Urban and rural differences

In the slums and poor neighbourhoods of major cities, hygiene conditions are poor and often dire. In the slums, the demeaning overcrowding and cramped conditions make life uncomfortable and unsanitary. During heavy rains, floods and landslides frequently occur due to the lack of drainage facilities. Sanitation services, access to drinking water, toilets and electricity are all too often non-existent or defective. The lack of proper waste management increases the risk of disease. Widespread pollution compounds the problem of malnutrition. Compliance with hygiene standards is almost impossible to enforce. Slum dwellers attend hospital only in extreme circumstances. They tend to choose overcrowded and overstaffed state hospitals lacking sufficient resources. due to the cost: with no health insurance, they know they cannot spend money on healthcare.

Despite sustained growth as measured by economic indicators, India remains predominantly rural and poor. The exploding population affects primarily major Indian cities, even though three quarters of the population still lives in rural areas. While hygiene in general and access to drinking water pose roughly as great a challenge as in the metropolises, it is important to be aware of the subtle differences between the contrasting cultures of villages and cities. India has one hospital bed for more than 2,000 people. This statistic is hardly applicable to remote rural areas where a hospital stay is unimaginable for many of its inhabitants. The difference between the care offered to the rich and that which the poor can afford is staggering. Almost 90% of the rural population has no health insurance.

India's health system is one of the world's most unequal. Only money guarantees access to health services. Consequently, an astonishingly high number of Indians do not have access to even the most basic healthcare, although the central Indian government is trying to set up a medical programme to exempt the poorest individuals from medical costs in some public institutions. As public hospitals are overcrowded and lacking in resources, this medical response programme cannot be extended nationwide.

Our health programme

Amid this medical-social crisis, we have sought to bridge the vast healthcare gap by organising travelling health clinics where doctors and nurses visit pupils at our schools in Bengal, Bihar and Rajasthanon. We have been doing this since our first school programmes were introduced at the end of the 1990s

During the first visit of the school year, doctors and nurses carry out health check-ups at each school. Following the first medical consultation and in the light of the results, all subsequent visits are given over to the care and treatment of the pupils concerned.

Despite difficult and austere working conditions due to the lack of funds and the geographical distance from schools, check-ups are carried out regularly and  appropriate treatment is provided. After all these years of work, we have observed that the pupils' general health has tended to improve significantly over time.

In 2007, we built a rural health clinic in Bihar State for the inhabitants of about 30 villages. More than 1,000 pupils and apprentices are monitored in this clinic. The medical team administers about 30,000 treatments per year. For a small registration fee, residents of these villages now benefit from free healthcare. Accompanied by an assistant, a doctor also visits the more remote schools on a regular basis.

We would like to replicate this model in other Ecole de la Terre schools in India, but insufficient funds have prevented us from achieving our goal. We continue to provide medical consultations as part of our travelling health units at a rate of four visits per month.

However, the improvement in the general health of pupils and their families can also be attributed to a water purification programme established in the past decade.

Our water programme

As water hygiene is vital for health, we have taken action in this area given that waterborne diseases represent some 80% to 90% of the treatments provided to children and their families.

Contagious viruses, bacteria, parasites, plant and animal microorganisms, water and as a consequence food spread these diseases already mentioned above. This is a good opportunity to recall Louis Pasteur's statement that 'we drink 90% of our diseases'.

Not everyone has access to safe drinking water, particularly the most disadvantaged. Given that access is so difficult, rural populations struggle to regulate consumption for agricultural and domestic purposes. That is why Ecoles de la Terre has built well water purification and drinking water production plants to eliminate many of these diseases that come from impure or contaminated water sources.

Six well water purification plants and two drinking water production plants have been built in the West Bengal Sundarbans Islands to date, while three water purification plants are also in operation in Bihar's Gaya district. We now intend to install a special purification system for tank water in the Thar desert. Each of our schools is equipped with a large capacity water tank.

We want to combine our efforts for the benefit of those most in need. Our 'Health, Hygiene and Water' programme has an educational dimension and illustrates the interdependence of an interconnected and dynamic social project. Going even further, the same applies to our micro-credit economic support programme. All our programmes are closely linked.