Four tragedies and the endearing story of a woman in love with humanity

Armida Fernandez
It was while she was a neonatologist at Mumbai’s Sion hospital that Armida Fernandez, now 76, came across a six-week old baby girl who had been raped. The baby was badly mutilated and the man who had raped her had apparently done it to rid himself of a sexually-transmitted disease, a belief held in many communities. Despite trying everything available in their power, she and her team could not save the infant’s life. So shell-shocked and shaken was Fernandez that she doesn’t know what became of the mother or whether anyone had even seen to her in the aftermath of the incident. The horrific state of the baby and the barbaric nature of the assault had left her in a state of numbness that lasted years. 

Fernandez had been working at Sion since 1971 in the hospital’s neonatal care unit, looking after premature and often sick babies of mothers from the poorest communities in the area, including the slum of Dharavi. The mothers who came to her were often in a fragile state and their babies were even worse off. Several infants were born with crippling defects, a consequence of poor maternal health and lack of nourishment. Fatalities were very common, both of the infants and the mothers. In fact at the time, it was common for a large number of the babies born prematurely to die in the intensive care unit. At times, mothers took home infants that survived but often came back a few weeks later to say the baby had died. For many of the mothers, staying alive themselves was a challenge, let alone caring for a newborn. If the child had any kind of physical or mental disability, many mothers – who lived in abject poverty with multiple responsibilities - were simply unable to care for them at all.

The pathetic state of affairs of the mothers and babies in her care rankled Fernandez all the time even as she went about discharging her responsibilities to the best of her abilities. She couldn’t come to terms with the loss, the grief, the sheer helplessness of what she routinely witnessed around her. Yet, she was not certain how she could change things. Everything within her power she did relentlessly. She encouraged mothers only to breast-feed, in order to avoid babies succumbing to other infections. She started the first human milk bank in 1989. She explained the importance of nourishing the mother for a healthier baby. She made them take every precaution they conceivably could. From 6-7 fatalities, the number of deaths fell to just one in ten over a period of time.

But the incident of the raped baby girl marked a turning point for her. Fernandez understood that this was not a battle where she could wait for the victims to fall in her lap. She needed to enter the battlefield to make sure her victims were spared. Whether it was to stop violence against women and children or to ensure that to-be-mothers took better care of themselves so that their babies would have a fighting chance, she realised she needed to enter their homes, lives and communities to induce change in attitudes and behaviour. She could not wait for Mohammed to come to the mountain. The mountain had to reach Mohammed.

Yet, she had no experience of the kind required. She barely knew what an NGO did or stood for, let alone how to register or run one. She did, however, mention her desire to a friend of hers at a wedding. The gentleman ran a business, had five children and told her that he had a house in Nasik that he would sell and give her the money to set her off on her journey, something he felt quite moved by. Call it fate or providence, this gentleman in his mid 40s died of a massive heart attack the morning following her chat with him. His wife, who had overheard their conversation, decided to honour what she felt was one of his last wishes, despite having five young children to care for. She sold the property and handed the cheque over to Fernandez.

That left her with very little choice. The money was now there: the generous spirit of a departed friend and his grieving widow loomed large before her. She needed to keep her word. In any case, it is what her mind was set upon by now. 

This marked the birth of SNEHA, an organisation as it evolved committed to maternal and newborn health, child health and nutrition, empowerment, health and sexuality of adolescents and prevention of violence against women and children. Instead of waiting for patients or victims to turn up, SNEHA began to enter the communities directly – the slums and chawls - to which the poorest belong. Volunteers from within the community were galvanized to spread one primary message: a newborn’s health is inextricably linked with its mothers so the latter’s nutrition is every bit as important. 

With no prior experience and a plate full at the hospital, Fernandez says she started in a most unstructured fashion, with no great, big plan or method in place but things would just fall in her lap. She cites numerous other examples like the wedding story. At a paediatric conference, she met another doctor from University College, London, who came to see the work they were doing, and entered a partnership that has lasted 15 years and is still going strong. UCL provides research and all kinds of support to SNEHA.

Help came in other ways whenever she felt she’d bitten off more than she could chew. A colleague pitched in as director for a while and brought in significant changes. In 2007, Priya Agrawal, who’d worked in the NGO sector for a while, joined her and helped improve the operations structurally over five years. In 2013, Vanessa D’Souza, who had spent 21 years in Citibank, joined the organisation first as a volunteer and then as CEO, bringing in much-needed financial savvy. Both of them brought to the table what Fernandez felt she didn’t. Many others assisted and Fernandez says that without their contribution, SNEHA would not be what it is today. 

