Meet Dr. Kiran Modi

Founder and Managing Trustee of Udayan Care

When girls come into the care of the Udayan Ghars, what are some of the most common health issues that they face? Are there any common mental health issues that they face when adjusting to group home living? 

• A child, who is too young, often lacks toilet training and personal grooming skills.

• Poor oral and personal hygiene is common among the children.

• Children are often underweight and exhibit poor eating habits.

• Incomplete or no vaccinations which are compulsory for children.

• Adolescents often have little awareness about menstruation and menstrual hygiene

• The girls are often anemic.

• Sometimes children come with minor injuries needing immediate attention.

• Incoming of children with chronic ailments like Diabetes, epilepsy, tuberculosis, etc.

• Recently, it has been observed that many children who come in have holes in their ear drums. It raises the concern of children being physically hurt or abused in their early years of development, before coming to a care institution. 

Concerns regarding Mental Health:

• Children often are distraught when they come to the home

• Concept of functional family is new to many of them 

• Preconceived notions about closed spaces and new environment

• It takes a lot of time for them to heal from broken attachment to move on to secure attachment

• Building of trust of being at a safe place in the initial days.

• Traumatic past around history of physical, sexual abuse or emotional abuse. Experiences of separation, abandonment and loss of loved ones.

• Inability to form and/or sustain relationships.

• Little or no social skills leading them to take time to open up, understand their & other’s feelings

• Lacking age-appropriate independent skills corresponding to self-care

• Inability to manage anger and experiencing emotional outbursts

• Children with extreme emotional & psychological turmoil often are suicidal in nature often resorting to self-harm especially by cutting wrists.

How do the girls adjust to the routine and discipline of going to school? What resources have you provided to help them with this adjustment? 

• First Interaction – When a new child comes to the Ghar, many times they are not used to the family environment and also have little understanding / inclination towards education. Thus, the child during the first interaction is shared about the Ghar structure and also the daily routine of the Ghar. 

• Provision of a Counselor – The counselor has a session with the child wherein the feelings, emotions and experiences of the child are understood. Sharing about the experiences gives the child a ray of hope about a new beginning in life.

• Inclination to Education – Involvement of the new child in the Ghar activities and sessions enables it to grow from being an observer to a participant giving it a sense of achievement and encouragement. 

• Provision of Home Tutor - An assessment of the level of education is done and accordingly the home tutor supports the basics as well as preparing for school. Eventually as the child settles in, it is prepared for schooling and the admission process is taken up.

• Motivation from other children – As the child adjusts to the home environment, the experiences of other children and witnessing them study motivates them to also study. 

• Library at the Ghar – A library consisting of story books and educational material which is accessible to children all the time motivates them to pick up the book and read or glance through it. 

• Discipline at the Ghar – A child friendly time table at the Ghar helps every child to get into a routine making them utilize their day in a fruitful manner. Bringing in structure helps them to adjust well at the school. A zero tolerance abuse policy makes the children adjust in the home, as they do not have to fear consequences all the time.

• Interactive Sessions with the Child – Individualized care is given to children for their growth and development. This even extends to resolving conflicts as well as building essential skills of the child. Through individual sessions with the Mentor Parents, counselors and other staff at the Ghar, the child is given an opportunity and space to reflect, resolve differences and be an active part in decisions for itself. 

My experience volunteering at Udayan Ghar, Noida in the summer of 2019 was extremely rewarding because the girls were so welcoming and kind. How are you able to create and maintain such a positive environment?

• Inculcating the spirit of LIFE (Living in Family Environment – Every child who comes to the Udayan Ghar is given a sense of being a family unit and all homes taken together are one big family. This is also strengthened by having meals together and engaging in group activities.

• Residential carer team -  Each Udayan Ghar has two residential caregivers who are available at the Ghar with children 24X7. They look after the children, prepare meals, help them get ready for school, accompany children outside the ghar, inculcate values

• Unique Feature of Mentor Parents – The Mentor Parents are long term volunteers who have raised their own children and now are part of the Udayan family. They fill in the gap for a child who has been devoid of parental care. 

• Capacity Building of Staff & Children – Workshops are designed as per the stakeholder involved to inculcate the practice of empathy, spirit of oneness, understanding attachment, recognizing trauma and building resilience. For children, workshops are designed which range from educational development to inter & intra-personal development in the psycho-social domain.

• Mental Health Programme – Mental health experts such as Child & Adolescent Psychiatrist, Trauma therapy experts are on board to guide the in-house psychologists and social workers to plan and implement the psychosocial interventions with the kids. Through small steps and gradual implementation of mental health interventions, the trauma of the child is tapped to see a new lease of life & give hope. 

Economically disadvantaged girls around the world have been especially impacted by the COVID-19 pandemic. Currently, within the larger community in which Udayan Care operates, have you seen an increase in the number of girls entering the Udayan Ghar network? If so, have they faced greater challenges because of the abrupt nature of the change?

With the push of the government, many girls after being provided with intensive counseling had returned back to their families. However, with the current situation, there has been an observable increase in the number of girls entering the Udayan Ghar Network. Some of the key reasons for the same are as follows:

• Rescue from difficult circumstances – There has been an increase in adolescent girls who have been seen to be cases of elopement, teenage pregnancies among others. These are there at the Ghar for a temporary basis till there is reconciliation with the family.

• Closure of Child Care Homes – The closing of children’s homes is not affected by the Pandemic. With the continuing closure of child care homes due to different reasons, girls continue to be transferred to the Udayan Ghar on a short or long term basis. 

How have the girls dealt with isolation during the pandemic? How have you continued their education/ Have they had remote learning? If so, what are some of the challenges they have faced?  

