run the centres more efficiently. She did.

With the primary health centres running efficiently, about 75-80 per cent of the patients were cured of minor ailments. As many as 15-20 per cent of the more difficult cases got treated at two rural hospitals which she had started, and only about 5-10 per cent of the really serious cases landed in her Pune hospital. The rural hospitals were used to train nurses from the countryside, as they seldom migrated to the cities.

Coyaji tells doctors who apply to the King Edward Memorial (KEM) Hospital in Pune, where she is chair of the governing board, that until they have worked for six months in villages she will not give them a posting.

When she started working there in 1946, the hospital had 40 beds. Today it has 550 and is one of the largest in Pune. It is run by a trust for the benefit of the poor and resembles a government hospital, with crowds milling around. Coyaji's reach extends to 300 villages, and foreign agencies constantly urge her to expand her programme.

One day she got a phone call from a woman with a foreign accent. She was speaking from the Philippines and asked Coyaji if she would accept the Magsaysay Award. She thought a practical joker was playing a prank on her. Hesitantly she said yes. An hour later, she went to her room at the Sakal newspaper, where she is a director. The news editor charged in and said, excitedly, `Madam, madam, you have got the Magsaysay Award. It has just come on the telex.'

The prestigious award has been given more often to Indians than any other Asians. The citation for Coyaji's $50,000 award reads: `In recognition of her mobilizing the resources of a modern urban hospital to bring better health and brighter hope to Maharashtra's rural women and their families'.

Coyaji served for six years on the Scientific Advisory Group of the World Health Organization that looks after women's health. She has visited 120 countries and while on WHO assignments has seen the plight of women in many lands.

Ever since I first met Coyaji, I have been intrigued not only by her achievements but also her energy. The latter is a gift of God to her. Her life is all of one piece and her high energy level, in her mid-80s, is thanks to her sense of purpose, hard work, incredible organizational power and, above all, her positive thinking. `There-are negative thoughts and positive thoughts,' she says. `Judgement is usually negative. So are anger and jealousy.'

Whatever the provocation, I have seldom heard her speak critically of another person. So her energies are canalized into creative channels. `You can have all the wealth and health in the world,' she remarks, `but unless you do something for another person you cannot be happy.' That is another secret of her boundless energy.

Coyaji sets a scorching pace. She wakes at 5 am. The morning goes in preparing papers and speeches. She is often invited to address Indian and international conferences.

At 7.30 am she hears the BBC news, glances at an English and a Marathi paper and at 8.30 am leaves for the hospital. She has been director of KEM, for over 50 years.

She is an authority on rural health, population planning, and the reproductive health of women. Coyaji speaks to young and old alike--to young people on achievement, and to old people on growing old gracefully.

Once when I met her, she was about to inaugurate a programme on `total quality care' at the hospital. Pune, an industrial city, is home to many competitive companies that strive for quality production. `Why should we not have total continuous quality care?' she asked. Afterwards, I asked how her meeting had gone. `I was amazed. Everyone in the hospital at different levels was there,' she said. `What did you tell them?' `I told them that to give total quality care, each one needed to ask, "How can I do more?" We need introspection. I said I had examined myself and realized that till the hospital had about 200 beds, I had visited each patient daily. Now the hospital has 550 beds and I have no time. It takes a minute, but it means everything to the patient if you touch and ask how he or she is.'

From there, she drove 40 kms to her rural project at Vadu--the work that gained her international recognition. She came to our house at 6 pm, having driven back 40 kms. I hesitated to ask her to join me for an important personal engagement I was going to. I knew her presence would help.

`Oh, don't worry about me. I have inexhaustible energy. I am born a Virgo. It is written a Virgo has a back of stainless steel. I am strong as a horse and I work like a donkey.' Coyaji was then aged 78.

Those who work like donkeys don't do the strategic planning which Coyaji does. She carries a monthly chart that accompanies her everywhere and every appointment is entered there. The KEM Hospital Research Society which she heads has 31 projects running at the same time, ranging from nutrition of women, to income generation, to training in health and hygiene.

Coyaji's main focus is to improve `the physical quality of life index' and this includes life expectancy, infant mortality and adult literacy. For more than 26 years her projects have aimed at safe motherhood, maternal nutrition, integrated health care services and reproductive health. She moves with the times, and some of her projects undertake leadership training to empower women--who hold one third of the panchayat (village council) seats--to increase their contribution for the betterment of the area.

The girl-child, Coyaji says, is treated terribly in India. Government schemes cover the girl-child from birth to six years and maternal child health, which focuses on the pregnant girl. The snag is that, in between these ages, the girl is left to fend for herself. Women come to Coyaji with other problems also. So from health issues, she has moved to income generation and basic education on hygiene for rural women.

With no regrets for the past and no anxiety for the future, Coyaji is free to concentrate on today. She quotes: `Yesterday is a cancelled cheque. Tomorrow is a promissory note. Today is hard cash--use it.'

Till almost 80, she spent most afternoons taking an active interest in the operations of Sakal. At 4.30 pm she took off for her clinic for a couple of hours, saying, `I have to make a living, you know.' She draws no salary from the hospital. When she reached 50, donations were raised in her honour to fund improvements to the hospital.

Coyaji is a pioneer of family planning. She launched a family planning programme in 1946 with Shakuntala Paranjpe. In 1951, the industrialist J R D Tata focused national attention on the subject. When his Family Planning Foundation of India started (now called the Population Foundation), he included Coyaji on the board. In 1996, she wrote to a Tata trust, saying, `The biggest mistake we made in family planning was to neglect the male and his problems.' She got a grant to start the Tata Centre for Reproductive Health.

I have known few people as well organized as Coyaji. She plans on a grand scale but can also bestow immense care on individuals who are in need. `By training, I am a gynaecologist. But at heart I am a general practitioner, a counsellor.' When a woman in Bombay, whose husband was ill, needed her moral support, she drove all the way from Pune to be with her, had lunch, and sped back for a 6 pm appointment in Lonavla, reaching home at midnight: a drive of 384 kms.

At the age of 80, in 1999, Coyaji fell down. A swelling appeared on her shoulder. Her son, a Harvard-trained gynaecologist, advised her to go to hospital and get an X-ray. But the woman who headed a hospital for over 50 years defied her doctor. `I will disappoint the children whom I promised to meet at their schoool.' She told her daughter-in-law: `Jeroo, put my sari on for me,' and off she went to the school. After going round the school for half an hour, she felt dizzy, settled down on a chair and was rushed to hospital. For the first time in her life, she was hospitalized and then house-bound. When I visited her, I inquired, `What is God trying to teach you through all this?' Without a moment's hesitation she replied, `To find myself'.

A little more than a year later, Coyaji was back in circulation. She was her old self again, doing her work at the hospital and supervising the work in rural areas, which has earned her the blessings of tens of thousands of women.

This article is taken from a chapter in R M Lala's book, `A touch of greatness', about the lives of eminent Indians, published by Viking, Penguin Books India 2001, New Delhi, and reproduced here with permission.