Are all local values and meanings "cultural" and should we consider all services, methods, models to be "appropriate"? What "can" be done and what "should" be done? Assessments of "can" and "should" are bound up with views of the "culture" in question, assessments of its boundaries, its integrity, its authenticity, its very location "in" some places, some practices and some knowledges but not in others. If this is true how can "outsiders" design and implement a "culturally appropriate" intervention? Is there one way, a defined path for health interventions? Which is political and which is not? Are alternative paths the best ways? Isn't the alternative medical system/ ways to curing and healing also a product of the struggles over colonialism, nationalism, modernization and globalization? Aren't many noted votaries of "Ayurveda", "oriental medicine", "chinese medicine" etc..also politically savvy players whose articulation was more for their advancement and understanding of "science"? Why are errors of repudiation important? Do they not occur both when alternative medicines are assesseed by orthodox biomedicine and also when orthodox biomedicine is assessed by alternative medicines?
I have had the fortune of being associated with many health campaigns and radio programs. In 2006-7, we launched a radio program on "safe motherhood" and "sexual health" targetted at adolescent and young women of Orissa. It was a hugely popular program but when examined under the critical lens, it left a lot to be desired. It used donor language, it was not participatory, the language used in many pieces were paternalistic and condescending, it created controversies, it was accused as not being "culturally sensitive", it carried advertisements of condoms, family planning messages. We offended parents, we offended government functionaries, we offended women, and we always managed to tread the thin line with the All India Radio as we were giving them the much needed revenue. The program also elicited numerous letters and queries from young women from all corners of Orissa and we tried to answer most using reputed, gynaecologists and obstretricians who were known for their erudition and "a good hand". For me reading the letters was a humbling and frustrating experience. The letters and their texts, inscribed experiences, questions told me how ineffective all our work was in relation to what all had to be done. It told me how comfortable we were in our own coccoons of knowledge and the existence of valuable lives around us whom we did not in the least impact. Did we do the right thing by broadcasting the program, what could we have done to get the "right balance"? Should we have not entertained the questions on "masturbation" in a public program?
What are those alternative ways of healing and knowing? When does the familiar becomes unfamiliar and the mainstream becomes alternative?