New Internationalist

Small, gifted… and they work

Issue 080

Some of development’s most encouraging success stories are relatively small-scale. But they succeed because they involve people and because they are highly practical in concept. In the following three pages MARCUS THOMPSON, looks at a successful community health project in India that has received support from Oxfam and Christian Aid. In Africa, MAGGIE BLACK visits a Kenyan fabrics factory originally set up to provide work for destitute women but now a successful business venture as well.

MIRIDADI FABRICS - Production and people

Maridadi Fabrics’ spanking new factory stands on the outskirts of Nairobi’s growing industrial quarter. Twelve years ago, when this embryonic textile business consisted of five employees in a dilapidated primary school classroom operating one silkscreen printing press the size of a small tabletop, no-one could have pictured how it would grow.

‘I had very great hopes, and I was imagining and wishing that it would be a big thing’, says Martha Gikonyo, Manager of Maridadi, who has been with the project almost since the beginning, ‘but I never thought it could be as big as this.’ Mrs. Gikonyo’s first-floor office window looks out over the factory floor, where groups of women workers are slapping the wooden-framed silk screens onto pinned-out cotton fabric and pushing the dye through onto the cloth with rubber-edged spatulas. ‘All the people were eager to work and I kept telling them that one day we would move to a big factory of our own. So when we moved here I was very happy, because everything 1 had been telling them had become true.’

From producing basketfuls of tablemats which helpful volunteers, mainly expatriate wives, took home to Nairobi’s leafy suburbs and sold to their friends, Maridadi has become a business with an output of handprinted cloth worth 500,000 a year. Maridadi is a Swahili word meaning ‘pretty’ or ‘gay’, and the company’s distinctive African textile designs have earned them customers in North America, Britain, West Germany, Holland, Sweden and Denmark, as well as among Nairobi’s lucrative tourist trade.

Maridadi is however very far from being just another entrepreneurial venture promoted by aspiring Kenyan businessmen. It was originally conceived by an imaginative social worker from St. John’s Community Centre in one of Nairobi’s more depressed areas, as a way to help needy women. The slums of East Africa’s fastest growing city are the depository for a good deal of human misery, much of it endured by women who have been dumped, deserted, widowed or otherwise cast out by their original families away in the rural areas. It goes without saying that they are almost invariably unskilled and uneducated, and so are forced to earn a living in the least savoury professions that man has invented. It is from this unpromising workforce that Maridadi draws its labour, as a fundamental principle of the factory’s existence.

No-one among the non-professional staff at Maridadi obtains a job without the recommendation of St. John’s Community Centre. These women work in the groups which go up and down the long 60 foot tables with the printing screens, or else they wash or dye the cloth, or help ‘fix’ the finished printed material in the huge oven in the centre of the factory floor. Currently there are 95 employees, most of them women who have stayed in their jobs ever since they were taken on. ‘I have never seen a woman resigning; they have been with us throughout,’ says Mrs. Gikonyo. ‘Those few who have retired still take tablemats and neckties home for sewing.’ The regular employees earn the Kenyan minimum urban wage, which is $50 a month.

Henry Kathi, the General Manager, who joined the factory just before it moved a year ago from its less salubrious premises, also believes that one of the project’s main achievements is to give the employees a new sense of dignity. But Mr. Kathi, whose background is commercial, is very aware that there can be a conflict sometimes between providing for the needy and making the factory as commercially successful as possible. The policy of Maridadi has always been to be as labour-intensive as possible and to over-employ deliberately. They never sack people even when the balance sheet is causing anxiety. ‘I came here with the idea of maximising profits,’ he says, ‘but I have had to change my ideas. We dont talk here about labour efficiency.’

