The power of listening in public health

The general public was concerned about vaccines. More than just the illness. Which is understandable for something new that has immediate implications for their life. The same thing happened during the first and second waves of hospitalization. During my 17 years of experience, I encountered this fear among parents as well. To immunize their children. But my team and I overcame the refusals. Both for children and adults. How? Simply by listening to them. People must have concerns. Concerning vaccines. Especially in this day and age of social media. Fake news spreads like wildfire. So, in order to dispel myths, we must respond to their inquiries. We must make time to listen to and respond to their concerns. To convey that we are always available to you if something goes wrong. Nobody wishes to die. This pandemic did not occur in anyone’s lifetime. Nobody, not even us. It only takes a second to inject a vaccine. However, we must first gain a person’s trust before inserting the syringe into their body. After all, it is his or her life. That’s vaccination, in my opinion. To capture the heart, gain confidence.” 

As Nilima Parmer, the ANM of the Shipra subcenter, answered my questions, I thought of Baba. His perspectives on public health and preventive medicine. Behind prevention are the hidden layers of social medicine. Concerning listening to patients’ stories, which we call the patient’s history. Where both diagnostic clues and prevention methods are embedded. Baba believes that teaching medicine without the bedside and public health without the field is impossible. 

Dr. Raj Shankar Ghosh echoed Baba’s voice about one and a half decades later. While he was preparing me for the field and teaching me the art of listening. In preparation for photographing the three-dimensional essence of public health in two dimensions. As because it is about the public’s health, one must understand the public. Understanding their health will come naturally. Vaccines don’t save lives; vaccination does, as Raj Shankar Da taught me. If vaccine is the science, then vaccination is the art, in my perception. Science would not exist without the arts. 

Yesterday afternoon, Nilima Didi revised me on those lessons in public health one more time. I could see why state health officials kept praising her. Why are the people on the Shipra River’s bank only listening to her words? From immunization to antenatal care to tuberculosis treatment to family planning. Why do parents of physically and mentally retarded children want their children to be vaccinated only by the ANM extraordinaire? I’m the eyewitness. The influence of frontline workers. 

I was on my way out of the subcenter. An elderly lady approached me. An ASHA dressed in a purple saree. The attire. “I’d like to say a few words to you.” I leaned down to hear what she had to say. She was in tears. “In my life, I lost everything. Nilima gave me this job. She taught me all I know. She gave me a new life. For Shipra, she is Bahu, Beti and Bua. She is my mother in my eyes. Despite the fact that she is younger than me.” I was staring at her. Her gaze. There were tears everywhere. Even in the eyes of the people around us. I suddenly felt a ball-like discomfort in my throat. 

I made my way back to my car. Head bowed, eyes fixed on the ground. I was working hard to keep my emotions in check. Nilima Didi was following me. Before getting into the car, I bowed in front of the extraordinary woman and said, “Merry Christmas in advance, Didi.” “May Jesus be with you,” she replied with a smile. 

I began my return journey to Indore. Carrying on the life lessons taught by Baba, Raj Shankar Da, and Nilima Didi. “Listen to what people say. Allow them to question you. Respond to their questions in their language. The solutions are frequently hidden within their stories. In the field stories.” 

[In the image, Nilima Didi is teaching me her methodology for correlating data from other public health programs that she used for the COVID vaccination drive, particularly for women and the disabled.]

Indore, Madhya Pradesh