And it struck me that this woman was alone. She was so isolated: I sensed her tremendous loneliness. She was weaving a shawl, and it was almost finished. I told her I would buy it from her. But the moment I gave her the money, a man came in and took it. It stayed in my mind - that this woman had managed to make something and sell it, and the moment she had done that it had been taken away from her. And I thought: this can’t be. This has got to change. In that village there was no school, no medical care. I knew that this woman needed some means by which she could change her life.

I also knew that that woman - like any woman anywhere - can only be active in changing her circumstances when she feels healthy and well. Women’s health experiences reflect their positions and roles in society. The Veerni project began there.

The Strong Women of Jodhpur
Veerni means ‘strong woman’ or ‘heroine’ in Hindi. The project delivers comprehensive reproductive health care to village women as the starting point for awareness - and so change. Our approach is a holistic one and departs from what has been a traditional approach to women and reproduction. Before the 1994 Cairo Conference on Population and Development, governments focused on a family planning approach that was geared toward controlling the population and had little to do with women’s reproductive health. It was about targets, and numbers. This approach was often abusive to women and neglected the real circumstances of their lives. At Cairo, policy-makers recognised that the old family planning approach needed to be replaced by a holistic approach to women’s reproductive health.

Providing comprehensive reproductive health care involves recognising a woman as a whole person, with varying needs throughout her life and according to her circumstances. It means working towards her overall well-being, listening and providing choices. After all, most women in the West will have had the children they wanted with good pre-and post natal care, will have access to a variety of contraceptive methods during their reproductive years, and had treatments for infections if necessary. Why shouldn’t all women have the same choices?

But in the developing world, the realities of women’s lives are quite different. Women’s health is directly affected by a range of social, cultural, physical and psychological factors - including access to education, income security and resources, and to a safe environment free from violence. In India - where the Veerni Project operates - the most important challenges to women’s reproductive health can be divided into seven main areas:

Motherhood - past, present, or anticipated - is a woman’s primary social identity. It is also dangerous. In India, maternal mortality is 500 per 100,000 live births per year - compared to 280 in the world as a whole, and just 7.4 in the USA. Seven hundred thousand women die each year in the world of easily treatable pregnancy-related causes - 100,000 of them in India.

Around the world half a billion women suffer from untreated reproductive tract infections (RTIs) every year. For some of these women, the social consequences of RTIs are grave: a woman shunned by her husband or who cannot bear children as a consequence can literally starve to death.

By the millennium, AIDS will be the leading cause of death for women of reproductive age all over the world. There are already between four and five million people with HIV in India, and the numbers are rising exponentially - moving inexorably from the city into the villages, carried along trucking and trade routes by truck drivers to rural women. By the end of the century, experts predict that India will become the world’s centre for the disease.

Boy preference is killing women in India. So strong is the preference of families for boys that girls are four times as likely as boys to suffer from acute malnutrition - and 40 times less likely than boys to be taken to hospital. Every year 330,000 more girls than boys die - and the ratio of women to men is dropping. In Rajasthan as a whole, it is thought to be under 900, and in some villages it is as low as 830 to 1000 men. The World Health Organization has estimated that up to 100 million women are missing in the world as a whole - 30 million of them in India.

Two-thirds of the world’s one billion illiterate people are women. In Rajasthan, only nine per cent of women were literate in 1991, and the figure is far lower in villages. Without education, girls are married and become mothers as teenagers.

Early marriage has a profound effect on girls’ lives. Though the legal age of marriage for girls in India is 18, the government estimates that three million out of four million marriages in the country involve an underage bride. In Rajasthan, child marriage is still widespread - young girls who marry as early as 15 usually have four children by the age of 21. One quarter of the 700,000 women worldwide who die from pregnancy-related causes each year are under 17 - making it the main cause of death for 15-19 year old girls.

Without education, and by marrying so early, many girls suffer from social invisibility. It’s as if they don’t exist as whole people. There are, for example, an increasing number of dowry deaths in India. Young married women are burned to death by their in-laws when they fail to meet the demands for more and more money and goods from the bride’s parents. The husband can then take another wife and get another dowry. In 1994, there were 6,700 registered dowry burnings in India - with Rajasthan as one of the worst states in India.

Agents for Change
So what can a small project like the Veerni Project do about these terrible injustices to women? Launched in April 1992, the project is based in the city of Jodhpur in Rajasthan - but reaches out to villages within a 60 km radius of the town, delivering reproductive and basic primary healthcare. Through a variety of activities - including mothers’ meetings, village health promoter training, cultural events and games - the team brings women and young girls together to learn and to discuss their lives and aspirations. We provide pre-natal and post-natal care to mothers; family planning counselling and the choice of contraceptives to those who request them; fertility treatment for women who want children and have trouble conceiving. Our emphasis on reproductive health differs from the old family planning approach in that it aims to provide a woman with sensitive care throughout the different stages of her life - rather than focusing on controlling her fertility.

Initially women were slow to trust us. When we first went to the villages, we talked to the men, then the 'Panchayat' leaders - the village government, of which 30 per cent now have to be women. That way we got to the older women, and through them to the young ones. Now the project gets a wonderful reception in the villages and the women have begun to remove their veils and speak of the conditions that oppress them. They have begun to seek out the health services they didn’t have access to before - and now they are demanding loans for small businesses and education for their daughters.

In the Veerni Project, we don’t look at women as the passive recipients of a welfare project - but as active agents of change. They are a force for social transformation that can alter their lives and the lives of their families. Through the project, I have learned that women have the creative energy, the strength and the brilliance to change the world: all they need are supporting frameworks.

A 16’ video about the Veerni Project, directed by Aditi Desai (1997) is available from: Jacqueline de Chollet, The Veerni Project, The Global Foundation for Humanity, 1010 Fifth Avenue, New York, NY 10028, USA. Tel: (1 212) 861 3890; Fax: (1 212) 517 4054; Email: j dechollet