Dr. Lakshmi Rahamathullah tells Soma Basu how she pioneered innovative birth control programme facing every challenge four decades ago

It is not easy to “tie down” Dr. Lakshmi Rahamathullah. “Nobody can,” she declares. The doctor, at a local nursing home in Kariapatti, where she was admitted for a week with fever and diarrhoea, couldn’t. Just few hours before this scheduled Weekend interview, she insisted on getting discharged and was in her minimalist office at the appointed hour.

Dressed in a maroon silk saree, a dash of vibhuti and kumkum on her forehead, she hid all signs of fatigue, and initiated the chat with flair.

“This is an original from Nepal meant to keep my Blood Pressure under control. My grandson says, it should rather keep my temper under check,” she pre-empts, catching my stare at her rudraksh mala.

Idealist

“I am and remain a Hindu Iyengar Brahmin. I married a Muslim without even exchanging a garland. Our marriage was registered in 1952 GOI gazette. My husband was modern and liberal and we decided not to change our respective religions. We vowed never to chase money but help the poor as and when the way we can. We both were idealists,” she tells me even before I shoot my opening question.

I started by perceiving this to be a difficult interview as Dr.Lakshmi suffering from middle ear infection for over a quarter Century, asked for written questions. Each time, I passed her one she was unstoppable, passionately talking about the health care needs of rural women and other issues close to her heart. When done, I realized that the Managing Trustee of Family Health and Development Research Service Foundation (FHDRSF) had actually made my job easy. With the authority in her subject and the command over language, she actually gave me an effortless copy.

Born as Vijayalakshmi in a Thanjavur-based family of freedom fighters and social reformers that later migrated to Kerala during the 19th Century famine, this MBBS doctor from Delhi’s Lady Hardinge Medical College turned into a public health activist unable to douse the “fire in her to do something different.”

Motivated individual

Her motivation stems from her lineage and the early influences in her life besides her books and teachers, she says. “I was born in a mission hospital in Iraq and the gynaecologist, Dr.Scudder, who brought me into this world, is my first inspiration.”

A year at Shantiniketan and another year with Mother Teresa when she was in her pre-teens shaped her thinking.

“I have faint memories of sitting at the feet of Rabindranath Tagore under the tree weaving mats every evening while he spoke about the country’s struggle for freedom and pride.

“My initial years were spent in the Middle East and Europe but when my father, working in a British company was posted in Bahrain, he sent me to Calcutta where I came under the tutelage of Mother Teresa who had not yet begun her charity work. She taught scriptures.”

The launchpad

Dr.Lakshmi’s marriage to Col.Rahamatullah in the Indian Army took her all over the country. When the couple arrived in Coonoor, Nilgiris in 1970, with their two sons and a daughter, little did she know that the place would become a launch pad for her family welfare and population control programme.

Her husband’s untimely demise the next year immediately after a promotion as Brigadier, losing her daughter to leukemia a year later followed by her mother-in-law’s death did not deter Lakshmi. She stayed on for the next two decades getting involved with the problem of over-population.

“They thought since they were paying me, I would toe their line. But they failed to realise that I was an independent person,” she chuckles.

The employers were worried about paying more maternity benefits. They bluntly believed that more babies were born due to maternal support and were looking for solutions. The Government of India believed people were raising more children because their children were not surviving and its policies were lopsided. It first advocated vasectomy without proper instructions to men (no sex for six weeks). When their wives became pregnant again, they accused them of infidelity and families broke down. Then women were given pills which did not work but induced early menopause. So tubectomy was started.

Dr.Lakshmi painstakingly worked across all sections of people convincing them that “if women and children are taken care of properly there will not be unnecessary pregnancies.”

Her concept

She founded the Nilgiris Family Planning Association in 1970 and remained a medical Advisor to The United Planters Association of Southern India at Glenview, Coonoor, for 17 years developing the concept of ‘link workers” in maternal and child health and family welfare.

“My criterion was only motivated individuals should willingly choose to spread information regarding health care services available and the needs of the community would be vice-versa conveyed to the employers.”

Over 4,500 volunteers joined her for the next 14 years working with a population of 2,50,000 living around them propagating the two-child norm. The Crude Birth and Infant Mortality Rate dropped from 120/per 1000 population/live births in 1971 to 21 and 34 respectively in 1984. Quality of improved life among workers was visible and plantation managements voluntarily adopted welfare measures.

Will the plantation workers remember her on this Labour Day (May 1), I casually ask. She smiles: “I left in 1987 but my scheme was hailed by the Ford Foundation and later documented and used as a training tool by the Government of India in all family planning programmes across the country.”

