An app that is saving women’s lives in Dharavi

One of the most positive fallouts of the rapid mobile phone penetration in India has been the impact on education and health in rural India. These are parts of the country that have been left out of the benefits of the economic boom and progress seen in urban parts, either due to poor infrastructure or lack of political will. Be it apps that provide health updates or learning tips, start ups are coming up with creative, innovative ways to reach a constituency that was regarded as difficult to access for the longest time.

One such initiative that has received much attention, and for the right reasons, is SNEHA’s Little Sister project that deals with the sensitive subject of domestic violence. DV is rampant in India but has never been given the attention it needs given the scale as most women do not report it. Many of them don’t even see it as an issue as a nationwide survey in 2013 found out. Over 50% of women said it was justified on many counts.

Apart from being a human rights issue, DV is also a health issue. It impacts women’s health in a myriad ways – from causing Post Traumatic Stress Disorder to depression and even affecting maternal health outcomes. Also think of the impact on a child who watches his mother get verbally abused or physically beaten up? You are looking at a generation that will grow up to be either abusers or victims of abuse.

SNEHA’s Little Sister app works by offering women in Dharavi a safe space to seek help. It is private, non intrusive and effective. Most victims of DV are not looking to walk out when they seek help. Often they want a shoulder to cry on before deciding what to do next. Little Sister does just that. It allows the woman to set the pace. Its the comfort of reaching out to someone who you do not have to see again if you don’t wish to and who will not judge you, or your situation.

To find out more about the Little Sister project click here. There is a video link about the project as well. 

 

 

 

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Pyaari Meenu -Telling SNEHA’s story through the letters of a young girl

How does one even begin to express why investing in women’s health is so vital?

Be it reducing maternal deaths, improving infant and maternal health, family planning, or tackling domestic violence, a healthy woman is at the core of a prosperous urban world, and this is effectively conveyed in Pyaari Meenu, the film by Social Access on SNEHA’s efforts to build strong, healthy and secure urban communities.

Bringing together SNEHA’s various community interventions is not easy. However, Pyaari Meenu weaves those strands together quite beautifully.

“Our challenge was to convey all the program interventions they undertake in one central thought” says Lynn De Souza, founder, Social Access, “and we did this by stepping back and driving home the underlying premise, the belief that empowers all their work. This came through in the tag line “A healthy world begins with a healthy woman”. Even men get included in this thought!”

Pyaari Meenu uses the form of letters written to an unborn child to convey these ideas. “Letters are always a nicely emotive way to tell a story from a personal point of view. They draw the viewer into the experience, as observer and participant,” adds De Souza.

Shooting the film came with its own set of challenges as the milieu had to be real to bring home a sense of the community that SNEHA works in. Pooja Das Sarkar, who directed the film, says it was shot in just one day over 17 hours, remarkable given the noise and chaos that is present in any urban settlement.

“We chose a two-storied house – one to show the life stage of a younger girl, and another to show the older woman”, says Das Sarkar. But the challenges remained. “We chose lights that were small and could be used in a smaller space. At night, people were very curious and stood outside the house commenting on “Who is the heroine”? etc. It was funny but natural and we did not let it affect the shoot.”

Helping to make the process smoother were SNEHA workers. They explained to local residents what the film was about. “We sourced the kitchen, a baby’s cot and even a baby from the community”, adds Pooja. SNEHA staffers were also roped in to act, with Nasreen playing the key part of Bharati Didi.

The result is Pyaari Meenu – a haunting, evocative film that helps the audience understand SNEHA’s work and makes an emotional connect.

 

 

 

How Aahar is making a change: A community speaks

Approximately 50% of children under 5 years are malnourished in India. Nearly 39% are stunted, that is low in height for their age. And in the financial capital Mumbai, 26000 children die every year because of malnourishment.

Aahar, which means food, is a program that combines home-based and facility-based care to reach out to a large number of vulnerable children in need of monitoring. In order to make maximum impact, it reaches out to mothers when they are pregnant and  addresses nutrition and feeding practices throughout the first 1,000 days of child’s life. The program was launched in Dharavi, Mumbai’s largest slum colony in 2012 by NGO SNEHA, and works in partnership with the Centre’s Integrated Child Development Scheme, the Municipal Corporation of Mumbai and the Lokmanya Tilak Municipal General Hospital.DSC_0395

This week SNEHA will felicitate the many champions that help Aahar make a difference. A series of events will be held to honour the dedication and commitment of mothers, the municipal staff and community workers.

