Affordable health care is coming to India (or is the goal)! With the closing of 2018, Prime Minister Narendra Damodardas Modi announced that the Indian government will pay for health care for half a billion of the poorest people in the country. While one of the richest nations in culture and religion, India has also become one of the poorest thanks to colonialism and the disparity created by the shambles they had left behind. As India continues to build itself, less than 100 years after the British rule, the hope is to make sure that everyone, especially the working class, is allowed the most basic of human rights with access to health and hygiene. Raising the quality of life for the poorest will allow India to function at its maximum potential.
In India, affordable health care is a wonderful idea but only if it can come to fruition in the most efficient way possible.
Currently, there are not enough doctors to support the influx of patients in private hospitals which will likely lead to the decrease in the quality of care provided to all patients since, according to the Washington Post, only one out of 1,315 Indians are doctors. Yet, 8,000 hospitals in India have signed up under this plan to take on patients as a part of India’s national health-care plan. Health care for all is a wonderful concept if and only if it is executed on the foundation of a social state, like many European countries that offer this kind of structural health care. At the moment, India has neither the infrastructure nor the stability to handle such a big change in the way health care is taken care of. Modi plans to increase the health-care budget in the Indian government from 4 percent to 11.5 percent allotting $8.3 billion to cover the anticipated costs of “Modicare.”
When asked by experts how Modi plans to help hospitals deal with the new influx of patients he did not offer any real answers, except stating that “the market will take care of that”—as though there has been no thought to how the health industry will handle or even prepare for such a radical change. As of now, this will be anticipated as one of the largest government-funded health-care plans (and considered an experiment by many), but if not executed with proper foresight or radical change, this will be written down as one of the largest failures for social health-care plans. However, if it succeeds, not only will hundreds of millions of people have access to care that they previously could’ve only dreamed of, India will set an example for the world.
July 7, 2023September 10, 2023 11min readBy Ushma Shah
BGM literary editor Nimarta Narang is honored to work with author Ushma Shah in this utterly creative and novel, pun not intended, story about a young woman who has just moved to the United States with her husband, and her trusted diary. Ushma is a short story writer and an aspiring novelist. She has her short stories published in a few anthologies and online literary magazines like Kitaab and The Chakkar. She was born in Mumbai and raised in Mumbai and Cochin. She has an MBA and works in the corporate world. Work and life have given her the opportunity to live in multiple cities in India. She currently resides in Seattle and goes by the handle @penthythoughts on Instagram.
She is the kind of person who doesn’t like to go into stores without a purpose. But she sometimes does. And that’s how she becomes a hoarder. She also prefers only tried and tested places. The kind where she doesn’t have to go out empty-handed. The urge to not disappoint people is strong. So she ends up buying useless things. Like a snow globe with a turnkey. Or 12. She loves the tiny magical people and animals in it. Rotating. Glowing. Musical. But I am deviating from the point. Who am I, you ask? I am her. A piece of her. She takes me everywhere. Writes down her thoughts in me. Writes how her day was. That’s why I know her so well. Why am I telling you all this? Because she hasn’t written for a week now. Longest she has gone in half a decade. I don’t understand it. She won’t tell me anything anymore and I am just so curious. No, curious is the wrong word. The intensity is just not right. I am impatient. Restless. Maybe even hurt, too? I see what she does. How she looks. But that’s just not enough. Not for me. Her confidante for five years and suddenly it’s all poof.
Human addiction is a true addiction. I was superior for those glorious thoughts that nobody knew about her. She doesn’t look happy. She opens and shuts me, picks me up and then back down. In her new Michael Kors bag she bought recently at a premium outlet mall. She always wanted to see a new country. 32-years-old and she had never visited any country other than the one she was born in — India. She should be happy she is finally here. She couldn’t stop chirping about it when they got their visas approved. She and her husband. She has been here for three months now. Initially, she was happy. But then the euphoria died down and anxiety kicked in. The last thing she wrote was: “I haven’t had a bath for a week now.” Her husband is too busy with work to notice. The new project takes up most of his time. Plus navigating life in a new country is a project in itself. I hear him not understanding why an appointment is required for a self-guided tour of the apartments. And that they have appointments only till 5 p.m. which means they have to go house hunting during his office hours. Downtown Bellevue mostly has apartments for rent that are managed by corporations rather than individuals. But at least he is okay with the cold, having survived Delhi weather all throughout his life. It also doesn’t help that she is not used to the cold, having lived in Mumbai all her life. It only needed to turn 22 degrees Celsius in Mumbai when she used to set off; removing her sweaters and jackets from the untouched-for-a-year cupboard. So house hunting is a major bummer, painstaking process even for her. In a place where it always drizzles but doesn’t bring the smell of wet mud. Everything around her is concrete. Asphalt. Sterile.