The factory’s major expansion took place in 1975-1976, on the wave of the economic boom Kenya then enjoyed thanks to high coffee prices. But Maridadi is no more impervious to economic fluctuations than any other enterprise. The capacity in the new factory is double that in the old premises: 150,000 metres of printed material a year. So far they have only reached 100,000 metres. ‘The credit squeeze in Kenya means that not so many people are buying. The level of sales to tourists has dropped. Big orders are more difficult to come by.’ Most big orders come from sources like the new hotels, whose African atmosphere is often provided by Maridadi bedspreads, table linen, and curtains.

Mr. Kathi has no great confidence in opening up the local market significantly. ‘Much as we would like to take our goods to the common man, I think that it is only realistic to see our market as the middle class.’ Costs of manufacture are $2.50 a metre, whereas some manufacturers can sell at $2. ‘1 see the major expansion in the export market, particularly in Western Europe.’ Ethnic chic has apparently caught on better there than in North America, where people do not appreciate finding minor discrepancies from one bolt of hand­printed cloth to another.

Whatever the difficulties, Mr. Kathi’s optimism in Maridadi’s commercial future is as reassuring as Mrs. Gikonyo’s concern for the twilight women of Nairobi’s darker corners. Somehow between them they manage a harmonious balance between the different aims that Maridadi stands for. Mrs. Gikonyo is looking forward to providing jobs for the first ten graduates of a new sewing school for impoverished women started by St. Johns, who she hopes will be eventually absorbed into the workforce of 17 seamstresses the factory employs. But any expansion must come ‘slowly by slowly’. ‘We are now in a period of consolidation,’ says Mr. Kathi. It is a tribute to the tremendous energy of Maridadi’s promoters that there is already, so much to consolidate.

 

JAMMED - a successful treatment

‘I never imagined that I would ever be asked to teach other people about their health; I never dreamed I could learn to read and write.’

Gangabai is an old lady. A labourer all her life, she left her village for lack of work to take her chance on the building sites of a city. By chance she and her husband built a shack in an area where there was a health programme run by a local church group. As an elderly, respected and public-spirited lady, Gangabai was nominated by her neighbours as ‘community health worker’. She had 10 days of training and now visits 10 houses a day, where she talks about scabies, diarrhoea, lice, immunisation, family planning, eating green vegetables. She also cleans cuts and encourages people to take their medicine and to take their children to the clinics.

Gangabai, herself an agent of change, is changing. She’s learning to read and write (the keenest student in the class) so that she can keep her own records of visits, children and illnesses, instead of relying on her grandson.

Gangabai has never been to Jamkhed 500 miles away, nor even heard of the place, but she is working on a pattern that Raj and Mabelle Arole pioneered and developed in the Comprehensive Rural Health Project outside that onehorse town in the drought-prone, dusty and rocky district of Ahmednagar in Maharashtra State. In 1970 they chose to work in Jamkhed just because it was a poor and neglected area with no significant agricultural, irrigation or medical projects, and no mission hospital - and so no preconceptions about medical care.

Raj and Mabelle deliberately started in the most ‘unmedical’ way, using mud­brick village buildings, loaned or rented as much as healing the sick they were declaring that they had no permanent commitment to the place. They would stay, they said, only as long as the villagers’ co-operation showed that they were wanted. Secondly, they insisted that they were not there to build a medical institution but to help people improve their own health. All serious cases were sent to the hospitals in the District headquarters, Ahmednagar.

The key to success in community health is just that - community health. The medical profession in India has betrayed the poor and the sick, especially in the rural areas. In the cities the doctors’ surgeries crowd upon each other as they compete for private business, money and prestige. Even government doctors regard rural postings as a punishment, a sentence to be served. Small wonder the few doctors who choose to go where they are most needed feel their first job is to convince the villagers that they must rely on themselves. The medical profession have for years outlawed the village midwives as public enemies. However, 95 per cent of all deliveries in the villages are conducted by traditional midwives, whether the medical profession approves or not. It is obvious that the priority must be to give these midwives some training and support so that they’ll do the job better; obvious to some that is, like the Aroles.