The impact of the pandemic and isolation that it has brought with it has a similar impact on both girls and boys. From inaccessibility to educational resources to buying rations & medicines everyone has been dicey about assuring of the availability. Moreover, presence of key people in the child’s life whether it be Mentor Parents or other professionals has been reduced to be virtual.  The challenges seemed to increase with only two care staff being round the clock alone to manage from 12 to over 30 children. The movement was drastically reduced due to fear of the spread of the disease. 

However, certain measures were taken as part of immediate response:

Development of a Standard Operating Procedure (SOP) – With movement restrictions and information sharing reduced to online means, it became the need of the hour to prepare a crisp document that provides the required information about the pandemic. Thus, an SOP was developed for internal circulation across all the Udayan Ghars highlighting briefly the background of the Corona Virus to the precautions to be taken to be safe. The SOP was developed both in English and Hindi and was circulated with each staff working at the Ghars. 

• Technological Upgrade – A tech upgrade was initiated across all the Udayan Ghars wherein devices such as laptop and mobile phones along with peripherals such as microphones, web cameras, high speed internet connection etc. were provided.  

• Training of the Care Staff – The role of a carestaff immensely expanded during the period of lockdown wherein they were required to don multiple hats. From ensuring all safety precautions, to stocking rations, from understanding computer technology to helping children in basic academics, the care providers were there 24x7 with the children. Despite their limited educational levels, rigorous in-house training on a range of themes & topics enabled them to take up this challenge, enhance their skill set and ensure the continuum of standards of care. 

• Capacity Building Workshops – In-house workshops were conducted online on a range of topics which ensured continuity in holistic learning. Topics for the workshops were different for the stakeholders based on their role in the programme. 

• Online Counseling Sessions – Continuity of Mental Health Support to children was one of the major areas of intervention. Counseling sessions both individual and group were conducted through online mode wherein the assurance of a safe space for sharing for the child was created. This enabled continuity in mental health interventions for children under high psychiatric care as well as continuing a positive atmosphere at the Ghar. The counseling sessions were extended even to the care staff who has been tirelessly working with children round the clock. 

• Online Tutoring – Many children at the Ghar are at their crucial years of education. While some were building the basics, others were preparing for board exams & other competitive exams. The lockdown period brought a complete halt to their visits, initially bringing up the fear of educational lag to even a loss of the academic year. However, with the gradual shift to online modes of study, children could once again engage in a continued mode of education and ensure that there is limited chance of drop in education. 

• Challenge with Alumni – Young Adults who were living in scattered housings had a setback when it came to accessibility to online classes and other basic educational material. This was addressed by extending monetary support through the Emergency Response Fund. 

Have you had to provide greater psychological counseling during this difficult time? If so, what are some of the common issues that the girls have faced? 

Common Issues Faced by the Girls

• Increased Levels of Anxiety – Children and young adults took time to adjust to the new ways of living. Moreover, the uncertainty of the future along with a constant worry about family members living away added to the anxiety. Their fears highlighted their concern of the safety of the family to the availability of basic resources such as food.

• Restriction on Movement – As children were at the Ghar round the clock which has been for over a year, there has been a building of emotions and a need for a change to rejuvenate. This also led to increased frictions amongst themselves as well as with Care staff. 

• Uncertainty about Future Prospects – Many girls were to begin their jobs and training. However, with the pandemic, these were withdrawn, making them remain at the Ghars. Moreover, some even lost their jobs or had their exams postponed leading to more uncertainty. Thus, the priority for these children was psychological support through counseling and brainstorming on alternatives. 

• Provision of Psychological Support

• Need for Greater Psychological Counseling – While children were provided regular counseling sessions, during the pandemic the sessions were to be increased to address COVID-related queries, anxieties & fears and also provide them a safety net. 

• Continuity in Counseling Sessions – The girls were provided with regular counseling through online media and a follow-up was done with each of them. Discussions with children about the pandemic were done age-appropriately.  

• Need to Provide Factual Information – It became important to provide children with factual information about the pandemic and also instilling the fact that children are safe if they follow all the necessary precautions. 

• Motivational Sessions – In addition to the children, the caregivers were also involved in sessions with a motive to boost morale, recognize initiatives and the continued dedication to the work. Certain staff were provided with counseling through the Programme Coordinators and Counselors on a regular basis. 

You provide tremendous health resources, has the pandemic brought to light any other resources that you believe will be of help going forward?

• Creation of Sick Rooms at the Ghars – Part of the safety precaution and legal mandate, a sick room at each Ghar was made mandatory. At each of the Ghars, space was identified and restructuring was done. However, keeping in mind the family environment and the rooms being multi-purpose in use, it became difficult to isolate in a small space. 

• Provision of Masks, Sanitizers, etc. – With a large number of people living in a single children’s home, it becomes important to provide an adequate number of masks and protective equipment to ensure safety. Moreover, regular sanitization of the homes along with provision of pocket sanitizers has become part of basic needs. 

• Organizing the Vaccinations for Staff – Support is required for timely vaccination of the staff and later on the vaccination for over 200 children who are residing at the Ghar. 

• More Gadgets and Technological Support – Every child has been attending online classes and the staff is building their capacities through online training. This brings to light, the need for major technological upgrades wherein there are sufficient gadgets as well as good internet connectivity. 

• Support to Aftercare & Alumni – It has been a tough time for the young adults and alumni of Udayan Ghar who have been living independently or with their families. While some lost their jobs, others had to grapple with the family pressures. Expanding the health safety net to the aftercare especially those living in scattered housing and the alumni is considered to be the need of the hour. They were extended with the support of safety equipment such as masks, sanitizers, basic ration, etc. Awareness sessions were also conducted with them so as to disseminate correct information & address queries.