Tuesday, October 15, 2013

One idea in eight stories

Published here on October 4, 2013.

The term ‘governance’ gained currency several years after I started studying political science. I may have first heard it used when I was hired as a researcher on a now-classic  multi-country project on governance in South Asia. I had such a lowly part to play on the project that it really didn’t matter that I had no idea what it meant. I came to understand that while government was the structure and framework my political science classes had taught me, governance was what government delivered. There was no good governance or bad governance. Governance existed by virtue of being delivered; if government was not delivering on its functions, governance wasn’t happening, didn’t exist. Now, twenty-five years later, everyone talks ad nauseum about good governance. The truth is I still don’t have a text-book, “expert” sense of what it means.

Never having formally learnt a pithy definition that I can put to work, measuring the government’s performance, in the time-honoured Indian way, I turn to the stories from mythology and history that are deeply embedded in my consciousness. What do they tell me about what to expect from my government?

Once there was an Emperor who built himself a new city. In that city, he built a special place for teachers and thinkers from different places to meet and exchange views. He dreamt of building a new syncretic way of thinking based on their best and their common teachings. In his heart, their incompatibilities were outweighed by the possibility of their confluence. We remember Akbar for many things, but most of all, he stands out in our memory as a person who wanted to make space in his empire for every faith and every school of thought.

And it’s not just about religion and secularism. It’s the idea that all are equal in the eyes of the state—irrespective of sex, age, caste, faith, class, language or any of the other. To me, bringing people together, and not dividing or ghettoising them, is an important political and policy value. The minimalist corollary of this is not to discriminate on any of these bases. The maximum extension of this is to facilitate everyone’s participation and to invest in consensus-building and consultative decision-making.

A very long time ago, kings sitting in Pataliputra imagined, directed, strategized and created an empire whose borders look incredibly like those of modern South Asia. They had no telegraph, no photography and not even horses. They pulled this empire together through conquest, but their genius lay in holding it together. The Mauryas did this by creating a clear administrative structure where every level and office knew its jurisdiction and where every functionary knew their work, who was reporting to them when and to whom they were expected to report and on what schedule. Well-established lines of reporting, feedback and information sustained the system.

Work is so much easier for governments in this information age. Government works when public servants are able to communicate and implement policies across jurisdictions. It works best when citizens are able to engage with these processes and inform them. Indispensable to this end are clear maps of authority and lucid delineation of duties—as well as rights.

A single road connects Chittagong to Kabul. It was said of the king who got it built that in Sher Shah Sur’s kingdom, an old woman could safely walk highways at night carrying a basket of gold on her head. The elaborate multi-level structure of administration created by the Mauryas was now supplemented by infrastructure development and codified systems of revenue collection. His dynasty was short-lived, but his administrative legacy makes Sher Shah one of India’s most celebrated rulers.

It is the small things, the boring details that make government effective. The road that is paved. The garbage that is collected. The tax assessment that is clear. Comprehensible procedures for every transaction. Beyond the vision statements, laws without loopholes and unobjectionable policies, the work of government is done everyday in individual transactions and exchanges.

He did not make the promise in person but in a guest appearance in a dream. But when the venerable sage came to claim the kingdom he’d been promised in that dream, Harishchandra did not hesitate and gave it all away. Selling his wife, his child and himself to meet the sage’s demands and honour his promise, Harishchandra brought the same integrity to his work at a crematorium when he insisted on his wife paying tax to cremate their child.

The proprietorial sale of wife and child make me flinch, but combine Harishchandra’s commitment to truth with Gandhiji’s transparent introspection and you have a quality of integrity that public servants must have. The Right to Information would then be hard-wired into them, and their inner Lokpal would suffice—no need for a monster institution with all kinds of powers.

All over the northern part of the subcontinent are strategically located rocks and pillars that took his words and ideas out, in multiple languages and scripts, to those in his land and those who visited it. In addition, these edicts were read out to the people from time to time. There could be no doubt that Asoka, who saw everyone in his empire as his children, tried very hard to communicate with them.

It is not enough to have good intentions; it is very important to communicate them. In recent decades, how many large budget projects have been launched without the initial field assessments and expert reports shared? The will to communicate, to respond, to engage is conspicuously missing. That there might be questions or objections or that there might be alternative views is rarely taken on board. We are left fighting decisions after they are made, rather than engaging with the process of making them.

One morning, he heard of a husband’s taunt to his wife who had stayed away all night, “I am not Rama to accept my wife after she spent a night elsewhere.” Stung by the thought that someone in his kingdom was sceptical about his actions and motives, and moved to respond with action, Rama exiled a pregnant Sita.

