Announcer (00:01):
Welcome to Role Models for Change, a series of conversations with social entrepreneurs and other innovators working on the front lines of some of the world’s most pressing problems.
Peter Yeung (00:12):
Hello, Angela and welcome. Thank you for joining us today at the Skoll World Forum.
Dr. Angela Chaudhuri (00:17):
Hi Peter.
Peter Yeung (00:17):
And to begin with, can you just introduce yourself and give us sort of a brief explanation of the work that you’re doing?
Dr. Angela Chaudhuri (00:26):
My name is Dr. Angela Chaudhuri. I used to be an oral surgeon, I’m a public health specialist, also a journalist. So I wear many hats and I lead an organization called Swasti. We believe that everyone should have a right to have everyday well-being. Which means that it is aspirational, as you know, vulnerable populations just want to survive, and therefore everyday well-being is a fairly audacious goal that we’ve set for ourselves. We work in the intersections, which means we want people to be well and have a good journey, not just survive, but move to thrive. And therefore we work on the intersections of health, climate, education, livelihood.
(01:09):
Because really working with vulnerable communities is about poverty. It’s about lack of education, lack of safety, justice, security. And if you worked on those intersections, we can imagine a world where people can have everyday wellbeing. And that’s essentially the work that we do.
Peter Yeung (01:26):
Right, and obviously it’s a massive challenge there because it’s really the scope of pretty much all the people’s lives. And I wonder how have you gone about then trying to address that problem?
Dr. Angela Chaudhuri (01:36):
The first thing is we listen to the people that we serve, sitting with them in the same room at the same level, really understanding what their problems are. So I’ll give you a little story that will help you imagine the kind of work that we do. Back in 2003, 2004, India was going through one of its worst tides of the HIV epidemic, and it was mostly affecting gay men, transgender populations, and women in sex work. And the programs there were largely about testing for STIs, sexually transmitted infections and HIV. You know, convincing them to wear condoms every time they had a sexual contact and other things. And of course they were very stigmatized.
(02:18):
But when we got into the room, it’s a room about this large size, just this small, all of us sat on the floor, looked at each other and said, “Hey, what does well-being really mean to you?” I was surprised as a young professional that health was not even the top five of their requirements. It was really safety from violence. It was livelihood. Do we have the next meal at our table? Are our children safe? Am I going to get beaten up today? Am I going to get raped? Am I going to be jailed and then exploited? All of those things were much ahead of health. Forget about HIV, something that one may have, may not have, may not have symptoms, may not die off.
(03:01):
And so we had a challenge, where the whole world was professing use of condoms and testing for STIs. The women really wanted something else. And we wanted to see long-term change with the women. So despite a lot of oppositions from donors and the environment who thought we were really stupid, our action was building agency and empowerment with these women. It meant that we moved our programming to preventing gender violence. We moved our programming to advocating with the cops, so that they could be their protectors and not the perpetrators. It meant livelihood options. It meant safety, security, and justice. And when the women saw that they had a right to live, and that they had a right to well-being, and they had a right to be happy, they automatically took care of themselves.
(03:51):
So cut to the chase, five years later, women were asking for condoms so much more that there was a condom stock out in my city. And the HIV petered out and stayed that way for the long-term. And that’s what we mean by work, listening to people, understanding what they need, devising and innovating programs with the people so that they can see long-term change.
Peter Yeung (04:13):
That’s a really interesting approach. And I just wonder how exactly did you go about doing that, making first contact with those communities, and then I suppose how exactly did it work? So would there be events that you’d hold in public buildings? Have you been going to homes as well? Through what medium exactly have you delivered that?
Dr. Angela Chaudhuri (04:33):
We work with the communities and community champions. We are situated on the ground. We have partners that have been there for years. So trusting proximal leaderships and not swooping down from the top is how we really work with those champions, and they call people. Just a recent example was during COVID-19, where the world was getting vaccinated, we saw that a whole number of transgender populations were being left out of the mix. And vaccine hesitancy was being blamed on them and many other issues. When we worked with them, we said, “Hey, can you bring us to them and can we have a discussion on what’s really bothering them?”
(05:11):
We found out that a lot of people depend on alcohol because of their situation, and they thought that they would die if the vaccination interfered with alcohol consumption. A lot of them were just trying to make the ends meet. And so we knew that if we provided food, if we provided mental health counseling, if we corrected the misconceptions, that we would have transgender people come for vaccination. So we devised a program with the trans community leaders. We expected about 20 or 30 to show up, and we had 500. We had lines that crossed roads, we ran out of vaccinations. We had to call other government authorities to help us out. But that’s just the power of conversation, communication, understanding, learning and co-designing programs through trusted and proximate leadership.
