“Women must be seen as the agents of change rather than the objects of change” Amartya Sen.

When I first met the late Dr Indumati Parikh in January 1999 while attending the 14th World Humanist Congress in Mumbai, I could not believe that here was a woman who for 35 years had been putting into practice what was only then coming to be recognised by the international development community as the leading development paradigm: integrated health care, education, and women’s empowerment. The women’s self-help organisation that Dr Parikh founded, Streehitakarini, is still going strong.

In early 2001, after discussions with Dr Parikh, Dr Ramesh Potdar, now executive director of IHEU member organisation Centre for the Study of Social Change, and the International Foundation for Population and Development in Lausanne (despite its name, a small Swiss organisation), we decided to try to replicate the success of Streehitakarini in other slum areas of Mumbai. Based on the MN Roy Human Development Campus in Bandra East (the home of CSSC and the location of the 1999 World Congress), the idea was to open 20 small clinics in the neighbouring slums, with a small hospital for referrals in the M N Roy building itself. We called the project WIN: the Women of India Network.

The WIN project is now five years old and our initial objective has been achieved, with 20 slum clinics now operational on a regular basis, providing the only social and medical services to a total population of some 84,000 people.

The WIN Program

Each clinic now opens typically two afternoons per week, attended by a GP and a dispenser/record-keeper.

Each doctor sees an average of about 15 mothers and children in an afternoon. The GP visits are supplemented by monthly visits to each clinic by a paediatrician and a gynaecologist. Each clinic caters for a total population of about 4000 people, about 400 of whom visit the clinic in any three month period. The most frequent conditions presenting are respiratory infections. But WIN provides more than simply medical attention, important though it is. The program also provides non-formal education, vocational training, adolescent education and organises savings groups.

The key to the entire operation is the network of local women trained as health workers, and their detailed record keeping. Over 150 local women have so far been trained. Many more women are trained than can be employed. According to Dr Potdar, 80% of those trained would want to be employed if employment were available. There is demand for the training course simply as a course to help women become better mothers.

Each clinic has a team of four health workers and a junior supervisor. 15 of the health workers have received in-depth training on infant and maternal health. There are four senior supervisors, each responsible for four to six clinics. All have been recruited from the local community. Overall supervision of the health workers is in the hands of Mrs Aruna Churi, recruited from Streehitakarini, and who had worked with Dr Parikh for 35 years.

In addition to their health promotion activities, each health worker is responsible for record keeping for her community of 250 families.

The Human Impact

Over the past four years I have visited most of the WIN clinics. Some are in poor slum areas. While others are in very poor areas. But nothing prepared me for my visit last month to the clinic in Garib Nagar. To reach this climic you have to pass through a gap in a wall alongside a disused railway track, covered in garbage. Then a narrow alley between rickety buildings leads to a lean-to structure about 9 feet square. There were four Muslim women with babies waiting to see the young doctor. As I arrived, one woman left carrying her baby, paddling through some filthy effluent outside the door as she made her way home to a tar-paper shack. She had no shoes. In Garib Nagar the people are Muslims, in other clinic areas there are Hindus, Jains, or mixed communities. Ambedkar Nagar is a Dalit community. WIN, a Humanist organisation, is the only medical service these women and children see.

Without the help of our donors there would be no medical services for these people. There are no medical services for thousands upon thousands of people just like them in slums all over Mumbai – and in many other cities in India.

Without doubt WIN has been an enormous success. In over 20 years of involvement in human development this is by far the most cost-effective program I have ever seen. Part of the secret is that the doctors give their time freely to the project, being paid only a nominal sum for expenses. Vaccines and contraceptives are supplied at no cost by the government. Another secret is that the women of the slums themselves are responsible for much of the work. Their positions as health workers gives them some status in the community and their modest income helps with the family budget. Patients that can afford it pay two rupees (about 4 cents) per visit and one rupee per antibiotic pill. The net cost that needs to be met by donors is just $5,000 per clinic per year.

Where Now?

Given the evident success of WIN, we do not intend to rest on our laurels. We intend to replicate WIN as soon as possible in two other slum areas of Mumbai. But to do this it will first be necessary to fully document the medical and social procedures and the training programs. This will cost money. We are currently seeking funds to appoint a research and documentation professional to take on this task. This is an essential step both to ensure continuity as well as to provide the handbook to enable the WIN programme to be replicated elsewhere.

We are still dependent on funds from supporters to keep the existing programs running but we shall need new donors if we are to spread the program to other slums.

For those of you interested in supporting WIN, an excellent DVD film of the project has been made and is available in English and French. Please email for a copy.

Please help us, it costs so little – and brings hope to people who otherwise have nowhere to turn.

Roy Brown is immediate past President and currently Chair of IHEU’s Growth and Development Committee.