At Jamkhed Drs. Raj and Mabelle Arole found themselves on new ground, and stumbled more than once. Should they accept for training as Village Health Workers (VHW’s) those women that the villagers selected even though they seemed to the Aroles most unsuitable? Or should they select better-suited people themselves? They tried the latter - it didnt work. Raj and Mabelle have told me they never cease to be amazed at how good the villagers’ choices actually turn out to be.

After selection the VHW’s undergo two weeks of training. Back in their villages they have the support of weekly visits from the mobile team from the base health centre, and a weekly Saturday training session all together at the base. Their work is to know thoroughly the health position in their villages: which pregnant girls need advice and routine checks; which newborn babies need immunisation; which mothers of young children need nutrition education; who are the leprosy and TB patients; and so on. They also need to know how to prevent (and cure) scabies and such diseases. All this early detection of illness, early referral for treatment, good follow-up and teaching by a respected lady of the village has paid off handsomely.

To date there are VHW’s in 60 villages around Jamkhed - serving a 100,000 population. Family planning is widely accepted - the birth rate has dropped from 40 to 20 per thousand. Infant mortality has slumped from 200 to 40 per thousand; in rural India it averages 139, in Bombay 80, in Britain 16.

Nothing succeeds like success. The VHW’s are given the respect in the villages that they are given by their health centre colleagues; their advice has been found to be good so their new ideas on other subjects are more readily accepted. The programme has spilled into young farmers clubs, well-drilling, women’s clubs and so on.

Raj and Mabelle Arole were early in the field but they are by no means alone in India. All over the country on projects like Gangabai’s, other similarly-minded medics are experimenting, developing variants, trying different models of health care. Perhaps the most important question is how these services can be linked with the government health programme that is supposed to cover the whole population. Several projects have floundered in the attempt to resolve this - trying to yoke a flexible, privately-financed, small programme to the rigid, professional, bureaucratic government health service. But the experience of Jamkhed and the other projects has had a profound influence on government thinking on health. As Health Minister in Moraji Desai’s Janata Government, Raj Narain attempted to gear up the whole health service to identify, train, support and pay VHW’s in every village in India. It is doubtful whether the scheme would ever have succeeded against the opposition of the medical profession, who felt threatened by it. Since Raj Narain left the government the scheme has languished.

Raj and Mabelle Arole have just been awarded the Ramon Magsaysay Award - Asia’s Nobel prize. This well-deserved honour brings with it $10,000 and will no doubt also bring an even greater number of visitors to Jamkhed. Already if you visit Jamkhed you are likely to find a training course of doctors or nurses from other projects in India, possibly a group of experts from the World Health Organisation and perhaps the Health Minister of Indonesia who have come to see for themselves. Raj Arole now refers to himself as full­time public relations officer of the project - ‘the villagers and health centre staff are getting on with the work; they don’t need me’. But if you visit on Saturday morning, even if you are Oxfam’s Field Director, you’ll be told politely that the Village Health Workers have come for their training session so you’ll have to wait till it’s finished.

 

EDUCATION - for life

At Kuriftu, a rural location about 110 kilometres from Addis Ababa, a woman’s literacy class is in progress. One by one, the women students come up to the front of the class and write words in wobbly Amharic script on the board, Amharic being the official language of Ethiopia. The teacher, a young assistant maths teacher from the local primary school who does this in his spare time, is doing Lesson 26 from the IFLE manual. IFLE stands for Integrated Family Life Education, which is the name of the programme this centre is attached to.

The lesson is mostly about raising poultry, and by now several relevant words are on the board: ‘chicken’, ‘eggs’, ‘grain’, ‘feed’, as well as others from earlier classes: ‘illness’, ‘advice’, ‘treatment’ and ‘innoculation’. The women pore over today’s lesson card which illustrates rows of chicks and rows of eggs in various numerical combinations. The lesson is devised to combine literacy and numeracy with nutritional information about proteins and vitamins, child welfare, the way to keep hens, and the economics of broiler production.

