Improving Rural Health


Dietrich Fischer – TRANSCEND Media Service

Drs. Rajanikant and Mabelle Arole, a husband and wife team of physicians, founded the Comprehensive Rural Health Project in Jamkhed, India, about 8 hours bus ride east of Mumbai. They first worked in a hospital, but soon realized that despite seeing hundreds of patients every day and working tirelessly, they were reaching only a small fraction of the sick people in their area.

They then went from village to village, giving demonstrations and lectures about hygiene, balanced nutrition, and preventive health care. But to their disappointment, when they returned a year later to the same villages, they found that people had reverted to their old superstitious beliefs and little had changed. For example, based on false beliefs, pregnant women were not allowed to eat certain foods which they needed to have a healthy baby.

So they tried a new approach, which worked. They invited villages whose council of elders agreed to participate in their program to send a representative, usually a young illiterate low‑caste woman, to spend a year at their clinic and observe with her own eyes the consequences of various approaches. Instead of simply telling people what to do, they help them make informed decisions about their own welfare and share this with others. When they returned to their own villages, their teachings were accepted by the villagers, because these health workers spoke their own dialect, not a strange different dialect that distracted from the message, and knew all the local myths and stories that they could weave in with the new knowledge they had acquired so that it made sense to people.

They also had a certain status, because they had been selected by their own village council, usually consisting of elder men. They involved the village council so that the men did not feel passed over and ignored. With this approach, the Aroles saw infant mortality drop from 176 per 1000 to just 19 per 1000 over a decade. The Aroles published a book in 1994 entitled “Jamkhed: A Comprehensive Rural Health Project” and now people from many developing countries come to work and study at their clinic to learn about their Community-based Primary Health Care Approach.


Dietrich Fischer (1941-2015) from Münsingen, Switzerland, got a Licentiate in Mathematics from the University of Bern 1968 and his Ph.D. in Computer Science from New York University 1976. Fischer was a MacArthur Fellow in International Peace and Security at Princeton University 1986-88, has taught mathematics, computer science, economics and peace studies at various universities, and been a consultant to the United Nations. He was co-founder, with Johan Galtung, of the TRANSCEND Network for Peace, Development and Environment in 1993.

Excerpted from Dietrich Fischer’s Stories to Inspire You – TRANSCEND University Press-TUP.


This article originally appeared on Transcend Media Service (TMS) on 11 Jan 2021.

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