For a healthier next generation: Hand washing session at a school in Ludhiana

Today in many of the slums and villages in Ludhiana, the sight of children and their families crowded around a big green and yellow vehicle on a hot summer or a cold winter day is not unfamiliar. This vehicle is Smile Foundation’s Smile on Wheels mobile hospital that provides free healthcare to children and their families at their doorsteps.

Over the last two decades, Ludhiana has emerged as one of the most important industrial towns in not just Punjab, but the whole of North India. Such rapid and enormous growth of the city has resulted in migration of poor population from smaller areas of Punjab and other states like Bihar, UP, Haryana and Rajasthan in search of employment. Due to low income level and inadequate housing facilities, several slum clusters mushroomed in and around the city to accommodate the migrants. As per the provisional records in Census 2011, at least 15% of Ludhiana’s estimated population of 1.6 million live in slums; this does not include a significant number of the homeless and other people from non-notified slums who remain outside the purview of municipal records.

Absence of safe potable water, sanitation and toilets, waste collection and other civic amenities in slums have made living conditions onerous for its residents.

Communicable and vector borne ailments like tuberculosis, diarrhoea, dysentery, worm infestation, malaria, typhoid, dengue, skin infection, scabies and RTI/UTI among women are common in the region. Already burdened with the grim physical environment, these slum dwellers working as daily wage labourers, rickshaw pullers, rag pickers and housemaids can hardly make ends meet let alone spend on healthcare.

Smile Foundation has partnered with Deutsche Bank to serve the underserved population in the city. Jugiana, Shrabha Pind, Pratappura, Jamalpur, Tajpur Road, Fatehpur and Mandi Ahmedgarh are among the 18 slum settlements in Ludhiana where Smile Foundation is rendering preventive, promotive and curative healthcare services.

Every day at 9 AM, the team of Smile Foundation’s health workers, including a doctor, nurses, pharmacist, lab technician, volunteers and a project coordinator, start their journey through the grey streets of Ludhiana. They carry out daily OPD services in two shifts – morning and afternoon. The Smile on Wheels mobile hospital treat more than 100 children and women every day for common illnesses, providing medicine and immunization services, as well as micronutrients and nutritional supplements to treat and prevent malnutrition.

“The most common cases we see are related to cold cough, joint pain, scabies, UTI among women during winters and diarrhoea, vomiting, scabies, dysentery, and worm infection during summers. During monsoon, the number of patients increases and we get many cases of malaria, typhoid, dengue and skin infection,” said Dr. GP Singh, Senior Doctor who leads the medical team.

“The slum dwellers live in poor hygiene conditions - amidst the rubble, combined with a general lack of safe water, causing more children to fall ill,” he added. The number of families relying on the Smile on Wheels mobile hospital is increasing every day, as the nearest Primary Health Centre is at least at a distance of 10 km. Moreover, the unwillingness to lose a day’s wage makes people ignore health conditions of their self and of their families.

“Although we come here every day for six hours, we barely stop work for one minute. We see one child or mother every 10 minutes while dozens of others are lining up outside in the chilling cold,” said Sitaram, Project Co-ordinator of the Smile on Wheels Mobile hospital in Ludhiana.

To spread awareness on health-seeking behaviour, a team of community volunteers also accompanies the mobile health clinic, passing on information to caregivers and answering questions on how to prevent children and the family members from common illnesses. Several IEC activities like street plays and audio visual shows are also conducted to encourage health-seeking behaviour in people and sensitise them about basic hygiene and healthy living.

On a regular basis, exclusive community meetings are conducted to address women-related issues, such as childbirth, ANC/PNC, maternal and infant nutrition, immunization and family planning.

“Newborn children and infants are left to be cared for by their grandmothers, deprived by default of natural breastfeeding and even complementary infant feeding, which they can’t afford to buy,” said Gangandeep, one of the nurses and counsellor from the project. Some caregivers are improvising by preparing sugary water drinks. But even children who are under the care of their parents face challenges as well.