The IFLE programme is based on the premise that literacy can enable a rural community to secure its first tentative foothold on the ladder to modern economic progress. There is the obvious practical advantage that if people can read and write they can deal with suppliers, keep accounts, consult instruction manuals and plan work programmes. Secondly, there is the feeling that if people work together in a group to achieve something they previously saw as totally beyond them, they gain enough self-confidence to initiate other changes in their way of life. So far, IFLE’s results tend to support the programmes’s thesis.

Photo: Peter Dunne
In Emperor Haile Selassie's time there were effectively no literate women among Ethiopia's peasant population Photo: Peter Dunne

In the pre-revolutionary time under Emperor Haile Selassie there were effectively no literate women at all among the 85 per cent of Ethiopia’s 32 million population who are peasants working and living in the countryside. Equally, the numbers of community development projects run by village groups in order to raise their standard of living could in most parts of the country be counted on the fingers of one hand. Whatever else the Revolution has brought, it has at least begun to provide rural people with all sorts of opportunities to improve their circumstances.

IFLE, which began its programme amidst the turmoil of 1973-74, is not actually a part of the government’s own social services programme, but a comparatively small independent scheme, funded unostentatiously by the USA through a voluntary agency, World Education. This makes it subject to a degree of political sensitivity, but it works harmoniously within the new social structures, the Peasants Associations and the kabeles (the Community Associations), and its policies are in line with those of the ruling military council.

Abeba Hailu stresses the importance given to the practical side of the learning programme. ‘When we just had a literacy class, only three or four people would register. But these classes are popular because people are interested in the subjects. If people know that at the end of their six months course they can put their hard-won literacy to good effect their attitude is completely different.’

At each of the 25 centres, the group leaders enrol between 25 and 30 new students every eight months. Their manual, or primer, is a loose-leaf book with one card per lesson. The carefully structured course takes the women stage by stage through different aspects of nutrition, child care, home management, gardening and raising poultry, and family welfare and spacing. Within three months the class establishes its own co-operatively-worked vegetable garden. The group leader, usually a primary school teacher who receives a short training from IFLE and supplements his income by a very small amount, also visits the members of his class and encourages them to start vegetable plots.

Apart from disease-prevention and nutrition, knowledge which enables people to earn money is given a high priority. Market gardening is the most familiar and straightforward method, but poultry-keeping and craftwork such as spinning and weaving, for which Ethiopia is famous, are also encouraged.

About two thirds of IFLE’s 3,000 graduates have stayed in their groups and become involved in new ventures. The participants of the first-year and second-year courses at Kuriftu provide an example of the programme’s capacity to fuel their impulse to improve their environment.

Conscious for the first time of the relationship between a polluted water supply and poor health, they realised that the effluent from the paper mill upstream on the Awash River, from where they took their water, was making them sick. They organised themselves and took their complaint to the mill and recived a pledge of 60 cubic metres of clean water per day from an alternative spring if they would build a concrete reservoir and lay 1.5 kilometres of piping. It took the villagers a year to raise the money and dig the trench for the pipe, as well as to obtain from another source the gift of a pump to get the water up to the village. Now that the water supply is installed, not only has their health improved, but they are able to expand their market-gardening activities as well.

One of the keys to the project’s success is that the graduates themselves decide how to use what they have learned and draw up their own projects according to how they perceive their needs. They might want an electric generator for the community centre, a new well or a knitting machine for a group of handicraft workers. It may be that they are content simply with a cleaner home, healthier children, and better prepared food. Or as one woman replied when asked what she valued most: ‘I can write a letter to my husband when he goes away, and he is very pleased. Before, he thought I was wasting my time coming here but now he knows the value of it.’

The articles Maridadi Fabrics and Education for life are reprinted from Africa Guide 1980, with the permission of the publisher. Africa Guide, a comprehensive annual social and economic review of development in Africa is published by World of Information, 21 Gold Street, Saffron Walden, Essex, England. Africa Guide 1980 will be available from 1 January 1980.

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