Kashmir’s Women Paramedics: Bringing hope and driving change

It was just another mundane day for Munira Manzoor until a knock on the door changed her life. That moment marked her journey of transformation – from school drop-out to respected paramedic in her village of Zuhama, in Kashmir’s Budgam district.

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The year was 1997. The valley was in the throes of armed insurgency and the healthcare system, especially in the remote areas, was in a shambles.

“Most of the doctors, who were from the minority Hindu community, had fled Kashmir,” 35-year-old Munira says. “Both the government and private healthcare facilities were in poor condition. Even the treatment of small injuries was not possible, as paramedics were too scared to step out. This severely affected women, particularly pregnant women. The nearest maternity home was in Srinagar, and for people in remote areas it took a long time to reach the hospital as we had to stop regularly at army check posts.”

This crisis in healthcare deeply disturbed doctor Ali Mohamed Mir, a retired Indian Administrative Service officer. He wanted to do something to ease the problem. So he collaborated with the Jammu & Kashmir Voluntary Health and Development Association (J&K VHDA) and decided to reach out to the worst affected villages. Ten villages in Budgam, seven in Pulwama and five near the border in Khansaab were adopted.

In the beginning, the J&K VHDA organised out-patient departments for administering first aid and other treatment. But women were very reluctant to be treated by male doctors and paramedics. That’s when they decided that they needed to build a team of local women paramedics.

Training

Mir went from door-to-door in the villages, asking women and girls to volunteer. That’s how Munira suddenly found herself undergoing training in basic healthcare, natal care and in trauma counselling. As a class nine drop-out, Munira had never thought that she would one day make such a contribution to her community, but when Mir presented her with the opportunity, she instantly agreed.

“I learnt about anti-natal and post-natal care. I underwent training – gradually – and began by going from home to home, finding and registering pregnant women,” she says. She also learned how to talk to women about basic healthcare, nutrition and pregnancy care.

But it wasn’t easy. In the shadow of militancy, Munira and her colleagues worked at great personal risk. The women say, although they felt insecure, they were able to persevere because care-giving is considered as apolitical work.

Mir’s daughter, Ezabar Ali, conducts the training sessions. She says, “To make our working transparent, we conducted all our meetings in the open so that the entire village would know what the volunteers were doing.”

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Opposition

Despite the open approach, they faced a lot of opposition. “Initially, people laughed at me,” says Sakeena Shafi. “They would poke fun by saying ‘Look, the doctor has come.'” She had just passed class 10 when she saw her first J&K VHDA medical camp and decided to become a paramedic. She became a volunteer in 1999.

Sakeena has since become irreplaceable for the pregnant women in her village. She has become an expert advisor when it comes to anti-natal and post-natal care. She also talks to them about family planning and occasionally helps train other volunteers as well.

Safeena, from Zuhama village, has been working as a volunteer for the last five years. She says she’s thrilled that she can help people. Inspired by Munira to undergo training, she has been particularly effective in reaching out to women who’ve been emotionally scarred by the conflict.

Counselling

Trauma counselling and mental healthcare have emerged as big issues in Kashmir. Scores of mothers whose sons have disappeared or been killed have suffered great trauma. Wives have had husbands go missing for years. Everyday they find themselves trying to cope with the pressures of loneliness and uncertainty.

Many women in far flung villages had been suffering in silence. But now, in volunteer counsellors like Safeena, they find a sympathetic ear. Seventy year-old Magli, who lost a young son to militants and suffered from acute depression for years, has someone with whom she can talk; Safeena visits her regularly and Magli has slowly begun to recover some of her composure.

Today there are more than 50 women health volunteers in Budgam, Pulwama, Baramullah and Srinagar. Besides the healthcare they deliver, they have emerged as icons for the local people. Safeena says, “Earlier, most families sent only their sons to school. But after seeing our work they have also begun to pay attention to their daughters. They can see that girls too can play a role in the development of families and the community.”