They have developed initiatives and programs aimed at reducing infant mortality rates. Their initiatives have been endorsed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) for work carried out across India and in parts of Africa.[1][2] Abhay and Rani Bang also founded the non-profit Society For Education, Action, and Research in Community Health (SEARCH), which is involved in rural health service and research.
SNDT Women's University, Mumbai has also awarded a doctorate honoris causa to Rani Bang.[5]The Lancet described the couple as "the pioneers of health care in rural India."[6] In 2016, Abhay and Rani Bang were recipients of the Distinguished Alumni Award from the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.[7][8] They were also inducted into the Johns Hopkins Society of Scholars[9] for their leadership in community-based health care focusing on newborns and children. During their careers, the Bangs have helped foster a renaissance in community-based primary health care.[10]
Early life
Abhay Bang
Abhay Bang was born in 1950 in Wardha, Maharashtra India, to Thakurdas Bang and Suman Bang, both adherents of the Sarvodaya movement inspired by Mahatma Gandhi.[11] His father, Thakurdas, a young economist, had initially planned to pursue doctoral studies in the United States but, following Gandhi’s counsel to study the lives of India’s rural poor instead, chose to remain in India to focus on the economics of village life.[11]
Abhay spent his formative years at Gandhi’s Sevagram Ashram in Wardha, in the company of prominent Gandhian leaders, including Acharya Vinoba Bhave. He received his early education at a school based on the principles of Nai Talim, Gandhi’s model of practical, experiential learning.
At the age of 13, after conversations with his elder brother Ashok, Abhay resolved to dedicate his life to improving the health and well-being of India’s rural communities.
Rani Bang
Rani Chari was born in Chandrapur in 1951. She came from a family with roots in medical and public services, being the daughter of a doctor and the granddaughter of a prominent Member of Parliament (MP) affiliated with Indian National Congress (INC).[12]
Abhay and Rani Bang, along with their youngest son Amrut
Education
Abhay and Rani studied together at the Nagpur University, a public university located in Nagpur, Maharashtra, and completed their Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.) in 1972. They remained at Nagpur University to complete their Doctor of Medicine (M.D.) in 1977 and 1976 respectively. [13]
After finishing their Masters at Johns Hopkins University, they returned to India and started working in Maharashtra. In 1981, Abhay Bang, while working in the villages of Wardha district, published a critique of existing minimum fixed wages for agricultural labor in the state, which the government subsequently raised.[15]
In 1985, Abhay and Rani founded two NGOs: the Chetna Vikas organization[16] and the Society For Education, Action and Research in Community Health (SEARCH) and started working on community health problems in the tribal and rural areas of Gadchiroli.[17] SEARCH established a partnership with communities in Gadchiroli for health and development and helped create "tribal-friendly" clinics and a hospital in the district.
Reduction in infant mortality rate
When the couple began organizing People's Health Assemblies, they discovered that addressing infant mortality was a pressing need, particularly after the death of a one-month-old child within minutes of being presented to them. They identified 18 possible causes of such an infant's death, including poverty, diarrhea, infection, pneumonia, or lack of a hospital.[18] The Bangs and their colleagues at SEARCH conducted research on practical approaches to reducing young child mortality in resource-constrained settings. Abhay Bang's solution was to train the village women in neonatal care.[1] He wrote a draft of the action research to be conducted and sought feedback from his mentor, Carl E. Taylor, the founder of the Department of International Health at Johns Hopkins University. In a handwritten note on the draft, Taylor wrote "Abhay, this will be the most important work that you will ever do in your life".[19] Subsequent work by Abhay Bang and his colleagues, particularly in two of the most notable of their studies demonstrated the feasibility and effectiveness of community-based management of childhood pneumonia and the provision of home-based neonatal care by community health workers.