One day on their way back, they visited the Meydenbauer Beach Park along Lake Washington. I saw a hint of a smile. The first one in a week. The pine trees are a solace. They stand strong, holding their ground at maybe a 100 feet. She cranes her neck back and tries to catch a look at the tip. Making her feel dizzy. She feels like she is falling back. Tilting her five feet frame. She removes her feet from the shoes. She looks at the rounded stones. Big stones. The size of an ottoman big enough to comfortably sit on but hard enough to not sit for long.
But by the end of the visit, she looked worse. That night she wrote and I was thankful for the visit. The first sentence read: I feel claustrophobic. She has lived in Mumbai all her life and never knew that subconsciously the sea made such a big impact on her psyche. The sea, unending in its view. Its waves crashing and rebelling against the rocks gave her a sense of space even though she lived in a one-room kitchen apartment. The warmth. She missed the warmth, although sometimes too stifling. The sweat, and the saltwater smell. There was much to be thankful for here in Bellevue, even though there were no crashing waves and it was 45 degrees Fahrenheit today. The sand, too cold. But there was peace, there was calm. But what about the sounds that she craved, the feeling that stimulated her senses? That accompanied her every morning: the ‘tring tring’ of the cycles, the ‘tip tip’ of the water overflowing from the tank after it was filled. The daily TV news her Ma watched. The smell of her morning chai with grated ginger. The ting ting of her small bell during pooja. These are the things that she does not write but I know her. I know how to read between the lines.
But somewhere I have failed her. I must have. If she did not find comfort in writing. For how could she have gone on without it for a week? How could she? She is as used to me as I am to her. Or at least I thought that.
But now is not the time to feel irritated. She has started writing again. I was overjoyed; I thought everything would be back to normal now. How naive was I? A few lines in, and I am worried. I am also worried that my annoyance will seep through the pages and into her hands. She writes: I miss my place where the duration of the days and nights are almost the same throughout the year. A place where I don’t have to see a 4:30 pm sunset. Or a sunrise after 7:30 am. Nobody prepared me for less than 10 hours of daytime. I feel like I took the sun for granted. When I first came here in October, the sun set at around 7 p.m. Every day, the sun set a little early from then on. 6:50, 6:43, 6:22, 6 p.m., 5:54 p.m. And then on November 6 came the thing I was least prepared for. The Daylight Savings. I would gain an hour, they said! What I gained was a sense of doom. Because the clocks were set back by an hour, the sun set before 5 p.m. every day from then on.
The seasons are what make me. Why then, am I afraid of the seasons? No matter what the weather, the weather is constant. It is constantly too hot, or too cold or just not warm enough or just not cool enough. Every day in itself brings a new season.
“Oh, there is a heavy rain forecast for the whole day today.”
“Do you know it’s going to snow today?”
“Amazing weather! Isn’t it a perfect day to travel?”
Seasons are a universal language, everyone understands it. It transcends manmade boundaries. Just as I am feeling the cold under the layers of clothes I wear. A breeze rippling through the surface of the lake water makes me shiver. If the seasons are what make me, why do I feel cold and sad. Maybe because I long for a different weather. Having grown up in a tropical city, my body is not used to the cold. But is that all? The great reason for the hollow? It can’t be. And I am restless because I can’t figure it out. If not this, then what else? What else could it possibly be?
When she writes this I figure it out. I am always able to figure her out. Her mind does not want to go there. Because after all, this is the life she chose. Of course, how could I have been so blind?
