There are thin white lines made freshly this morning in some sort of powder that stretch down the edges of the road through the village that leads to the Community Mobilization Coordinator (CMC) station. They stretch around a bend where they meet abruptly with a large “WELCOME” painted across the width of the road in the same white powder. Following the lines further I can see our ASHAs standing on the side by the station in eager anticipation. This is our first visit to the village and they promise to make it an interesting one.
We disembark to greet them and meet a handful of the village’s CMCs who all dress in a similar sky blue and wear ID badges around their necks. Two of them simultaneously hand us each a pair of yellow flowers and smear a tilaka on our foreheads while a few others bring out plates of sweet and savory snacks. There is a wood fire burning that will soon be used to deep fry more chakli, long strings of yellow, savory dough fried until crisp. The smokey aroma drifting through the fresh air of the country side is a welcome change to the horn-blaring filled streets of Lucknow. We sit in a tight circle around the entrance to the station, surrounded first by a row of the CMCs, each twirling a hand-made fan above our heads, then by a far larger row of on-lookers and passers-by, a constantly fluctuating mob of youngsters and oldsters alike, elbowing each other for a better vantage point.
Three of our ASHAs, Snelata, Vinuto, and Somyan share responsibility in this village and each tend to visit four or five households per day or in the case of a delivery or an emergency perhaps only one preceding a trip to the hospital in Sitapur. Although these are not every day occurrences, with each ASHA responsible for approximately one thousand women, they occur more frequently than one might imagine. The CMCs and the ASHAs cooperate in their work, although the CMCs are responsible for a broad range of programs, including general nutrition, child services and community education.
Once we get started testing our new CommCare revision the positives and negatives come out literally in seconds. The ASHAs are familiar with the phones and the look of the system and have no trouble voicing their opinions. It is nearly impossible to tell whether “Yes” or “No” is highlighted in each question before selecting it and afterward it is just as difficult to tell which one was chosen. This is the core functionality of the entire program and it is beaten to smithereens within five minutes of field testing, rendering the rest of the application practically useless before this problem is fixed. The surprising thing is that it took even this long to recognize that the problem existed. Development inside a structured environment is easily blinded from the harsh realities of the field: poor eyesight of workers with no glasses versus screen glare from the sun, calloused, insensitive fingers versus tiny keypad buttons, and general comprehension of a technological system by non-technological minds.
Regroup and reformulate. We focus more on our discussion and potential changes we could make. Our group has strong opinions on what they would like to see and we get concrete responses towards introducing better visual and oral feedback and creating a rating system to use for the mothers-to-be. We end the discussion and head off down the dirt road with Snelata to observe a household visit. The woman we go to see is well in to her third pregnancy, with her second and youngest child now at the age of six. She sits on top of a straw mat on the floor next to a near-complete, woven basket. Her leg is swollen and she complains that it hurts badly. Snelata questions her on her food consumption and whether or not she has followed her regimen of Iron and Folic Acid tablets that she is supposed to take daily, from which she concludes that the woman may be anemic and needs to up her dosage of both the food and the tablets. The woman complains that she doesn’t feel hungry and doesn’t want to eat more than two meals a day, but Snelata insists, telling her that she will be back tomorrow with additional tablets and coaches her on proper vegetables to eat with a high Iron content. The clouds are getting heavy and dark and we are told that we had better get moving, so we thank the woman for allowing us in and are on our way.
The moment we are on the road, the wind starts howling and the temperature drops degrees in seconds. We are told to hurry.