I now read this problematic episode from the Uttarakandam of the Valmiki Ramayana as an illustration of how patriarchal our traditions are but what it also shows is that kings were meant to respond (with tangible action) to public opinion. It was one person’s opinion, but it was important enough to hold up a mirror to the king, who felt obliged to respond. That is the only good thing we can take out of this story, and we must.

By omission, this story also underscores the importance of justice and rule of law. Should responsive action be summary justice? Following procedure, listening to both sides, allowing people to defend themselves—qualify a response as appropriate. A fair response is also a proportionate response. To have explained himself may have been a proportionate response, and also fair to Sita. Disproportionate responses please some but are unfair to others.

Backed by an army of friends and family, faced with an army of friends and family, Arjuna’s resolve wavered. He put down his bow and asked, “What is the point?” And the answer was: The point is to do your work. Your only entitlement is to do the work in front of you, without expectation of reward. It is more important to do your work than to agonize and strategize and pontificate, the charioteer’s teaching suggests.

The best stories are fine clay and can be shaped as we wish. Anyone who has been given the run-around to get work done to which they are entitled and anyone who has been trying to figure out who is supposed to do what work in an office would like to use this one to say to people in public service: Please do your work properly. If governance must have a very simple definition, surely it is this: things working as they should.

Whoever approached him with a request was sure to go away satisfied. One morning, he tore off the armour he was born with and gave it to the mendicant who was seeking to secure his son’s life. On another, he promised his mother he would leave all his half-brothers unharmed except one, so that she would always have five sons. Karna’s generosity stuns, every time you hear the story.

The generosity of kings is repeatedly extolled. Travellers to Harsha’s Kanauj wrote about the grand assemblies where he generously gave away food, clothing and wealth to everyone who came. Giving is important because redistribution of wealth in order to provide for everyone is an important duty of the state. Whether you call it development work or social welfare, taking care of those in need and those in distress is an inalienable duty of government. Caring government is good governance.

And what is the role of citizens in ensuring the quality of governance? After all, they say, “yatha raja tatha praja” (As the king, so the people) and that “people get the government they deserve.” And the distance between those who rule and those who are ruled has shrunk so much that citizenship must matter.
The relationship between citizenship and governance is a symbiotic one. Citizenship is entitlement, but it is also public service. It is ownership and it is responsibility. Government works when citizens make it work—holding representatives and government functionaries accountable; engaging with law and policy; taking responsibility to vote and participate, and being responsible and honest consumers of government services. Good citizenship enables good governance; and apathetic citizenship reinforces governance failure. Which one do you choose today?

PS: None of my stories feature women as agents; they are merely objects that are sold, exiled or protected. I noticed that, did you? If we cannot come up with stories starring women, how will our daughters know that they too can be rulers and decision-makers? What are the stories of women you would bring to this discussion of governance?

No money, no value; no value, no money

Published here on September 27, 2013.

“Where is Daddy? Daddy is in the office. Where is Mummy? Mummy is in the kitchen.” When I was a child, a very long time ago, girl children mostly played house, or teacher, or sometimes, doctor. Our doll sets rarely included males, because men were always outside the house or away from the kitchen set which defined the boundaries of our ‘house.’ I hope that play is not as gendered any more (I fear it might be); but that is another topic for another day.

From this very simple middle class childhood experience, one took away abiding lessons. First, men do not work in the house. My father did, but sooner or later, I came to tag him as exceptional. Second, the work that is done in the house somehow lacks value. Chicken-egg reasoning: Men did not do this work because it had no value, and the work had no value because men did not do it. When men did housework, they were to be celebrated and their work valued. Third, the daily work of women in the house did not need to be acknowledged (that is, paid). A woman (family member or worker) doing work in the house created less value than a man doing the same work. Fourth, women only worked outside the house out of necessity. Fifth, the work that women do, inside or outside the house, was in general less valuable. Furthermore, because it was safe to assume that women were not the primary bread-winners in the household, one could pay them less. Sixth, men needed to support a family, so for the same work, they deserved to earn more than the women who might just be doing the same work as a hobby or who might be better able to adjust their needs and household expenses to their income. Finally, for women, the lessons of acceptance and adjustment came with doing housework free and earning less than men at every turn. Most of us, in my generation, never learned to negotiate good working terms for ourselves.

I qualify all these statements with ‘in my generation,’ but my suspicion is that while the young women I work with are less reluctant to ask for better money, they are a lot more accepting of other workplace sexism. That too, is another topic for another day. The bottomline is, in an age where value is expressed as money, women learn very early that they are worth far less than men. This is reinforced by the world in every transaction.