The Home Based Neonatal Care (HBNC) model developed by Bang has resulted in a reduction in infant mortality in the study villages of Gadchiroli.[20] The home-based neonatal care interventions developed at SEARCH ignited worldwide interest and research on preventing neonatal deaths in high-mortality, resource-constrained settings. Today, based on Bang's Gadchiroli model, over 800,000 village women in India have been trained by the government under the ASHA program. [21][22]
India has incorporated this model in their 12th national five-year plan to reduce infant mortality. This approach, which brought down the infant mortality rate in rural Gadchiroli from 121 per 1,000 live births to 30, was honored by TheLancet in 2005 as one of the Vintage Papers.[6] This approach was incorporated in the national program by the Government of India and was accepted by the WHO, UNICEF and USAID for reducing newborn mortality in developing countries.[23][22]
Abhay Bang with the Breath Counter he designed
In May 2017, the High Court of Bombay invited Abhay Bang to provide suggestions about how to reduce child mortality and malnutrition in the state of Maharashtra. The High Court accepted the suggestions made by Abhay Bang and directed the state government to incorporate the recommendations in its policy decisions and take appropriate actions.[24]
Liquor ban in Gadchiroli district
Abhay and Rani Bang were the driving force for the liquor ban in Gadchiroli district. Gadchiroli is the first district in Maharashtra where liquor has been banned due to public demand. The Bangs initiated a liquor ban campaign in 1990 by informing residents about the negative health effects of alcohol consumption. The movement resulted in liquor ban in the district in 1992, being the first example in India of liquor ban due to public demand.[clarification needed]
In May 2012, Abhay Bang was a member of a panel to study a possible liquor ban in Chandrapur district.[25] He advocates the need for an alcohol- and tobacco-free society since, per the 2015 Global Burden of Diseases, alcohol and tobacco are two of the top ten causes of death and disease in India. Abhay Bang is developing a multi-pronged approach named Muktipath in the district of Gadchiroli to reduce the prevalence of alcohol and tobacco consumption there.[26] He also welcomed the Supreme Court of India's ban on liquor shops on state and national highways.[27]
Abhay and Rani Bang
Women's medical issues
Rani Bang has worked extensively on women's medical issues. The community based study of gynecological problems in rural areas that she conducted in 1988 is the first study in the world focusing on women's health beyond maternity care. Rani Bang first brought to the notice of the world that rural women had a large hidden burden of gynecological diseases. She worked on training the Dais (traditional doulas') in villages to become village level community health workers. She advocated the need for a comprehensive reproductive health care package for rural women in India.[28]
She has written a book, Putting Woman First, which sheds light on women's issues in rural India. Their research showed that nearly 92 percent of women had some kind of gynecological condition.[14]
Rani Bang was one of the principal speakers in the Tietze symposium in Rio de Janeiro, Brazil in 1990. She served as a consultant to the International Clinical Epidemiology Network (INCLEN) for Reproductive health, International Women's Health Advocates on Microbiologist (IWHAM)'s 10th Five Year Plan Maharashtra Health and Nutrition Committee Member. She was nominated for the Nobel Peace Prize in 2003 as a member of 1,000 women worldwide for peace prize.[5]
In 2008, Rani Bang was awarded the National Award for Women's Development through Application of Science & Technology in recognition of her outstanding and pioneering contribution for the past two and a half decades to improving women's health in rural India through an innovative and powerful approach of research with the people and for the people. The award was presented to her by the President of India at the National Conference on Showcasing Cutting Edge Science & Technology by Women in New Delhi.[28]
Tribal health
Abhay and Rani Bang have worked with the tribal communities in the forest area of Gadchiroli district in Maharashtra since 1986. They identified malaria as the biggest health concern for this population. They sought to increase awareness around using insecticide-treated mosquito nets as a preventative measure alongside regular medical treatment among the local Adivasi.
They also run a mobile medical unit in the forty eight tribal villages in the Dhanora block of Gadchiroli district and a network of village volunteers trained in providing primary care in these villages. In July 2017, the Government of Maharashtra formed a task force to control the spread of malaria in the district of Gadchiroli. Abhay Bang was appointed as the head of this task force which comprises the nonprofit SEARCH, Tata Trusts, National Institute of Research and Tribal Health (NIRTH) and the Government of Maharashtra.[30]
Abhay Bang is currently chairing a 13-member expert committee set up by Union Health Ministry and the Ministry of Tribal Affairs, tasked with coming out with a nationwide status report on tribal health issues along with suggesting possible policy formulations. While the "old" problems of malaria, malnutrition, and mortality persist, Abhay Bang emphasizes "new" health issues among the Adivasi, partly caused by outside socio-cultural influences and market forces. Tribal women now list alcohol addiction and tobacco addiction among men as their biggest concern, with over 60 percent of adults in Gadchiroli consuming the latter daily. Combined with an increase in sodium consumption, hypertension rates have been increasing in these communities, according to Bang.
NIRMAN
Started in 2006, NIRMAN brings together a group of youth aged between 18 and 28 years who are looking to give meaning to their lives. Amrut, Abhay and Rani Bang's younger son actively manages NIRMAN.[31]
NIRMAN looks at identifying and nurturing young social change-makers in Maharashtra. It is an educational process to train the youth to take up crucial issues and problems in the society. NIRMAN provides guidance, expertise, and an environment to inculcate self-learning and encourages youth for social action. NIRMAN includes a series of 3 camps, each separated by 6 months. A group of NIRMAN participants will go through 3 camps in a period of one year. A camp generally runs for 7–10 days at SEARCH, Gadchiroli with a view encourage young Indian students to step out of their generally secure urban surroundings into the world of rural and tribal Indians to help them come face to face with the nation's plethora of social issues and with people working hard to solve them.
NIRMAN is a learning process based on Nai Talim way of education introduced by Mahatma Gandhi. It believes in problem-based learning instead of classroom-based learning.[32] NIRMAN initiative is providing a common platform for youth to engage, self-educate and decide on how they can make a difference to the society.
