Challenges in Reaching Goals

There have been many challenges that have stood in the way of my goals. Some center on certain social factors, some of which I wasn’t completely aware of, while others have simply to do with bad timing.

I believe my biggest challenge in this project has been getting the individual women to want to be part of a larger group. The ability to get the women to meet regularly represents the potential to propel my project to new heights of productivity and sustainability in terms of creating anemia awareness both in the women themselves and the larger community they belong to. I envisioned this group to not only serve the purpose of legitimizing the project and my efforts to the women, but also of providing a support network that reinforces the need to take the pills and the benefits of addressing their anemia. When I approached the women to get an idea of when and where the first meeting should be held, I was confronted with the first signs of ambivalence towards wanting to be a part of the group. I knew it wouldn’t be easy and continued to push the women by setting the date and time and making it mandatory. More…At this point, I had tested all the women and given them their HB counts and explained to the anemic women that it was absolutely necessary for them to take iron pills. I was able to make the first meeting mandatory by leaving the distribution of the iron pills until then, with the hopes that this would get the women to the meeting, however reluctantly, and once they met everyone there, they would be willing to come to future meetings. I was disappointed to find that my approach did not work, as only 6 of the 15 women that would make up the group came to the meeting. In addition, those six women are part of the same larger family, live near the meeting place, and required a helpful kid to pull them out of their work to come to the meeting. Since sticking to my original plan would mean that only 6 women would be in the group throughout the 2 months of my project, I proceeded to go to each woman’s house that did not show up for the meeting in order to give them the iron pills. The responses I got from the women that did not come were disappointing: I had to go collect firewood for the chulo for tonight’s dinner; Oh, the meeting was today – I thought it was tomorrow; I was busy; I couldn’t find the house; None of my neighbors knew the name of the location. The responses and the attitudes that accompanied them made it clear that the real reason for the lack of attendance was a sheer lack of effort. This lack of effort can in turn be attributed to many things, some of which could be a lack of importance placed on the women’s health, the amount of work at home, other social factors that I’m not privy to.

An extension of the challenge mentioned in the previous paragraph is that the women don’t prioritize their health in a general sense. The women here often complain of their physical ailments when the topic is broached, but rarely take the required action to begin to address those issues. The lack of priority assigned to their health is an obstacle to my project. In addition, they seem reluctant or, in some cases, not empowered to be proactive about their health. When working with a condition like anemia, whose symptoms are not evident until late into it’s progression, preventative care is essential for eradication. It has been difficult to incite the women to change their diets or to take iron pills in order to prevent or stop a condition whose primary symptoms are weakness and exhaustion. Especially when other more visible or painful chronic conditions are present and neglected.

There are many women in the group that apparently do not favor taking pills everyday and require constant hand-holding in order to ensure that the pills are being taken even somewhat regularly. I have not been able to determine why exactly the women are averse to taking pills, if it’s a societal issue or more natural reasons like simply forgetting or not wanting to take pills due to other side effects they can cause. Either way, this has consistently been a challenge since much of the success of this group stems from the women consistently taking their iron pills, thereby raising their hemoglobin count.

Another challenge I face is the community’s perception of me, and this challenge is extremely complex and has many different aspects. There is the consideration that I am a foreigner, and this status renders an intricate mix of awe, fascination, and instant respect among the women – all of which sometimes works in my favor and other times works against me. In that same breathe, although I am a foreigner, I am still Hindustani and in many ways held accountable by the women to comply with the societal norms of this community. I spent the better part of my earlier days in the community going house to house to meet women that would be interested in being part of my group, and then later going to each of the member’s houses to ensure they had taken their iron pills and to go over general nutrition with them. This wandering all day, visiting houses of different castes, is definitely not acceptable for girls my age in the community. So the extent to which I am held accountable for behaving in a way that does not comply with the societal standards is still in question. Is my credibility or respect amongst the women in my group compromised by the way I go about my work? I believe this is a challenge, although I cannot assess the extent to which it contributes to the other more tangible challenges (women not taking the pills regularly, or the two women dropping out initially). Another aspect of the challenge of my credibility is the fact that I am not a doctor or health worker. The women may be reluctant to take pills and nutritional advice from someone that is not certified as a doctor or health worker. Again, I anticipate that this is a factor in the challenges I face although I don’t know the extent to which it is.

In addition to these challenges, there are some that are purely logistical. In some cases, women had other medical illnesses and ongoing medical treatments that stood in the way of my project as I was not willing to introduce the iron pills to an existing regimen of drug treatments. Another logistical challenge was that I lost a couple of women in my group to holidays they took to their hometown (pir) that lasted up to a month during summer vacation. There were also a few women that remained in the group but went out of town for a week or so and forgot to take their iron pills with them before leaving, which meant that there are gaps in their treatment for the length of the study. These challenges were circumstantial and may not have been avoided.