Around two weeks ago I observed her. Observed and observed for a few hours. A few days. Even then I knew something was amiss. She was writing but her heart wasn’t in it. It was dwindling. She doodled and dawdled. A sentence here. A sentence there. Then I was discarded on the coffee table in front of her. My observations, you ask? She scrolls through LinkedIn, going through a series of posts about the looming recession. She searches and applies obsessively to 50 job openings every day. And day after day, her laptop or phone chimes in with a rejection email. She refreshes. Refreshes. Refreshes. Every 10 minutes. Whatever she is doing. No matter if she is in the kitchen or the washroom or the living room. She is glued to her phone checking for a new email. A new job opening. She set her filters to relevant job openings… And then goes on to the painstaking process of filling her details out on different company portals. When she reached the USA, she was hopeful. Of finding a new job. Was very optimistic. She had worked with global companies in India after all. Surely that had to account for something. But with each passing day, the light within her dimmed just a little. Bit by bit. I hate to admit it but I didn’t come to this conclusion when I observed her. It struck me when I stopped and she wrote again. Sometimes I need a macro perspective after micro is too much. She is so inside her head and not on paper that she cannot understand. But I also don’t think it is as easy to pinpoint. It’s a combination of things in her life, culminating in a single point of paralysis. Even now, who knows? It’s just my opinion of a subject I don’t understand completely. She is talented enough to fool everyone around her. Her friends and family also do not know this about her. They think she is enjoying her break from work. They think she is immensely enjoying the exploration of a new country without a worry in the world. She hates admitting that she is miserable. She wants them to feel that she has got it all together. That her life is perfect. When they go through her social media profile, they find her happy pictures. Ecstatic even.
A couple of months ago when she was leaving for the USA, her office colleagues had warned her: “One of my sisters lives in the States. She is miserable there. Wants to come back but her husband doesn’t.”
“He has a high-paying tech job and all so he is okay. But he is on an H1-B visa without an I-140.”
“So? What does that mean?”
“Which means the spouse can’t work. So she can’t work.”
“I am surprised you didn’t know this.”
“I haven’t started my research yet on the visa types and job search. But I intend to.”
“It is very important to understand your options. It is not always as picture-perfect as it seems. My sister is busy doing all the household chores. And she is not happy. Her social life was here. She has no friends there. Only his work friends they mingle with.”
“I know about my visa type though. I can still work there.”
“Oh, honey,” she gives a sympathetic smile, “but everyone wants to convert into an H1-B once they go there. So there could be a brief period where you might have to be unemployed.”
“But that doesn’t matter. Because we intend to come back in a few years. We just want to experience a different work environment and culture and to have that thrill of living in a new country. But only for a few years.”
“Honey, they all say that. As I said, consider your options once you are there before you decide anything. Okay?”
“I will, thanks. I am sure my husband would also check about these things. It is a major decision after all.”
“Oh, I am sure he would.”
She was very emotional on the last day of her job. She had worked there straight out of B-school. She had met some people who would become close friends and some who were toxic. But on the last day, she knew she would miss them all. She didn’t think that saying goodbye would be this difficult. Her name on the desk and chair in bright white letters with a black background came alive with memories. Memories of birthdays celebrated, lunches ordered, huddles and meetings, apprehension of deadlines, the adrenaline rush of getting it done just in time, the accolades. It felt empty by itself if not for the people she surrounded herself with. Her friends.
Her colleagues. They motivated her and pushed her to give her best. Her manager was always an inspiration. Solving problems and giving solutions in a way she herself didn’t think was possible. She learned a lot from each of them. But she was excited to begin a new chapter. But the isolation in a new country was what she hadn’t counted on.
Her husband noticed when she hadn’t had a bath for a couple of days. He thought it could be laziness. When he asked her about it, she said she would. Her reply was curt, and tone grumpy, so he left it at that. After a week of the whole no-bath scenario, her husband thought it was time to have a talk. This wasn’t one of those phases she would overcome on her own. A little push. A little nudge would maybe do her some good. When he saw her refreshing her Gmail inbox for the umpteenth time that day, he said,
“You know, we came to this country to experience a new place, a new city.”
“Hmm.” Eyes glued to the screen.
“Don’t you think it’s time to do that?”
He places his hand in front of her phone.
“What are you so worried about?”
She looked at him for a moment before answering. “That I won’t find another job. Every day on LinkedIn, there is a new company that’s laying off or announcing a hiring freeze and I am worried that my career break will just go on longer.”
“But weren’t you always saying that you needed some time off to pursue your passion of writing?”
“All that’s good to talk about. But I need to focus on my career too.”
“I understand that, but the recession is not your fault. You are doing everything you can.”
“I need to do more.”
“You need to get the bigger picture. Zoom out. You have a glorious opportunity to work on your writings. You have notebooks filled with stories. Don’t you think it is time you polished the pieces and submitted them somewhere?”
“What I need to do is get a job.”
“You will get it but the time that you have right now, in between jobs, is hard to come by. Think about it. You can try to do what you always talked about doing. Or was all that just big talk?” I could see, she took the bait.
She considered. “Hmm,” was all she said.
“I also found something for you.”
