The reality

Asha believes that it is not enough simply to provide medical care within slum communities. It recognises that only an approach covering land ownership, community empowerment, health care programmes and environmental improvements will bring about long-term change in the slums.

This has led to the development of a model centred on community organisation, where the agenda is set by slum residents and there is a wide range of activities based on their needs. The poorest are targeted, people's values are transformed and the development process is sustainable. Asha's strategy is based on the belief that it is the people who are the key to change.

Success in Asha slums

Today, Asha's approach has become an ideal model for slum development all over the world. The slum residents are proud owners of their own homes. They enjoy good health, have plenty of safe drinking water, hygienic toilet complexes and the children play happily on clean paved streets. Nearly all children go to school, and some even go on to university - a future that was once a distant dream. The women are confident, full of self-esteem and the women's groups look after the affairs of their areas independently.

The increased sense of community means that fewer individuals feel excluded and that social problems are less common. Where these problems do occur, community members have the knowledge to recognise the issues and are able to take steps to tackle them.

Many areas still in need

Slum communities not yet working with Asha are different in every sense. The dirt, squalor and overcrowding is relentless and the general sense of despair is oppressive.The issues are numerous and the scale of the problem is often daunting.

When Asha takes on a new slum, although some of the work has almost instant effects - such as the provision of a mobile clinic or a new health centre - other aspects of the work can take more time to show benefits. Women have to be trained to be Community Health Volunteers (or CHVs) and women's and children's groups are formed to educate others and create a united approach so that the authorities can be lobbied for environmental improvements. These initiatives are remarkably effective but results are not immediate.

As long as there is a wide gap between the rich and the poor, there will continue to be slum areas and people who are severely deprived and marginalised by society, and a great deal of work for Asha still to do.