Of course, lack of structure and experience meant that not everything worked out as it ought to have or as she may have hoped. Many years ago, a possible large donor from the United States paid them a visit once as they were considering funding their work. When the American gentleman asked to see her five-year plan and how she hoped to finance it, Fernandez had no plan to present and replied saying, “God will send the money”. He left – probably in disgust – and never came back.

But with a committed team and donors, SNEHA grew faster than Fernandez ever envisaged. The organisation now reaches a population of around one million and has 265,000 direct beneficiaries. Starting from one Mumbai slum, its core programmes are now in almost all the districts of the city and, through partnerships, have reached six other states, including Gujarat and Jharkhand. The approach is data driven and sustainable, involving training of all stakeholders associated with the change. The organisation has 400 full-time employees and 750 volunteers now.

To cite an example, SNEHA works and trains police officers to reduce domestic violence. “It’s not enough just to try and change community behaviour; the change has to be all encompassing,” she explains. More recently, the government has asked SNEHA to run the Nirbhaya centre to support rape victims in the city. 

As she sees it, what began as a small idea has catapulted into something that has indirectly impacted hundreds of thousands of people with very small nudges from her. It is a replicable model that can be adopted by other states. Ultimately, however, Fernandez hopes that they will be able to reduce infant mortality, morbidity, improve women’s health and reduce violence to an extent that SNEHA itself dies a natural death. 

SAVING MANY LIVES BUT ONE

A second happening in her life shaped the direction Fernandez’s life took. A Goan by birth, Fernandez grew up with loving parents who, in fact, discouraged her from studying science and medicine. Her mother felt it was too much hard work while her father – a poet and immersed in arts and literature – felt science was limiting as a choice. All her six siblings studied humanities and charted out careers in related fields.

But Fernandez insisted on doing her medicine in Hubli, close to Dharwar, where the family was based, followed by post-graduation in Mumbai where she met her husband, a fellow doctor and her future life partner of 51 years. After she finished her studies, she wanted to go and work in villages with those who needed her services the most, but her husband pointed out that Mumbai had enough poor people for her to work with. If her desire was to improve lives, the slums and chawls were full of those needing assistance.

Even as Fernandez continued to rise and became head of the department of neonatology at Sion, she and her husband had a daughter in 1974. At 16, Romila developed lymphoma and underwent radiation. The radiation led to her developing breast cancer and in her mid 30s, Romila succumbed to the disease. After she lost her only child in 2013, she realised that there was very little support for people suffering from cancer. “It wasn’t about the financial aspect. Patients and their families need support, be it emotional, spiritual or just a listening ear.” 

So in 2017, she started the Romila Palliative Care Centre that was then housed in Mumbai’s Holy Family Hospital, where she was medical director. The centre has directly supported over 700 patients since 2017. It provides home care to patients with end-of-life diseases, in order to relieve pain and offer emotional support, and helps them die at home in peace and dignity instead of in a hospital.

Two other initiatives were spun off as a result of her association with Holy Family. One morning, a famous gynecologist of the city was taking a morning jog past the Holy Family when he suddenly dropped dead. Upon closer examination, Fernandez and the other doctors realised that if someone had found him and given him cardiac massage in time, he may have been saved. That’s when, in collaboration with cardiologists and the hospital’s administration, she started i-Care that teaches cardiac massage to laypersons in the hope that lives can be saved.

Fernandez also found at Holy Family, many older people whose children were overseas and who were home bound for one reason or the other. She found they were beset with loneliness in addition to all the accompanying problems that old age brings. That’s when she and a few others who were as involved decided to start Connect and Care, a movement to visit home-bound older citizens.

Her direct association with Sion hospital ended when she retired, SNEHA is now in able hands and at 75, she stepped down from her medical directorship at Holy Family but Fernandez has her hands full even today. It is only because of a persistent cough that this writer manages to catch her at her beautiful and simple home in Mumbai’s Bandra, with an unobstructed view of the Indian Ocean. It is perhaps this that gives her a limitless view and the resolve to swim unhindered in life’s choppy waters.


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