Abhay thinks that it is important to make the present generation of doctors think about social challenges. "All doctors can earn enough to make a decent living and they must think about the purpose of their lives. Change would happen the moment they start contemplating." He believes that medical students should regularly be given rural or tribal stints as part of their curriculum so that they are exposed to the real challenges. He thinks that it is equally important to reward doctors who shun the charm of corporate world to serve the real people in need.[33]
Non-communicable diseases
Abhay and Rani Bang and their team at SEARCH work on non-communicable diseases as those are emerging as a priority area. A study conducted by SEARCH in 86 villages of Gadchiroli district has shown that rural people fall prey to lifestyle diseases like stroke which emerged as the most frequent cause of death. One in seven (14%) deaths in these villages occurs due to stroke, showing that the places like Gadchiroli are now passing through an 'epidemiological transition'. 87.3% stroke deaths occurred at home, indicating that rural people do not approach hospitals for treatment. Taking the study ahead, the SEARCH team now plans to test village-based solutions to minimize deaths caused due to stroke in Gadchiroli villages in collaboration with the UK's Wellcome Trust and the Department of Biotechnology of the Government of India. Yogeshwar Kalkonde, Neurologist and Senior Research Officer at SEARCH is the main author of the study. The team also included three young MBBS doctors from NIRMAN. The study was published in July 2015 in Stroke, an international journal published by the American Stroke and Heart Association[34] and was presented at the 5th International Conference on Neurology and Epidemiology held between 18 and 20 November 2015 in Australia.[35]
In a study published in Economic and Political Weekly, Bang and SEARCH team members showed that the rural and tribal district of Gadchiroli was spending approximately ₹73.4crore annually on consuming tobacco and related products.[36] More than 50% of the population was consuming tobacco. SEARCH has been conducting programs to spread awareness regarding the ill effects of tobacco use and providing de-addiction services. The Maharashtra state government has formed a 12-member task force under chief minister Devendra Fadnavis for creating awareness about ill effects of using tobacco products and Abhay Bang is an advisor in the force. It will concentrate on Gadchiroli district for the first three years[when?]. A committee has also been constituted under the Gadchiroli District Collector for implementing the plans devised by the task force. A representative of Bang's organization SEARCH will be a member of the committee. According to Bang, spread of information and awareness for prevention, initiation of village committees and urban ward committees, implementation of laws and regulations, treatment for de-addiction, counseling via NGOs and stimulation of an alcohol and tobacco free environment in government offices, schools, colleges, markets etc. will be the methods used by the task force.[37]
Surgical care
The couple, through their organization SEARCH, built the Maa Danteshwari Hospital for the rural and tribal people of Gadchiroli. Along with OPD and IPD care, a variety of surgeries are also conducted in this setup. Doctors from throughout the state of Maharashtra come and operate in this setup. Shekhar Bhojraj, a spine surgeon from Mumbai, and his team of 6-8 other spine surgeons have been associated with SEARCH for more than 10 years and have conducted more than 100 spine surgeries in Gadchiroli. In August 2016, when Rani Bang was to undergo spinal surgery herself, she too was operated in the SEARCH hospital by Shekhar Bhojraj and his wife Shilpa, an anesthetist in Mumbai.[38]
Positions held
Apart from being the founder directors of SEARCH, Abhay and Rani Bang have served on various national and state level committees. Some of them are as follows:
Member, National Expert Group on Health for planning the 10th National Five Year Plan, Govt. of India[52]
Member, Governing Board, National Population Stabilization Fund, India[5]
Member, Planning Commission's Task Force on Panchayat Raj in Health[5]
Member, WHO Review Committee on Anti-fertility Vaccines[5]
Member, WHO Review Committee on Measuring Reproductive Morbidity[5]
Member, Governing Body of IIHMR(Indian Institute of Health Management and Research)[5]
Member, Institute of Medicine U.S. Committee on Improving Pregnancy Outcome in Underdeveloped Countries (2000 - 2001)[53]
Works
Abhay and Rani Bang
Books
In Marathi
In *माझा साक्षात्कारी हृदयरोग Majha Sakshtakari Hrudayrog, Abhay Bang has written about his experiences during his heart disease and the learning he has gained due to it. The book won the Kelkar Award for the Best Literary Book in Marathi, 2000.
Rani Bang's गोईण (Goin) describes the relationship of tribal women with various trees in Gadchiroli district. It won the Literary Award of the Government of Maharashtra. Goin means Friend in the Gondi language of tribal people. Her book कानोसा (Kanosa) delves into the perceptions of rural women regarding various issues of reproductive health.
In English
Putting Women First: Women and Health in a Rural Community - Rani Bang (published in 2010.)
In Tamil
என் மாயாஜாலப் பள்ளி (தன்னறம் வெளியீடு) - Tamil translation of My Magic School[spelling?]
My Magical School by Abhay Bang, which was translated in English by Arvind Gupta
Sevagram to Shodhgram by Abhay Bang, which was also translated in English by Arvind Gupta
A Postcard from Dr Abhay Bang: Vidarbha, Marathwada deserve your maximum attention, CM Fadnavis, an open letter to the Chief Minister of Maharashtra, Devendra Fadnavis, urging him to act on balanced development of Vidarbha and Marathwada regions of Maharashtra and to take steps to reduce liquor consumption in the state
Awards and honors
Abhay and Rani Bang and their organization SEARCH have collectively received the following awards and honors, in chronological order:
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