She is helping to change conditions for an estimated 165 million Indian Dalits, also known as "untouchables." They are a mixed population of numerous caste groups throughout South Asia. Although the caste system was abolished under the Indian Constitution, widespread discrimination and prejudice still exist against Dalits, particularly women.
Dalits are frequently denied such basic rights as education, housing, property, freedom of religion, choice of employment and fair treatment before the law. This situation led Indian Prime Minister Manmohan Singh to draw parallels between "untouchability" and apartheid in 2006. As a result of discrimination, Dalits are denied full participation in Hindu social and political life.
In rural India, where caste origins are more apparent and Dalits often remain excluded from religious activities, many upper caste members believe that Dalits will pollute the temples if they go into them.
Every 20 minutes a crime is committed against Dalits, according to a 2005 government report. Although distressing in itself, this figure probably represents a fraction of all crimes against Dalits, since most of them remain unreported for fear of reprisals from the police or from member of the upper castes.
For several years now, Konsotia has been working to change that situation. She is a union activist and college graduate, leader of Delhi's sewage workers and their wives. For the last 10 years she has been working to empower them and make them aware of their rights while improving their education through mobile education centers she created in Delhi.
A woman of strong character (when a worker was repeatedly disrespectful to her she held him by his collar and slapped him in the face), she has the unwavering support of her mother, who went through an abusive marriage.
"My mother is my secret guru," she told a reporter. Konsotia is determined that Dalits, particularly women, will not suffer what women of previous generations did.
And they certainly need her help since a situation of centuries of discrimination has affected theirs and their children's health and quality of life. For most Dalits, good health care is unaffordable and inaccessible, and generally their experience of health care is limited to emergency care.
The maternal mortality rate is a reflection of accessibility and quality of health services. Prenatal and neonatal care is extremely limited. As a result, complications from pregnancy and childbirth are the leading cause of death among women of reproductive age. Because most Dalit women are poor, their health status is usually worse than statistics suggest.
The maternal mortality rate is 560 deaths per 100,000 live births (the same rate for industrialized countries is 13 per 100,000.) For every woman who dies during pregnancy and childbirth, approximately 20 more suffer injuries, infections and disabilities that may seriously affect their health. Anemia, which is frequent among poor women, predisposes women to sepsis and hemorrhage during delivery.
Child statistics are equally distressing, since 56 children per thousand who are born alive die before reaching the age of five, a rate that compares with five children per thousand in industrialized countries. In addition, both women and children, particularly among the poor, experience an alarming rate of physical and sexual abuse.
In January of 2007, the U.N. Committee on the Elimination of Discrimination against Women concluded that Dalit women in India suffer from "deeply rooted structural discrimination." Proud and determined, Konsotia's work with Delhi's poor has already made a difference.
**Cesar Chelala, M.D., Ph.D, is an international public health consultant and a cowinner of an Overseas Press Club of America award for an article on human rights.
