With the curiosity of a child, Venky’s eyes roamed the waiting room, focusing on a plaque in front of the doctor’s office. Unfortunately, his attempts at reading it failed.
Venky faces pre-diabetes, and I observed a diabetologist converse with him and his mother (in Tamil) about healthy lifestyle modifications (diet and exercise) to prevent diabetes. In the process, I learned how Venky’s current lifestyle makes it really difficult for him to follow through with the doctor’s recommendations. This 11-year old boy attends a gurukulam (a type of boarding school), where he only learns Sanskrit, a sacred Indian language. All lessons are given orally, with math, science, and English being out of question. When the doctor asked about playtime, Venky’s eyes widened and he shook his hands. “No, we are beaten if not studying!”
Venky is one of many children in India who face barriers to healthy living, which stem from illiteracy, inadequate physical activity, and traditional thought. Without being able to read and write, people like Venky will be incapable of learning from many intervention strategies and health promotion programs, such as pamphlets, posters, and presentations.
I often come across health-promoting signs and posters in the Tamil language. Without pictures or an English translation, it is very difficult for myself to understand its message! How will people reduce saturated fat intake and consume proper amounts of protein, without being able to read nutrition labels and understand MyPlate guidelines? Even with verbal explanations (which often slip the mind), I believe people who are illiterate will have great difficulty in learning to stay healthy.
So why exactly are these children not going to school? Are they just not interested, or is there an underlying reason?
A few weeks ago I stopped by a small roadside shop to buy a bottle of water. (Side note: Usually my water comes from supermarket bottles, but I was traveling and had run out. I’ve really come to appreciate the luxury of clean drinking water coming from my own tap. Some days I forget to buy water before coming home- having to again venture into the heat just to buy water is a struggle). Anyways, there seemed to be no one at the counter, so I looked around when a voice came from down below. A child, about Venky’s age, was asking what I wanted.
Child labor is widely present in India, and most common in poverty-stricken households. And without receiving any proper education, it is really difficult for these families to rise from their financial burdens and lead fulfilling lives. If there was a law prohibiting child labor in India, I would be all for it. However, it would also impose a burden on families who rely on multiple working members to feed each other.
So I would say the moral of this story, is that improving the health of populations is not only dependent on having knowledgeable healthcare providers; it is also important for people receiving healthcare to be capable of doing so. In illiterate populations from lower socioeconomic status, for example, it may be more useful to begin with teaching them how to read and write, before implementing higher-level health literacy programs. Or, scaling down these programs to verbal explanations, and tailoring them to the population of interest, is also a feasible approach.
Whatever it may be, this experience with Venky and others like him has really shown me the importance of looking past the physical body of a patient, and understanding the person in the context of their own culture and lifestyle. This is a theme that seems to repeats itself, whichever population you are working with, in any location and with all health problems.
And finally, I envision a world where all children can go to school– regardless of their race, gender, socioeconomic status, etc. In my opinion, learning to read and write, understanding the laws of nature, and history of our past is of utmost importance—in not only promoting the well-being of our world’s population, but also creating progress in our society.
My next blog post will address another issue concerning education in India: a factory of Engineers.
See you next time!