Peter Yeung (06:00):
Well, those are amazing results, obviously showing the demand of that when the services are actually there for them. And I just wonder to what extent that this is, how widespread and I suppose how much of the population really is being, well, not being served because of this?
Dr. Angela Chaudhuri (06:16):
It’s about 400 million people are in poverty across the world, and maybe more because we tend to under count. But by working through the intersections like this, and by working with community, I know in the last 20 years, we are in April, 2024, so Swasti turns 20 in May, 2024. We have put together $250 million in the hands of communities. By unlocking resources that are available in the world. So these are not resources that we are giving to people, but we are unlocking it.
(06:54):
So socialist countries like India have social protection schemes. Philippines has free health in different places. So we are unlocking what’s already available from the private sector, from the public sector, by understanding what it means to unlock for those communities. And so they’re able to rise out of poverty, have a foresight about their lives. And even, you would know in 15 years, India alone has taken 150 million people out of poverty in the last 50 years. So it is possible. We always focus on the poor statistics, which definitely exist, but we have shown that through this lasting efforts you can raise people and they can go beyond poverty.
Peter Yeung (07:37):
And just in terms of, I’d be interested to know what has the reaction of these communities been? Obviously you explained turning out in huge, huge numbers, but I presume you’ve spoken to a lot of the people in those communities, and when you first in those initial conversations, has there been surprise or shock, or a lot of happiness presumably that they’re actually being listened to now?
Dr. Angela Chaudhuri (08:01):
I think they were first surprised and felt acknowledged. They felt seen. When we ask simple questions like, “How has your day been? How many days have you been healthy in the last 30 days?” Sometimes they’re surprised. They said, “Oh, no one ever asked us how we’ve been or how we feel. And that makes us feel seen.” Because a lot of the people we work with are hidden or missing or invisible. And what we mean by that are people with disabilities, people who are gender non-binary, people who have mobility issues or who are beaten to submission and so they’re hiding in their homes. They’re invisible to the systems.
(08:39):
And by just asking those questions and taking them out in the sun so they can be connected to the system, they feel seen, they feel more powerful, they have confidence in themselves. And that’s a part of that magic that we, it’s not about delivering services, it’s just about being able to see them. They have to feel seen, they have to feel heard and amplifying that voice.
Peter Yeung (09:03):
Again, obviously we spoke about in terms of a few examples, like the condom stock out as you mentioned in your city and the big demand. But through your 20 years, I know you’ve done a lot of work, but how exactly do you measure the impact of your work? What do you consider a success?
Dr. Angela Chaudhuri (09:24):
When an entire community is able to take charge of their lives. They’re able to run water sanitation campaigns, demand that toilets be built, demand that nutrition supplements be given to their children. Know what their rights are and access those social protection rights. Those are really the results. If we are able to unlock $250 million in a country like India and some of the lower middle income countries in the last 20 years, and put them in the hands of community, that’s direct results for us.
(09:56):
Another north star metric that we use is healthy days. That’s an audacious goal. If I ask you how many days that you feel healthy in the last 14 days, it could be you are healthy because you took care of your physical health. It could be because your communities like you, respect you, you feel loved. It could be because you feel courage. It could be any number of reasons. And for a public health agency to be able to ask a person how many healthy days, it means that we are setting ourselves for a really audacious goal. It’s not about just testing for diabetes or testing for HIV, but really looking at all the things that make you feel like you’ve done well, make you feel capable and take charge of your health and wellbeing journey.
Peter Yeung (10:38):
And I just wonder again over that, it’s a significant amount of time that you’ve been working on this, and perhaps this has changed over time, but what have been the greatest difficulties and challenges that you’ve had to face?
Dr. Angela Chaudhuri (10:52):
Loads. Obviously we are dealing with intergenerational poverty. We are dealing now with more and more climate crisis. The kind of populations we work with are directly in the front line of any kind of climate or weather events. Farmers, fishers, dairy, women in sex work, they’re out on the streets. So if there’s a big rain or heat wave there, their livelihoods and health are directly affected. People who live in slums. And all of these vulnerable populations will see polycrisis. It could be conflicts, you know that there’s conflicts more these days and there seems to be no end date to wars. Climate, lack of water, there’s a big cholera outbreak happening in my city in Bangalore right now. So every day there are challenges and they are insurmountable.
(11:40):
What we want to do is help people increase their agency. What is the awareness? How can people help themselves? How can people help each other? How can we unlock the resources that exist? And how can we give information or share information that you, or people like you and I have. You and I know what is at risk, how to take care of ourselves. But poor and vulnerable people don’t have that knowledge. But if you had that knowledge, you would know that you can either wear some layers of clothing, or you can be hydrated because you’re going to be dehydrated, or work in the shade, change your timing. There’s many things that one can do by themselves, and many things what a community can do for itself. And so I see that our work will get more and more challenging, that we have to be faster, we have to innovate faster and continuously keep our ears to the ground.
