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 The Comprehensive Rural
Health Project (CRHP) can trace its origin back over
three and a half decades to a small dusty village
called Jamkhed located in the heart of Maharashtra
and hundreds of kilometers away from any major urban
centre. After completing rigorous medical and public
health training in India and the United States, two
ambitious doctors with the highest qualifications,
Raj and Mabelle Arole, vowed to dedicate their lives
to improve the lot of the poor and marginalized.
Selecting a site for the project and finalizing its
model proved to be a major hurdle due to the
feudal-like nature of rural Indian society where
suspicions by local upper caste politicians and
landlords stood as a barrier against efforts to
empower the mostly dalit (lower caste) poor. Years
of exploitation and isolation have also left the
populations of many rural areas disorganized and
suspicious of outsiders. But as fate would have it
the people of Jamkhed, having heard of the Aroles’
objectives and vision, extended their invitation to
start the project in their village.
In addition to donating small amounts of land and
labor to help start the project the people of
Jamkhed agreed to comply with the terms laid out by
the Aroles. These entailed full community
participation and involvement in all aspects of the
project’s effort to improve the health of the
community and initiate sustainable and integrated
development efforts. Ownership by the people was a
common theme in all aspects of CRHP’s community
work. The ultimate goal was to empower the people,
especially women, the poor and marginalized, through
mobilization, health education and value-based
training of health workers and community groups.
The challenges which lay ahead were indeed
formidable. In addition to water shortages and
frequent droughts, the Aroles had to find innovative
ways to reduce the infant mortality rate (IMR) of
nearly 180/1000, reduce the crude birth rate (CBR)
of 40/1000 and control the tremendous disease
burden that plagued the people of this area.
The poverty stricken population was suffering from
the effects of starvation and easily preventable
diseases and did not have the luxury of time to wait
for politicians and ineffective bureaucracies to
improve their standard of living. Immediate action
had to be taken and with the help of the Aroles such
action became possible.
The majority of these
"problems" of the poor stemmed from relatively
simple and evident root causes, such as extreme
poverty, malnutrition, poor sanitation and water
quality, lack of education, and the effects of such
social evils as caste discrimination and
social/physical violence against women. Years of
effort by CRHP and its partner villages has shown
that many of these issues are largely
amenable to intervention at the community level.
Indeed the most dramatic changes began to take place
within the first five years of the project's
existence.
 Jamkhed has come a long way from what it was
in 1970 when modern technology and even automobiles
were a rare sight in the area. Jamkhed is now a busy
market town with a population of over 40,000 and
numerous shops selling everything from food and
clothes to motorcycles, cell phones, satellite
dishes, and big screen TVs. But despite these
dramatic changes, partly brought about by
globalization, there is still much poverty and social
injustice affecting the people of this and other
rural areas throughout Maharashtra and the whole of
India. Distribution of resources in India is still
heavily skewed with the majority of wealth and power
resting in the hands of a relatively small "elite"
minority, mainly residing in cities and far removed
from the poverty experienced by the majority of
Indians (about 68%) who live in rural areas.
Today, the majority of
CRHP's work takes place in the
many smaller surrounding villages and far-off tribal
areas where the average populations are
1,000-2,000/village. The people of these villages
still suffer from many of the same plagues and
burdens experienced by the villagers of Jamkhed over
three decades ago. CRHP continues to carry out the
vision of its founders and propagate the movement of
health for all, which it started eight years before Alma
Ata. Through residential and mobile training
activities our comprehensive approach to health and development
has spread to many other regions and countries where the
root causes of similar health and social problems are extreme poverty
and disempowerment.
Learn more about the history of CRHP and Jamkhed
by purchasing a copy of Jamkhed: A
Comprehensive Rural Health Project, written by
Drs. Raj and Mabelle Arole with a forward by
Professor Carl E. Taylor. All proceeds go to
support the work and mission of CRHP.
Paperback, 1994, 262 pages, $15
To obtain a copy, contact CRHP directly at
crhp@jamkhed.org
or in North America, Alex Kaysin at
alex@jamkhed.org
 Look
for a copy of VOICES of South Asian Women
written by Dr Mabelle Arole (1995) as a regional
advisor for UNICEF. This extraordinary publication
takes readers through very personal and often
heart-wrenching accounts of the violence and
repression facing women at all stages of their
lives. Voices tells the stories, past and present,
of over a hundred South Asian women across the
region in their own words. The women featured
in this book were interviewed by Mabelle herself,
assisted by several social workers.
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