He had searched for a public library nearby. A magnificent three-storied red brick building standing beside a park. Just a mile away from their home. She could get herself a membership there. I thought this was an amazing idea. She had always wanted a house near a library. I could tell that this piqued her interest even if she feigned indifference to her husband. She wanted to see it first. I could see it in her eyes. And here I thought that the husband was too busy to notice her worries. I guess he was letting her be. Well, I couldn’t have guessed it. I can’t read his thoughts.
The next morning, she woke up to her alarm at 7:30 a.m. and had a shower. She was ready by 8:30 a.m., in time for the library to be open by 9 a.m. She was armed with her warmest winter jacket and a beanie. Wandered around the streets on her way to the Bellevue library. Taking in the strollers with their prams and pets. Warm coffees in their hands. In 10 minutes, she was standing in front of the library and was not disappointed. Covered with floor-to-ceiling glass panes, she could peer inside as she walked to the front door. She was also pleasantly surprised at a life-sized bronze statue of Mahatma Gandhi just outside the library; in the midst of now barren trees. There was ample seating space inside. Aisles and aisles of books: classics, romance, historical fiction, new interesting fiction and non-fiction sections, choice reads, monthly picks, and a dedicated holds section for reserved books.
Her husband was right. Isn’t this what she always wanted to explore? Read and write. Write and read. Surround herself with books and pages. She had found her place. She touched her fingers in reverence to the cracked paperbacks, reminding her of the piles of books she left behind at her place in India. She borrowed a few novels and set off with them and me in her backpack. Couldn’t resist a warm cup of coffee from a cafe she spotted. Picked a window-facing table overlooking a park. She read as she finished her coffee. A good girl’s guide to murder was a page-turner. It was the first time in months that she had ventured out on her own. She felt at ease. At peace. Her breath, a little lighter. A little deeper. She saw two dogs playing outside. Free and wild. She picked up her phone and googled bookstores and art galleries around. She found that a couple of independent bookstores nearby also host monthly book clubs and writing clubs. She signed up for them and started off in the direction of the art gallery.
I was happy. She was bouncing back. One step at a time.
Ten to 28% of the world’s population of women experience painful sex. Keep in mind, that this is just what is reported. As embarrassing and as vulnerable as you may feel, you are absolutely not alone. The good news is that in addition to your traditional medical care to treat painful sex (also known as dyspareunia) such as medication, injections and surgery — a conservative approach is effective and long-lasting. Conservative care ranges from pelvic floor physical therapy, chiropractic care and acupuncture which are beneficial in treating the root cause of painful sex, as well as symptoms, for long-term healing.
Some of the signs to look out for if you experience pain are:
Treatment options for painful sex such as pelvic floor physical therapy, chiropractic care and acupuncture provide a long-lasting and profound effect on the pelvic floor and address your entire physical well-being.
The pelvic floor is a layer of muscles that range from the pubic bone to the tailbone. The purpose of these muscles is to assist in bowel and bladder control, support a baby during pregnancy and contribute to sexual sensations. Just like any other muscle in your body, these pelvic floor muscles can become tight or weak which can be a contributing factor to pain.
Pelvic Floor Physical Therapy
Pelvic floor therapy can assist by strengthening and relaxing the muscles which is necessary to relieve pain during sex.
Chiropractors can be extremely beneficial with assisting in helping relieve pain. Associated pain and discomfort can originate from the lower back and buttock muscles. Chiropractors are trained in taking a history and performing a neurological, orthopedic and soft tissue examination to identify treatment options. Deep tissue massage, skin rolling, Active Release Technique, muscle energy technique, ice, heat and electrical stimulation are just to name a few.
Acupuncture can activate the human dopamine system which helps regulate hormone levels and can assist in psychological factors. Acupuncture can improve mood, decrease pain and can be vastly beneficial in managing pain and mental health symptoms.
Ask for help
“Everyone is having pelvic pain and no one is talking about it”
Start with seeing your gynecologist who you trust for a history and examination of current symptoms to rule out any other medical conditions that could be a contributing factor to symptoms.
How to talk to your partner about this in a safe/healthy way
Being open with your partner about your symptoms and painful sex may seem like a difficult conversation. Intercourse should never be painful and learning when to stay ‘stop’ is important in communication. Talking about pain before, during and after sex is important also in your own health diagnosis to see if pain symptoms are improving or becoming worse. Having open communication does not only benefit your relationship but most importantly, your own health.
To experience these symptoms may seem taboo or unheard of but quite frankly, they are common in many women. Women deserve to be directed to proper healthcare.