Patriarchy’s cruellest turn, I believe, is the expectation that women have a natural instinct for and derive pleasure from housework and domestic duties. No doubt, because they are raised to think of themselves as nurturing and natural care-givers, most women learn to feel this way. The truth is, and few will say it, housework is mind-numbing drudgery if you don’t do it out of true choice, and though it keeps the world moving, no one will ever thank you for it or pay the true value of that work. And it’s not just work within the home—in the kitchen, cleaning, taking care of children, the sick and the elderly—it’s also going to fetch water and firewood; it’s going to pay household bills; money management within the household; tutoring the children; income generating activities (for the household, not the woman). Think also of the number of small family-owned enterprises (shops, for instance) where wives and daughters work alongside, but never receive pay. Women’s work, they say, is never done and all of it is under-valued. Paying women for the work they do would not only express value for the work, but express value for the women.

An internet-based labour research project has found that in India, women earned about 54% what men did for the same job. The gap is negligible at lower income levels but grows with rising incomes and with age. That is, it is much greater at senior management levels than at entry-level or minimum wage jobs. And older women earn much less than their contemporaries at the same career stage. The same project also found that the more educated women were, the greater the gap between what they earned and what their male colleagues earned. The profession with the largest wage gap was medicine. And we’re not even talking about ‘glass ceilings’ here.

Women’s work within the household, we have established, is not regarded as ‘work.’ The International Labour Organization has found that fewer women in India are working outside the home or looking for a job. In part they attribute this to rising incomes (so women do not need to go out to work) and in part, to occupational segregation—women tend to seek work in fewer sectors than men. Women also work preponderantly in the informal sector, where wages are low. Whether it is domestic work, construction work, agricultural work or as a small entrepreneur, this work yields a low income and an uncertain livelihood.

Gender stereotyping and gender roles play a part in this. Women’s access to education and livelihood skills are often determined by what is considered suitable. While professional colleges admit more girls than ever before, elsewhere in the economy, it is less likely that women will choose to be plumbers, electricians or auto-drivers. Discrimination in health care and nutrition only compounds the physical challenge of coping with the double-burden of working inside and outside the home.

Economists have been writing about and debating the “feminization of poverty” for three decades. By this, they meant that women were making up ever-larger percentages of the world’s poor, largely because they earned less and held worse jobs; and because more and more of them were single-handedly bearing financial responsibility for their families, stretching one small income further. Where market reform and globalization are exacerbating income inequalities and inequalities of access within society at large, this impact is felt even more by women. They are locked out of many emerging opportunities, and end up earning less in a time when everything costs more.

The conclusion is inescapable: the low value placed on women is reflected in the value we place on their work and the way we express that value in terms of money. Women read this clearly, and learn not to value themselves as individuals. They are a burden, what happens to them is their fault, they have no rights or entitlements; so, they adjust, accept and live as lesser citizens. The real loser is society itself.

Breaking out of this cycle is one way to change the status of women in India. This could be done by helping women increase their incomes through education and training, access to opportunities and access to credit. More fundamentally, of course, this means that the life-chances of women, men and others should be the same in any society—health care, education, livelihood and security. The burden of unrecognized and unpaid work that women carry can be reduced, partly by acknowledgment, possibly by the payment of a standard wage, and most definitely, by work-sharing in the household and in family enterprises. Finally, civil society and policy experts need to step up advocacy efforts towards “equal pay for equal work.”  No money, no value, no equality, no citizenship.

The instinct to care, the will to heal

Published here on September 20, 2013.

The right to health is a human right. First, human rights violations such as harmful traditional practices (for instance, female genital mutilation), slavery and torture have health consequences. Second, health policies and practices can have human rights dimensions, such as discrimination or loss of privacy. Finally, respect for human rights usually goes along with better health care policies and access. The “right to health” idea works mainly as a “call to action.” The “call to action” in this short article centres on four challenges that stem in different ways from the cocktail of patriarchy and poor health care.

Maternal mortality

“In India, we worship women as mother-goddesses.” We hear this all the time. Notwithstanding such devotion, India’s Maternal Mortality Ratio is officially 212 per 100, 000 births but others estimate it may be as high as 450 maternal deaths per 100,000 live births. Data controversies should not detract from the unacceptable reality that too many Indian women die from pregnancy, childbirth and unsafe abortions. A 2009 Human Rights Watch (HRW) report says that one in 70 Indian women who reach reproductive age will die this way.

Why? Working in Uttar Pradesh in 2008-09, the HRW team identified four factors. The first was the difficulty of accessing emergency care. If complications arose, women were sent from clinic to clinic in search of one with the right facilities. The second factor is that at a very fragile time, women had to travel long-distances to be able for instance, to have a caesarean section. No proper transport was available to help them, either. Non-existent post-natal follow-up and care, ergo post-birth complications, were the third factor they identified. Finally, the researchers found that even free health-care cost money because of the expectation that health-care workers would be tipped for every service—from cutting the umbilical cord to cleaning up. Failing to pay once, meant that the next time families approached the hospital, they could be faced with the nightmare of referrals.