 

Here are some of those voices:

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Mukesh Kumar Jaiswal

Mukesh Kumar Jaiswal, 25

“I was 21 years old when I got married and I have two young children. My children used to fall sick very often when they were babies and my wife and I struggled to cope. We gave them whatever was cooked in the house, sometimes we fed them chips and biscuits. It was only when my youngest was nearly 6 months old when we realised that what they eat makes a substantial difference to their health. This was after SNEHA workers came to our area and held camps. They talked about the importance of breastfeeding and immunisation and it made a big difference to our children’s well-being and those in the neighbourhood as well. 

It is not like children don’t fall sick now. They do but not as often as they used to. We not only feed our children green vegetables, dal and fruits, but we eat healthy too”

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Renuka Kadam

Renuka Kadam, Community Organizer, SNEHA

“I started working in Dharavi 4 years ago and it was initially very hard to convince the families here to change their habits. They did not understand the importance of eating green vegetables, fruits and protein. We received a lot of support from the local anganwadi where these women would gather. Gradually they started to trust us and attend our sessions.

There was no awareness of the importance of breastfeeding. Most women would not nurse their babies due to misconceptions and myths so we had to work a lot on that aspect. They did not understand how important it is to take adequate rest, eat regular, nutritious meals while pregnant or take vitamins and supplements so their babies are healthy. They are so busy taking care of their families that they forget to look after themselves. They forget to eat. So we draw a clock on a sheet of paper and mark out the hours when they should eat. 

We hold camps twice a month when babies are weighed and their growth is recorded in charts. As the mothers see the improvement they are convinced. We also advice them about spacing babies and the various contraceptive methods.

From the time we started Aahar, there has been a big improvement in baseline indicators. But the challenge remains. Dharavi is home to a large migrant population so we have to monitor constantly”.

 

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Sangeeta Gupta

Sangeeta Gupta, 30

“I have three children and earlier I would never bother too much about what I fed them. If I could cook a meal I would. Otherwise I would give them some money so they could eat chips or biscuits. After SNEHA’s camps I have changed. I always give them a dabba for school with vegetables and roti or rice. I have seen what a major difference it has made to my children’s health”.

 

Marking 16 Days of Activism

Mumbai’s reputation as the safest city for women has taken a beating after the release this week of a new study that shows that the financial capital witnessed a surge of 49% in crimes against women in 2014-15. While this may be a heartening sign that more women are coming forward to report such crimes, the staggering near 50% jump should compel us a society to reflect.

This year’s 16 Days of Activism Against Gender Violence was an opportunity to do just that. Violence against women in India takes many forms. From sexual assault, public humiliation, abuse, domestic violence trafficking or ‘honour’ killing, crimes against women have more than doubled in the last 10 years according to the latest data of the National Crime Records Bureau.

One of the aims of the 16 days campaign is to raise awareness about this violence at different levels – local, national, regional and international. As part of this, campaigns and training workshops were conducted at various settlements across Mumbai city by SNEHA in collaboration with local organizations.

At community centres in settlements in Dharavi and Kandivili, daylong workshops were held with Safecity, a Mumbai-based organization that conducts campaigns to spread awareness about gender-based crimes.

IMG_0280The tone of these workshops was informal and interactive. Participants were asked about public spaces, their notions of what was safe and unsafe and interestingly there were several similarities in what boys and girls regarded as unsafe public spaces. The conversation would then broaden to include issues of sexual violence and harassment. The idea was to create a safe zone where participants could voice their opinions honestly about issues like consent, victim blaming, marital rape and domestic violence. They were also asked to map their localities, marking out areas that were regarded as safe or unsafe.

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“Through the maps, we saw the reasons why many areas were considered safe and unsafe”, said a member of the Safecity team. “Safe spaces generally were areas that people frequented, or areas near places of worship and police stations. Unsafe spaces were much more in number and included spaces that were dark and secluded and where crime had happened before.’

The next step in this campaign would be for this group of youngsters to conduct a survey of their areas based on a survey form SNEHA has prepared that is based on perceptions of people regarding sexual harassment.

Violence against women is one among the most important factors preventing their full participation in the economy. Above all it’s a fundamental violation of human rights. Involving boys and young men in such campaigns send out the message that it is time they got involved in ending the scourge of violence against women and girls in their homes and communities

Promoting breastfeeding

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On the occasion of World Breastfeeding Week, SNEHA organised three rallies at Dharavi on August 2. All the 79 community organisers, and others who work with the Aahar project of SNEHA, came out in support of the message. Nearly 150 people attended the rallies

“We spread the message of breastfeeding in the rallies. We told women that it is very important to breastfeed the first half hour of birth, and then exclusively for the first six months. There were some women from the community too who came and asked us questions. Our staffers counselled them on the issue, “said Dr Ganesh Mane, programme co-ordinator, Aahar.