Disclaimer: These are based on recommendations from a board-certified chiropractic physician and licensed acupuncturist. If symptoms become new or worse, consult with a primary care physician and or OBGYN to co-manage symptoms.
In July 2022, Sania Khan’s life was ruthlessly taken from her by her ex-husband. Sania was a young, vibrant South Asian woman – a creator and photographer who had the courage to step out of an abusive marriage, even in the face of community norms that discourage women from speaking out. While this tragedy seemed to stir a consciousness in the South Asian diaspora that we can no longer justify the status quo, it is far from the only such incident. Just months later in December of 2022, Harpreet Kaur Gill was stabbed to death by her husband in Vancouver. While the most extreme cases like those of Sania Khan and Harpreet Kaur Gill are highlighted by mainstream media, a small body of research provides evidence that intimate partner violence experiences are equally, if not more, prevalent in South Asian communities than the general population in the US or Canada. That’s why we need to do more as a community and throw light South Asians and intimate partner violence.
Despite the identification and investigation of these norms in South Asia, there’s so much we still don’t know about diaspora communities, especially in relation to South Asians and intimate partner violence. In the US, South Asians have become one of the fastest-growing populations, but we remain unaware of how the stresses of raising a family in a different culture, and the weight of growing up between two worlds, affect these norms, expectations, and experiences among South Asian immigrants, the second generation and beyond.
In this article, we’ll take a deeper look at how these norms are enacted to influence intimate relationship dynamics, discuss the recent rise in intimate partner violence, and explore the work that researchers, policymakers, and program implementers can do to address violence in South Asian diaspora communities.
Social Norms and Violence in South Asian Diaspora Communities
Why does it take catastrophic events to serve as a call to action? For one, the “model minority myth” continues to portray South Asians in America (who originate from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) as a healthy and wealthy group. As a child of Indian immigrants, I always thought this was just a frustrating trope that lived rent-free in my head next to the eternal question, “Log kya kahenge?” (What will people say?) However, I have realized that this constant worry is not just an innocent preoccupation. It’s the result of a dangerous spiral beginning with the portrayal of South Asians as a model minority and the need to maintain that well-to-do image. This only reinforces the traditional gender norms that overlook men’s perpetration of violence and encourage women’s silence, crippling any efforts to understand the scope of the problem and draw attention and resources to address it.
The Impacts of COVID-19 on Intimate Partner Violence
Prior to the start of the COVID-19 pandemic, the frequently-uttered phrase among researchers, practitioners, and advocates alike was “one in three” — one in three women ages 15-49 experiences physical and/or sexual violence inflicted by an intimate partner in their lifetime. Under the cover of the COVID-19 pandemic however, rates of violence against women rose dramatically, prompting UN Women to call for recognition of this “Shadow Pandemic.” During the height of the pandemic, the social isolation that came with lockdowns and quarantine procedures to curb the spread of disease made home a more dangerous place for an increasing number of women. As communities seek to rebuild, the inequities in access to and use of potentially lifesaving services have deepened. Now more than ever, it is critical that we shine a light on the many intersections of our society to prevent South Asian women’s experiences of intimate partner violence from being pushed even further into the shadows.
First and foremost, to better understand South Asians and intimate partner violence, we need better data disaggregated by racial/ethnic group. Since the 1980 Census, only those of Indian origin have had a fill-in bubble.All other South Asian groups have to write something in, decreasing their participation. South Asian communities in the US are not a monolith and they are certainly not all of Indian origin. This perception, fed by our lack of data, likely privileges the Indian community in America and limits the visibility of other South Asian communities.
More accurate information will help us better understand where the need is greatest. We can make a stronger case for more equitable resource allocation, improve South Asian language materials for survivors, and enhance provider training programs, accounting for the specific cultural implications of disclosing and seeking treatment for violence in South Asian communities. Public health researchers should increase efforts to understand the prevalence of experiences of violence, the environmental factors that make South Asian women in America vulnerable to experiences of intimate partner violence, and how it impacts their health.
While outstanding organizations such as Narika in California and Sakhi in New York are leading the charge in raising awareness, running active helplines, and providing support, they cannot be the sole safe space for survivors. While the system’s failure to protect Sania is not an isolated incident, it has served as a wake-up call.
All South Asian women in America should be able to be healthy and safe and lead lives free from violence, coercion, or abandonment. To achieve this, we need better data, more research, culturally-tailored resources, and appropriate legislative action that will allow for prevention, screening, and treatment efforts to finally take root.