Family planning in the slums of Mumbai
Bhiwandi, a couple of hours’ drive from Bombay, is renowned for its power looms. The cotton produced here is then sold everywhere in India and around the world. Some of the poorest people from all over India travel to Bhiwandi to take advantage of this lucrative trade.
Loom workers make about 8000 to 10,000 rupees (approximately £80 to £100) a month, which is not enough to live in Bombay, so, just like 50 per cent of the city's population, they reside in slums. Children are also often put to work to create additional sources of income for many families.
In the slum, hundreds of families of eight, some times ten or 12 people, reside in ‘houses’ that are on average only about 10sq m, with no access to drinkable water or toilets. Family planning and contraception are unknown options for most of the women who live in the slums and who, on average, give birth to six or seven children.
‘Contraception is often not a priority, as women know little about it and their husbands often forbid them to use it,’ says Jayashree, one of the social workers working with NGO Inter Aid, a French organisation that offers vulnerable families in the slums of Mumbay the chance to improve their living conditions. Seven social workers visit Bhiwandi's slums on a daily basis to speak to the women when the men are at work and to offer them advice.
‘Women in these conditions have no self-confidence’, says Jayashree. ‘From the day they are born they are told that they are inferior to men and only good for marriage. They are often married off very young, usually aged 13 or 14, and start giving birth to children almost immediately. Contraception is not an option.’
Layla (not her real name), 27 years old, was born here. ‘Malaria,’ she says quietly as she points at her husband lying next to her. Her sick husband is unable to resume his work as a labourer, leaving Layla to find other means by which to feed her family of five. Like most women in the slums of Bhiwandi, she spends her days beading bracelets when she is not looking after the children. She makes about 20 to 50 rupees (about 20p to 50p) a day from the sale of the bracelets – hardly enough to feed her family.
Layla looks after her husband’s three children from a previous marriage. His first wife ran away one day leaving her three children behind. Sick with malaria, her husband also has cancer, is HIV positive, and has previously battled tuberculosis. ‘We’ve had her tested as well and she is also HIV positive,’ says Jayashree, adding that she is not sure if the children would also test positive.
Aakriti is 25 years old and has four children, all delivered at home by her mother, but she is pregnant again. Her husband, a driver, is never at home, and she is left alone to look after the family. She tells Jayashree that she would like to take a break from giving birth, but her husband is against it. She tried putting her children to school, but they seem to lose their way and never reach it, and Aakriti is too anxious about her husband’s absence to really care about it.
Jayashree reveals that she has tried to convince Aakriti to give birth in a hospital, but that this is not commonly practised here, and for her to agree to see a psychologist to evaluate her anxiety level and state of mind.
‘Contraception is often not a priority, as women know little about it and their husbands often forbid them to use it’
Reetha (not her real name), 31 years old, smiles softly as the social worker talks to her. They have been advising her since September and she is used to their regular visits. Her daughter, aged 12, is beading beside her. She says with some pride, that she has sent her children to school, but only the girls are willing to go. A mother of six children, Reetha was born in the slums and has spent her life there, although her mother is originally from the Uttar Pradesh, one of the poorest states in India. Her husband does not work, so Reetha must find ways to make money, sometimes with the help of her children.
She tells us of how proud she is of her oldest son, who is 18 years old, because he works to help the family. What Reetha will not tell us, and what Jayashree only admits once we’ve left the house, is that the son suffers from substance abuse and regularly beats her.
‘We’ve made progress,’ Jayashree says, ‘we follow these families for months and inform them on the means available to them. We believe that with the necessary information, these women can go a long way.’