Peter Yeung (12:28):
And I suppose, what are those next steps going to be, and whether it’s in the next few years or next few decades, what for you needs to be done in order to well, respond to those growing difficulties, but also to help improve the situation in the long term?
Dr. Angela Chaudhuri (12:45):
I think we need to do what we’ve continuously been doing all the while, which is to be really humble and to listen carefully. And to rapidly unlock resources that are available. To talk to the powers that be and make these voices heard by the powers that be, so that action can be directed for them and with them.
Peter Yeung (13:08):
And just in the case of the example, you gave a few different examples, but often people like sex workers who often are outside of the traditional support network. And I just wonder for you, what drew you to, I suppose more broadly, begin trying to help them? And what was that initial, was there an event in specific, something that happened that triggered you to want to respond to this?
Dr. Angela Chaudhuri (13:37):
For me, I have a personal trigger. In my past avatar, I was an oral surgeon practicing here in the UK, and oftentimes as a senior house officer, I would see injuries on the head and face because of alcohol abuse, or children coming in with poor alignment of teeth and us having to do fairly complex procedures. But all they really needed to do was stop the habit of thumb sucking, or stop drinking alcohol and driving very basic stuff.
(14:10):
And so I realized if I wanted to make any kind of a dent in bringing health to people, I had to look at the other things that surround it. What are some policies, what are some behaviors, things that you don’t obviously see, but it’s always healthcare in the hospital. So that drew me to listening to people, understanding where their contexts are. A lot of the drinking and driving people were people who had mental or trauma issues, who knew what they were doing was wrong, but did it anyway. So it’s much more than the surface area knowledge that we were dealing with. And that triggered me into this career, and I found this platform that enabled me to continue that work.
Peter Yeung (14:53):
A couple more questions for you then, Angela. One is more to do with just more broadly across the world, obviously facing different challenges here. Are there any other places that you’ve taken inspiration from really, where you think that there have been some good examples? Obviously no example is perfect, but have you taken inspiration from anything, or has this really been something entirely that you’ve had to sort of help drive yourself?
Dr. Angela Chaudhuri (15:21):
I’ve taken inspiration from the communities themselves. They have lives that I can’t possibly imagine. And just by really little inputs, just suggestions, just by listening, I’ve seen people transform their own lives. And just seeing that hope and trust can just catapult people from being in very desperate situations to thriving, just keeps feeding us with more inspiration to work further. So I can’t think of a single story, just looking at these everyday heroes and heroines transform their own lives just by strength and energy and compassion is something that drives this organization.
Peter Yeung (16:04):
Right. And I suppose connected to that, do you think that such an approach, as you said, the community-led approach is something that would also work well in other contexts, other countries, other regions?
Dr. Angela Chaudhuri (16:17):
We’re headquartered in India and we’ve seen a lot of things upfront. And we’ve taken similar models to 25 countries outside. We have partners like ourselves who are entrenched and who are trusted by communities, and we share the evidence that we have and say, “Hey, do you want to try this? Do you think that works?” And when they try it and it works, they bring back to us what they tried. And so it’s kind of a self-fulfilling cycle that goes on, and it’s gone far and wide. And we’ve been very privileged to be able to design these programs with the government partners and resource them for years. And so you will see that there’s quite a bit of equity-driven programming in health, and allied health, across because we were able to take the lessons from the communities and move it upwards to the policy makers.
Peter Yeung (17:07):
Right. Amazing. And 25 different countries, I think you said? Yes, so it’s already pretty widespread. And I suppose the last point that I wanted to ask you then, Angela, was just to do with what your, I suppose, vision of the future would be. So obviously some progress has been made, but obviously there’s still quite a way to go. And I suppose, can you describe a bit what the ideal looks like for you? What that world would be?
Dr. Angela Chaudhuri (17:34):
So Swasi’s vision is a world of healthy people. And we aim to reach a hundred million healthy days, to add a hundred million healthy days, to the lives of some of the most vulnerable and people in the world. And that just means that we need to continue to work with ecosystem players and unlock resources that are available, continuously listen and co-design and locally innovate solutions, and communicate, communicate, communicate. And share gracefully and extravagantly so that other communities can pick them up and have solutions of their own.
Peter Yeung (18:17):
Brilliant. Well thank you so much for your time.
Dr. Angela Chaudhuri (18:19):
Thanks, Peter.