It was apparently through one of the nannies of Indira Gandhi that news about her work reached the corridors of Delhi. “This lady used to come to Coonoor for vacation and watch me work and became a via media between me and Mrs.Gandhi. She must have conveyed the usefulness of my work at a time when the country had experienced the 1960 population explosion.

“I never met Mrs.Indira Gandhi, but we corresponded through letters. She enquired more about my work. When my husband died, she wrote to Field Marshall Sam Maneckshaw to clear all his dues from the Army without delay. When my daughter was diagnosed with leukemia, she wrote a moving letter reflecting a mother’s emotions on the loss of a child.”

Dr.Lakshmi also had the opportunity of meeting the doyen of Indian industry, JRD Tata, over coffee. He was so impressed by her defiance to work with paid health workers that later when he learnt about her daughter’s illness, he helped in getting the expensive chemotherapy medicines from abroad.

Sanjay Gandhi’s forced sterilization programme in the later years somewhat soured her relations with Mrs.Gandhi. But it didn’t matter to Dr.Lakshmi. What Government tried to achieve by 2000, she had already in 1984.

“I manage with what I have. I have never known fear. Equity and justice is my creed and I believe every citizen has the right to a basic standard of living. Health is a long term investment, not a statutory expenditure,” she asserts.

When her husband died, many thought she would leave Coonoor. “Those days doctors were few and I got good offers from Government and other big hospitals elsewhere. But I wanted to serve in national interest in my limited way,” she says.

In 1987, at the behest of long time friend and founder of Aravind Eye Hospital in Madurai, Dr.G.Venkataswamy, she became Director of the Aravind Centre for Woman, Children and Community Health, Madurai, and continued till 2003. “I left because they wanted me to focus on eye only but I am interested in human beings.”

During the stint, she established the impact of Vitamin A on mortality and morbidity in children between six months and five years and contributed to the Government’s policy of adopting the same in 1990. Today she is internationally recognized as an authority on micronutrients particularly Vitamin A and her work is included in medical syllabus abroad.

She started the Foundation at Kariapatti in 2004 to work in all public health services for rural masses and low socio-economic groups and integrating the health care delivery system in Tamil Nadu. At present she is actively involved in immunization programmes, Census operations and increasing exclusive breast feeding practices.

As a general physician, she believes it is her duty to educate the masses rather than prescribe medicines. But corruption is killing the country, she rues.

Outspoken

Daring and compassionate, outspoken and level-headed, passing decades have not diminished Dr.Lakshmi’s rare and fiery streak. Despite two accidents and rods fitted in both legs, she refuses to rest. Her penchant to read, learn and work more can put any youngster to shame. In fact, at 80, she has just cleared an online exam of the American Paediatric Association for selection as Chief Investigator.

“I want to serve the people till I Iive,” she says humbly. There can not be a better comrade than Dr.Lakshmi to be remembered on this May Day.

FACTFILE

Dr.Lakshmi is dubbed as the first person in the world to study the relationship between anaemia among women tea plantation workers and productivity.

Her pioneering concept of link workers in maternal and child health care programmes which she started in the 70s was not only adopted by the Government of India in 2003 but several institutions co-opted it in their work later.

Has received the India International Achiever’s Award for Social Service 2010 from the Indian Achievers’ Forum; Consortium of Service Organisations in Tamil Nadu presented her an Award for “Empowering Women for a Positive Revolution” in 1997; For the Sake of Honour Award by Rotary Club, Nilgiris, in 1986; Was recommended by Department of Family Welfare, Tamil Nadu for Padmashri in 1986.

In a World health Organisation commissioned research project in vitamin A, her community-based study was recognized as one among the top three in the world. She was featured in the 14th edition of the World Who’s Who of Women, Cambridge, in 1996.

Dr.Lakshmi is widely travelled, participated in numerous conferences and has been appreciated for her presentations. Has published innumerable papers in national and international journals of repute.

Favourite books: “Conversation with God” by Neale Donald Walsch; Discovery of India by Pt.Nehru; Profiles in Courage by John F Kennedy; and Life of Hellen Keller.

A prolific reader, she scans every newspaper and magazine daily. If any issue tugs her, she shoots off well thought-out and worded letters or even full-length articles to the powers that be, from the President to the Prime Minister or Ministers, corporate honchos to local industrialists, politicians and bureaucrats. “I don’t care whether they respond to my notes but as a responsible citizen it is my duty to give suggestions for improvement,” she says non-chalantly

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