Running focus groups in other countries is always fascinating and you learn the most amazing things.
The Dharavi slum in Mumbai is one of the biggest slums in the world.
It’s where Slumdog millionaire was filmed. We were there to carry out research for a mobile phone messaging programme to help improve health outcomes among pregnant women and their babies. According to a recent World Health Organisation report one woman dies every five minutes in India from pregnancy and birth related incidents.
The women in the slum live in makeshift houses with no running water and no toilets. But when we invited some to a focus group, they turned up in beautiful saris and jewelled bracelets. They dressed up in their wedding saris, walked through grimy streets at 30-degree heat to sit on the floor in a local health clinic and tell us about their lives.
We thought six to ten women would come, but word spread and we had about 30 women in the room and another ten or so crowding around the doors and peering in the windows!
At first they were shy to talk about being pregnant and having babies. But like women the world over, once you chat a little to make them feel comfortable, they were soon competing to tell their birth stories.
What we learn from this process is invaluable. We do desk research of course so have all the stats at our fingertips. And we do hospital visits and interview experts. But how doctors see things is often very different to how the people see them.
One of the main causes of maternal death is anaemia. These women are so lacking in iron that once they start bleeding at the birth they don’t stop.
The doctors told us that iron tablets are free to pregnant women but they don’t take them. Why? The doctors said it is because they get constipated.
We asked the women the same question. There was a silence, then a bit of whispering and giggling. Then one brave woman spoke up. ‘That’s not the reason’ she said ‘it’s because we don’t want our babies to have dark skin!’ Iron tablets are black. They make the faeces black. In India having a fair skin is rated very highly and is your passport to a good job and a good marriage. So the thought that these pills would make their baby’s skin darker was a great disincentive for these women.
We listened and learned. We wrote messages explaining how iron pills could save their lives, how they would help their baby grow strong, how to cope with constipation and how they would NOT change the colour of the baby’s skin.