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The most common failure I see in urban health work is prescribing before diagnosing. A camp is funded, a leaflet is printed, a dashboard ticks upward â and the cough behind the sorting table continues, because the prescription was written for a body nobody examined. I have spent six years doing occupational health work with…
The form says “Other Urban.” That is the municipal classification for the settlement where Shanta Kamble has lived and worked for eleven years, sorting biomedical waste from Pune’s private hospitals and clinics. She knows exactly what she handles every day. Used syringes that arrive in thin plastic bags, sometimes torn before they reach her. Blood-soaked…
In public health, we often talk about efficacy and effectiveness as if they are two stops on the same train line. Efficacy is the controlled trial: the intervention works under close supervision, with trained staff, regular follow-up, and participants who meet strict inclusion criteria. Effectiveness is the messy real world: the same intervention, now handed…
The notebook belongs to Lakshmi, an ASHA worker in Laggere, a ward in west Bengaluru where the boundary between formal and informal settlement is less a line than a negotiation. It is a school-supply exercise book with a plastic cover, the kind you buy for forty rupees at a stationery shop. On its pages, in…
Health intervention is one of those phrases that sounds solid, like a brick you can hold in your hand. In practice, it’s more like a seed—whether it grows depends entirely on the soil it lands in. For the waste pickers of Pune, the street vendors of Mumbai, or the construction families bedding down on half-finished…
In the narrow lanes of Dharavi, where the air is thick with diesel fumes and the smell of open drains, a community health worker once showed me a neatly printed chart. It came from a pilot study—a randomized controlled trial, no less—that proved a low-cost, reusable mask could cut respiratory symptoms among informal workers by…