For the same study, Tamil Nadu provided some pointers to good practices (though not to remedy the above factors), from awareness campaigns around maternal health to better death reporting to better training for health workers on how to report death with a view to improving health facilities in both public and private hospitals.

Universal access and sex-selective abortion

Modernization and increasing access to health facilities, usually considered factors that are good for women, have made sex-selective abortion more accessible and contributed to India’s declining sex ratio. Modernization has promoted the small family norm without getting rid of male child preference. Dowry is more common and lavish weddings a common aspiration. Simultaneously, more and more people have access to pre-natal diagnostic tools. This partly explains why rise in female foeticide correlates to affluence and the richest cities in India have the worst sex ratios.

Technology and patriarchy have together taken sex determination and sex-selective abortion to every corner of India. In 2010-11, the Health Ministry’s report stated that 39854 ultrasound and scanning centres had been registered under the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994. Many of these were being used as mobile units—in addition to registered and unregistered mobile clinics. Access to diagnostic techniques that can be used for sex determination plus the availability of legal abortion have also placed sex-selective abortion within the reach of NRIs who live in places where this is not an option.

The solution here is not to limit access to pre-natal diagnostic tools and make abortion illegal. It is to ensure safe and universal access to both along with strict regulation, honest and rigorous implementation of laws and parallel programmes to create awareness. Creating universal access without regard to its unintended gendered consequences is irresponsible and boomerangs on the most vulnerable—here, the female foetus.

Violence as a public health issue

Sometimes it seems as if an epidemic of sexual and gender-based violence has overtaken India.
A recent report found that, worldwide, violence against women is one of the most common causes of death and injury among women. Experiencing or witnessing violence leaves women (and others) with mental health illnesses, including depression. Those who experience violence are found to be far more prone to alcohol abuse (and this probably extends to other substances). They are also far more vulnerable to sexually transmitted infections, and in some regions, to acquiring HIV. Finally, not only is sexual violence likely to leave a woman pregnant, but in the quest to have an abortion where this may be neither legal nor safe, she puts herself at great risk all over again. The report also stated that women who experience partner violence are more likely to have a low birth-weight baby.

In the context of sexual and gender-based violence, two care-related issues come to mind. The first concerns the level of preparation among doctors and nurses to recognize and respond to signs that someone before them may have experienced violence. Having good protocols to follow is one part of this, but inculcating sensitivity is the other. The second has to do with the availability of crisis support—not just crisis support for victims of sexual violence, but immediate and intermediate term medical, psychological and social support that is available to anyone experiencing violence. As a society, we are unable to stop the incidence of violence. Are we able to provide survivors with the opportunity to heal?

Trauma care in conflict zones

Innumerable Indian women live with conflict, whether in areas with insurgency and counter-insurgency operations or in the middle of a communal riot or inter-caste violence. They experience conflict differently from men—be it bereavement and widowhood with all the stigma it carries in India; being left as head of the household without proper title to property; living with fear; experiencing sexual violence as part of conflict; being displaced and homeless. In the immediate aftermath of violence (or disaster), the everyday tasks of reconstruction are typically undertaken by women—finding belongings in the rubble, gathering up and caring for family, making arrangements for food. They are raised to disregard their physical and mental health needs, and society and state take this as their cue. As the habit of violence—as protest and in response to protest—takes root in Indian society, so should an instinct to provide trauma care.

A 2011 study by the Centre for North East Studies and Policy Research set out to speak to women suffering from post-traumatic stress disorder in Nagaland and Assam. Their conversations in Nagaland suggested to them that in addition to the trauma of experiencing assault, women internalised the trauma that others around them experienced or that they had witnessed. They were traumatised by hearing, across generations sometimes, of the experience of violent assault; and by displacement, which deprived them of home and history. Forced interaction with and having to adapt to others was a source of trauma and despair did not help. In Assam, livelihood anxiety also caused trauma. But in both states, counselling facilities were rare and people knew very little about what was available.

And on a final note: I believe you can read the state of women’s health in a society by the absence or availability of clean, safe and functional toilets that women and girls can use. This is the most fundamental measure of how much we value women. High maternal mortality, female foeticide, gender-based violence and neglected post-conflict trauma—none of this should surprise us at all. The fact that millions of Indian women still have to risk sneaking out in the dark for the most basic bodily needs, says everything. It is the picture that speaks a thousand words.