Changing the lives of women.

Byline: By Rajeshree Sisodia

Having given birth clutching an iron pillar in a mouse-infested hut, the mother would find her baby's umbilical cord would be cut using a seashell and the newborn would be smeared in cow dung.

The scene, reminiscent of childbirth in medieval times, was commonplace until the turn of the 21st century in rural parts of the east Indian state of Orissa.

"Before we used to put an iron pillar in the home and the woman would hold on to the iron pillar while giving birth," says 42-year-old Hema Manjari Behra sitting cross-legged on the floor of a village hut in Tikhri.

"That house where all the women used to give birth was very dirty - there were mice in that house.

"The birth attendants would not use gloves. We used to use cow dung on the child, we thought the cow dung would clean the child but it caused infection, that was traditional Orissa practice. We used to use seashells to cut the umbilical cord."

Traditional methods of giving birth now consigned to the annals of history after communities realised, with the help of Non Governmental Organisations (NGOs), that health and community care in villages devastated by Orissa's supercyclone in October 1999, had to improve if affected communities would ever truly recover.

The impetus women now have to earn their own money through work projects including dry fish selling, basket making and bamboo craft making has come from, in part, the Aparajita project - a scheme run by NGO the Voluntary Health Association of India (VHAI) but also through the women's own resolve.

The initiative is important as it guarantees women in Tikhri - and other villages - an income.

Workers from VHAI - a collaboration of around 4,500 member groups across India - were among the first on the scene when the supercyclone ripped through Tikhri and continue to help to this day.

Through a project called `Aparajita' - which in the Indian language of Sanskrit means `the indomitable spirit of woman' - they have transformed health practices and initiated work programmes throughout rural Orissa since December 1999.

According to VHAI, which is part funded by Christian Aid, Aparajita was the first NGO scheme to focus on women - traditionally subservient to men in rural India - as catalysts for and instigators of social and financial reform.

Laughter rings out from Hema as she talks of her new-found freedom to earn her own money.

"Earlier on we would depend on our husbands for bangles but now we can buy our own bangles," says Hema.

The simple statement she utters has a more profound significance; the new economic independence of women in the patriarchal society which forms the backbone of Indian rural life has been a milestone.

Aparajita has targeted women in villages and encouraged them to become birth attendants, provided birth packages - which include cotton wool and disinfected plastic and given supplements and inoculations.

The programme aims to re-educate villagers about health so they are stronger and better able to cope from birth through to death.

The ethos forms the foundation of health reform in the region as VHAI officials say Orissa has an infant mortality rate (IMR) of 97 per thousand live births - the highest of all India's 32 states and union territories.

In Kendrapara - the district Tikhri is in - the IMR is higher still - 123 per thousand live births.

Shisira Ranjan Dash, VHAI senior programme officer in Orissa, says: "From 1999 until 2000, 46 children were born in the village and 12 died - that's very high. Last year, out of 32 children born, three died."

Sugar cane, jute trees, water hyacinths and paddy fields stretch as far as the eye can see outside Tikhri.

The road to the village is pockmarked with holes and craters.

"Seven days ago, we would have had to reach this village by boat," adds Shisira as we finish the final stretch of the journey to the village on foot.

We have long since passed herds of goats, cattle and rickshaws and left behind our four-wheel drive wheel-high in water, the most tangible reminder of widespread flooding to hit the region last month.

Itishree Kanungo, VHAI programme officer, works with the birth attendants and explains rural women are encouraged to donate 30 rupees each month to a village fund - money which can then be borrowed.

She says: "Aparajita was the first time women were focused on. Women in India, they have all the responsibility with them but no power.

"Initially the husbands were not positive about it because they thought 30 rupees would go from their income each month towards a communal fund so they were worried. But we explained that it would only be one rupee a day that you would otherwise spend on paan or chai (tea) and that this money would be for their benefit. Now they are happy about it."