“During one-on-one sessions with mothers, we hear all kinds of dreadful stories. Many of them are single mothers who are facing the world alone. Their psychological wellbeing and lack of a support system makes it hard for mothers to exclusively breastfeed and to provide the most nutritious foods in their children’s early years of life,” Gagandeep adds. “So we are their support system, we’re their friends and their confidants.”

Besides delivering preventive, promotive and curative services at the doorstep of beneficiaries, Smile Foundation develops a bridging network between them and the public healthcare system through referrals.

Started in 1st January 2017, the Smile on Wheels mobile hospital project in Ludhiana has benefitted over 18000 children and their families in one year.


People line up to receive healthcare services from the Smile on Wheels

“I have never been to school, neither did their mother
– but I know – Education changes lives”

Standing tall and proud - Mahesh with her three daughters, outside their "temporary" lodgings

I was an orphan – I struggled like an animal since I was a child. I begged for food, I carried bricks at construction sites – I did all kind of odd and small jobs to survive in this world. I was no one for anybody. I suffered from lack of food, lack of love, and lack of a home. I grew up vulnerably, with emptiness killing me from inside. I stopped smiling, dreaming and hoping. For everyone, I was just a homeless labourer – until I met Salma – another orphan who worked at the same construction site. She used to forcefully talk to me. I started talking to her too; it was different for both of us as no one talked to any of us before with respect. We got married after two years and were blessed with three beautiful daughters.

I have no regrets even though we are very poor. We have almost nothing except each other. Together we earn a very little amount of money but we are never hopeless about our earning and our life. We understand each other completely. The most valued part is that we love each other unconditionally. We help each other in our tasks. I help her with her household work, and she helps me in every possible way. Other workers in the construction site are surely jealous of us. I am certainly blessed with her.

We still don’t have a house of our own, but we have found shelter for ourselves in the roof of a public toilet. Most often

my eyes get wet when my children complain that people laugh at them for making a toilet their shelter. I tell them – this shelter is temporary, their permanent home is in my heart, which is the most beautiful of all the heavens.

I always wanted to send my daughters to school, to educate them. I wanted them to stand in front of people with dignity. I never wanted anyone to look down upon them like the way everyone did to me. My children are my world. I am really grateful to all the people who are educating our children for free. Today, all my girls go to school. When I go home they always show me their class work copy, I don't understand anything, but I use to kiss in their hand writing. I want them to be educated. I have never been to school, neither did their mother – but I know – Education changes lives.”

More than 700 children like Tulsi, Versha and Radha are currently studying at the centre. Uttan, a quiet rural settlement in Thane, Maharashtra, is being gradually transformed with the power of education.

- Mahesh, Father of Tulsi, Versha and Radha. His three daughters have begun schooling at Smile Foundation's Mission Education centre in Uttan, Maharashtra

More than 700 children like Tulsi, Versha and Radha are currently studying at the centre in Uttan village. Uttan, a quiet rural settlement in Thane district of Maharashtra, is being gradually transformed with the power of education. Majority of the children coming to the centre belong to poor Koli families who earn their livelihood through fishing.

It took months of counselling of the parents, door to door visits to their homes and continuous awareness sessions in

the community to bring every child in the school. At the Mission Education centre (Amcha Ghar), these children not only receive education, but also healthy food and essential healthcare. They are also being taught basic hygienic practices, good values and different activities, to ensure their holistic development. Recently, the centre has also initiated self-defence training by a professional trainers for all girl children.

Today, it is not just the children who are being impacted by this change, but also their parents, for whom life has become a lot brighter with the hope for a better future!

Self defense classes for girls is one of the latest additions in the school's curriculum to ensure holistic development of the children

Just 60 kilometres away from the bustling city of Bengaluru is the little known village of Bhaktharahalli which cuts a very different picture from its neighbouring metropolitan. Bad, broken down roads and limited transport facilities make even the most basic amenities inaccessible for the villagers.

