The best place to be, if you want to bring about change, is at the grassroots, says Dr Abhay Bang, putting in a nutshell, his approach to developing solutions of the community, by the community and for the community.  

  “For the last 40 years I have felt that the best situation if you want to make any change, from individual lives to the policy of the country, the best place to be is at the grassroots. You can see the problems first-hand,” says Dr Bang, explaining how working in the villages of Gadchiroli district in Maharashtra gave him and his wife insights into the problems faced and sometimes identified by the community. In a sense, “you are 10 years nearer to the problem,” he says, on identifying the issues, and often times ahead of the global health community.  

   Dr Rani and Dr Abhay Bang, Founders of SEARCH ( Society for Education, Action and Research in Community Health), won businessline’sIconic Changemaker award in 2018 for their community-based work on childhood pneumonia and mortality and maternal health, to mention a few.

  Working at the grassroots “with your eyes and mind open” can help develop local solutions that can contribute to changing policy as well, says Bang. In fact, the Bangs picked up on problems like alcoholism and back and joint pain, well before the global health community identified these non-communicable diseases (NCDs) as risk factors and public health issues.  

  Women working 12 hours in paddy fields, for instance, had drawn the doctor-couple’s attention to back and joint problems, he says. This, in addition to the increasing life span and deficiencies in protein and calcium, for example, is seeing an increase in the reporting of these pains, he says.  

  At any given time, about 53 per cent of the adult rural population has a back or joint pain that lasts for over a week, he says, of insights from their community-based study. Bang says they are seeing an “epidemiological transition” from communicable disease (pneumonia, malaria) to NCDs, and these bring up new challenges for the future since they have no vaccine or a cure.  

Highs and lows  

The last four years, that included the pandemic years, have marked some highs and lows for the Bangs. They started a new, 100-bed multi-speciality hospital at “very very low or zero cost for tribals,” he says. The infrastructure was funded by the Tata Trust and their overall work is supported by multiple donors, including individuals and the government, he says. The hospital became functional during the pandemic years.  

A pilot project they initiated to rid their district of alcoholism, a first of its kind in the country, is showing results. Again, a problem identified by women, Bang says they tackled it through a four-pronged approach including addressing the supply of alcohol through government licensed shops, getting the community involved in tackling illicit liquor, raising awareness among the young, and initiating de-addiction efforts, he says, illustrating how local measures were devised.  

“Alcohol and tobacco, world over, are major determinants of non-communicable diseases. The (community) efforts are showing remarkable results in terms of reduction in the number of people drinking alcohol and consuming tobacco. And the total money spent on purchasing these two,” he points out.  

 On a personal note, he says, nine months ago, his wife had a brain haemorrhage and stroke. “We went through a serious crisis…it made us realise we are 72,” he says. Dr Rani has since recovered and is back at work.

   Looking to create more changemakers, the Bangs started Nirmaan. A youth sensitisation and education process initiated 15 years ago in Maharashtra, it is now an all-India programme to identify potential changemakers. “It helps young people identify meaningful purpose for their own lives beyond earning money,” he says.  

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