Adventures with the Growth Chart
It was during my days with Mansi ( Program Executive- Nutrition at BHS) that I got the chance to help the Swasth Kirans (similar to ASHAs at BHS) and Phulwari Workers ( staff at Phulwaris, BHS’s creche service for children of 6 months to 5 years age) learn how to use the Growth Chart, how to mark on it so as to record and monitor the growth of the children in their locality/ Phulwari.
During the Pediatrics posting, every student must carry their bundle of WHO growth charts.Often the professors scolded for not bringing it or for not marking our patient’s anthropometry on it or for not paying attention and marking it incorrectly. One of the must said point when asked for its’ uses during the viva was, “It was helpful to monitor growth,especially in low resource setting.” All these memories, came flooding back to me when I saw our field workers with their Growth Chart Booklet.
To mark on the Growth Chart, they need to learn to derive the age of the child in years and months as per the present date which can be done either manually or using an app, which those who have phones can use.
Yes, I did use the word derive, it may seem like a simple Grade 5 Maths problem, but for the SKs/Phulwari Workers, some of them who only had formal education till Grade 8, of questionable quality, some of them illiterate, it was indeed a Herculean task. It was easier for them to manage Phulwaris with over 15 children, make the perfect round rotis and cook three meals for their families of 8-10 people, milk the cows, do all the work in the field-plowing, sowing, watering, weeding and harvesting than this nightmare.
During one of the Phulwari Workers Training Session, I came across the most graceful and calm Phulwari Worker (PW). She always had a smile on her face, be it when I visited her Phulwari, be it during this session. When the class on the Growth Chart started, she looked worried and tensed. She wasn’t able to keep up with her colleagues and everyone personally was in their own struggle trying to figure out what was being taught.
I sat with her and talking to her I understood that she doesn’t know how to read and write, and only learnt how to read and write numbers after starting to work as a Phulwari Worker. Hence she did not know how to manually calculate and found it difficult to enter the numbers in the app.
But she was determined to learn. She could have given up, because all the Phulwaris have one literate worker. She could have put the load on her colleague, but no, she wanted to learn to do it herself. With a toddler in hand, she started, with the spirit and determination of a mountaineer trying to summit Mt. Everest. I tried to help her and explain the process step by step and was she a quick learner ! It took her sometime to use the app and fill the data, but she aced marking the Growth Chart.
On talking with her, I got to know that she really loved going to school, but she had to give up when she was in Grade 3, as her mother was ill and she had to stay back. She was then caught in the whirlwind of life, married off at a young age, soon had children and was confined to her home. Now that she is a Phulwari Worker, she sees this as a second opportunity for her education, to learn how to read and write.
What did I do to be in this privileged position? Both of us are from the same country and clearly she is much more determined than me. But why ? Such incidents just make me realize how privileged I am, how I should value it and do my best and work towards bridging the gap.
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