Home to around 500 families, Bhaktharahalli has majority of its population engaged in farming and agricultural labour. Due to consistent low rainfall, the area is declared drought prone every year with the poor, landless farmers bearing the brunt of crop failure and incurring heavy losses.

For these families struggling to survive every day, sending their children to school had never been a priority. Steeped in poverty, the villagers had neither the awareness nor the time to understand the importance of education. Preparing children to become extra hands at work and add to the household income seemed a much better prospect to them for sustaining their hand-to-mouth existence.

“We were born here and grew up here. We have faced all the challenges first hand. Till 1986, there was only a single-teacher primary school in the village. Higher secondary education was a distant dream for us, which we pursued hard, walking more than 15 kilometres daily to reach the nearest school. For the girls, the situation was even worse. Parents would not let their daughters make the long journey alone. This became an excuse for confining them to household chores and marrying them off early”, shares L Kalappa, who initiated BMV Education Trust some three decades back with his friends, to make education accessible for children in the Bhaktharahalli village.

The idea was to start a school within the village, so that children could save the time and trouble of travelling far just to reach their school. L Kalappa and his friends worked hard relentlessly to get all the permissions and registrations, and then set about the task of finding the right space for the school, and starting the actual construction of the building. With limited resources, they had to face challenges every day, and many times they thought about closing down the project. But somehow one helping hand joined with another and they were able to establish a primary school in Bhaktharahalli.

One of the biggest challenges was inducting the first batch of students. The dedicated team of teachers from BMV went from door to door, talking to parents, convincing mothers to send their children to school. Many doors were shut in their face by parents who wanted their children to work and earn rather than learn. But they did not give up and with rigorous efforts were able to bring more and more children under the fold at education.

“It was the first small victory for us when after a few initial years parents started enrolling their children to the school without being prompted. It was all thanks to the efforts of the teachers, who were working day and night and giving their best to the children. Parents could see the difference education was making – the children behaved properly, dressed up neatly, talked confidently. What pained us was that despite the extra labour being done by the teachers, we could not pay them adequately. Due to lack of funds, there were times when we were not even able to pay their meagre salaries for months” L Kalappa says.

There were other hiccups – the upkeep of the school could not be maintained, no qualitative transformations were possible. With a fresh batch of children joining every year, and requests of admission coming in from neighbouring villages, the space as well as scope of the project was becoming limited. Just when the school had been accepted by the community, a crisis situation looked imminent, and L Kalappa and his friends started seeking help from all quarters to make it survive.

“We could not crush the hopes of the children, of the parents after first raising them. We were in the worst possible situation when Smile Foundation approached us. That was in 2008, and we have not looked back since. With the support of Smile, we were able to provide facilities like transport, computer labs, library, special coaching for senior students, nutritious meals, exposure visits, sports and other co-curricular activities to our students for the first time. Over the years, through continued handholding and training sessions they helped us not only remunerate our teachers well, but also facilitated their capacity building. Innovative teaching learning material, mathematics workshops, science exhibitions, brainstorming and ideological camps were introduced in the school to enhance the overall learning experience of the children”, shares L Kalappa.

BMV started as a primary school, but now has a High School and Nursery School too. Children from seven villages – Kakachokkondahalli, Basavapattana, Malamachanahalli, Belluty, Tadur and Thotluganhalli, besides Bhaktharahalli study at the school. The school has been consistently achieving 100% results in the SSLC examinations, and many BMV pass-outs are now studying to become doctors, engineers and officers. Every once in a while there is a gem like Kumari Monica who secured 96% in her SSLC (2015-16) examinations, and became the district topper.

L Kalappa sums it up, “We feel proud that we have been able to bring some change in our village, in the place of our birth. Our children do not have to face the same challenges that we had to. And the outlook of the people has drastically changed. But this is just the beginning. There is still so much more to do”.