The poorest of the poor

Last week while working in our urban slum clinic the social worker suggested that we visit the poorer side of the slum district.

There are two broad types of slums, authorized and unauthorized. The slum that I work in is authorized. It‘s been there for more than 25 years and is a well established community with permanent brick houses etc. But it began its life as an unauthorized slum. I’m not sure of its history exactly, but it usually goes something like this. On some patch of unused land, usually government land, but sometimes private, somebody puts a statue of a respected person or a flag representing something of cultural significance. An example is a statue of B. Ambedker; he crafted India’s constitution and is almost worshiped like a god here. Once the statue is there people will not move it or take it away without incurring the wroth of the masses who will conveniently be outraged by such sacrilege and may go so far as to riot. In order to avoid this, the statue remains. A few weeks later a tent arrives and then another. They get cleared by the police but the next day instead of two there are five. As it grows some people closest to the statue build a house with bricks. It gets knocked down. Where there was one, now there are five. Someone dies. Their land, still unauthorized, goes up for sale on the black market. The mafia is often in charge and they control the buying and selling of property. In order to make some extra cash they sell the same plot of land to three poor families. When it’s time to move in the family realizes that someone else is already living there. A fight breaks out. The strongest family gets the house, the others get the street, their life savings already handed over to the mob.

Eventually the number of people living in the slum grows large enough to create some political gravity. Politicians are forced to accept the slum, or risk being voted out at the next election. The slum becomes authorized.

On the poorer side of mukundwadi the slum is authorized but the people mostly live in tents. I met a woman who was hanging her clothes out to dry. I wanted to talk to her about her health. I asked her ‘with regards to healthcare, what do you feel you are in need of? How are the available services falling short? And what do you think can be done to improve them?’ Being completely naive and inexperienced in the poverty department I naturally expected a long drawn out answer full of complaints and suggestions. I wanted her to tell me about all the problems they had with their health and how difficult it was to get to a hospital or see a doctor. But that wasn’t her answer. Her answer was that she didn’t know and she didn’t know because she didn’t understand the question.

There was nothing wrong with my Marathi, my questions all made perfect sense. So what was the problem?
The woman I talked to has lived her entire life in the now. Her only concern ever, was that she had two rupees in her pocket for food. She told me that she wakes up every morning hungry. If she has money she goes and buys food, if she doesn’t, she goes and finds some way to make money, usually by begging. If she is able to make two rupees she eats, if she doesn’t she starves. She never went to school, she has no idea how old she is, she has four sons and two daughters but she doesn’t know where they are. So ultimately the problem was that after a lifetime of brutal reality, she was never able to develop the ability to think in the hypothetical. She literally cannot suggest improvements in health-care because she does not have the mental capacity to imagine them. This is a perspective of poverty that I had not realized, and it means that the consequences of poverty are far more insidious that I had previously thought. Poverty does not only diminish your physical and material well-being, but a lack of education and a lack of varied life experience starves your mind.