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The rallies had the support of our civic officials, and especially the doctors of Lokmanya Tilak Municipal General Hospital. In fact, Dr Alka Jadhav, professor of department of Paediatrics, with Dr Neeta Naik at LTMG Hospital, Mr Nandepalli, an ex-corporator from BMC, and Mr Gaikwad, CDPO, Dharavi block inaugurated the three rallies.

Dharavi diaries: The mystery of Aryan’s malnutrition

Healthyurbanworld will be following a severely malnourished child for a six months and note how the programme helps the baby’s development. 

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Aryan (centre) at SNEHA’s day care centre

Two and a half year old, Aryan Kothari is sick yet again. Almost every month, he suffers from a bout of diarrhoea or fever with a cold. Aryan is severely malnourished. He weighs just about 10 kgs and is only 86.8 cms tall. He been malnourished for nearly a year and has been in SNEHA’s day care centre at Matunga Labour Camp, Dharavi since September last year. He has been on medical nutrition therapy (a supplement with essential micronutrients mixed with peanut butter) for a few months.

His mother, Lata Kothari, 22, is at her wits end. “He does not eat well. I try so hard. People also say that since both my husband and me are thin, he is also thin,”said Lata. She shares the misconception of many parents who attribute the child’s malnourishment to genes.

Aryan was breastfed well for six months before his mother tried to give him supplementary food. “He just refused to eat anything. At most he would have one or two bites. I still find it very difficult to make him eat,”said Lata. She spends nearly two hours feeding him a small meal (a few mouthfuls, usually). The day care centre teachers too complain that Aryan is a poor eater.

Aryan's mother, Lata Kothari with the community organiser, Kunal
Aryan’s mother, Lata Kothari with the community organiser, Kunal

Aryan’s case is befuddling as his mother tries hard to follow most of the instructions provided by SNEHA community organisers. She tries to give him a nutritious diet and keep both him and his surroundings as clean as possible.

Recent studies have posited that poor sanitation, despite good diet, is one of the major causes of malnourishment. In all probability, Aryan is being exposed to a lot of germs. His house, though spic and span, is couched between a menagerie of houses. The house, which is on a mezzanine floor, has zero ventilation and no light. They need to switch on the tubelight all day long.

Aryan has to climb this steep staircase to enter the house
Aryan has to climb this steep staircase to enter the house

When we entered the house on a rainy day, the passage leading to the house was submerged in water. One has to climb a steep staircase to enter or exit the house, reducing his chances of outdoor exposure.

“We are trying to counsel these parents about how to feed the children and what is good for them. But if their circumstance is such that that they have to live in such unhygienic conditions, it becomes difficult for us to get rid of the problem of malnutrition in such cases,”said Dr Ganesh Mane, project co-ordinator, SNEHA.

A date with the doctor

While examining a 10-month old child at Matunga Labour camp in Dharavi, Dr Bharati Shanbhag chided the mother for stopping vitamin and calcium tonic for the child. “Please tell your husband that these nutrients are important for your child,” she told the mother.

Every month mothers at Dharavi flock the health camps organised by SNEHA. The camps are held at each beat at least twice a month. The check ups are geared towards treating children with malnutrition as well as children with normal growth rate who fall sick.

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Mothers flock for a health check-up at Dharavi

On Wednesday, 13 children were examined by the doctor mostly with monsoon ailments such as diarrohea and other infections. The community organisers at SNEHA inform the mothers at their door steps about the health camp and are compelled to give reminders when they don’t turn up.

Dr Shanbhag who worked at with a public sector undertaking said that handling children in Dharavi is tough because of the community is migratory. “It is very difficult to follow up with these patients. Parents do not follow up on vaccination and check ups,” she said.

The children at Dharavi usually get recurring diarrhoea and other infections which constantly bring down the weight of the child. This is one of the causes of malnourishment.

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SNEHA’s community organisers check the weight and height of children visiting the health camp

“The children start walking and step out of the house picking anything on dirty corridors between the houses to eat. If there is more than one child in the house, the infection spreads easily, she said.

Dr Shanbhag has been working for over a year. “I feel the situation has improved since the past one year. The community organisers who visit them regularly have made all the difference. The immunisation programme is followed better now. Also, the parents have started understanding the importance of sanitation and nutrition, ” said Dr Shanbhag.

Safety as a human right

When one talks of “access to toilets”, the first thought that pops in the mind is “sanitation”. In Dharavi, however, the immediate association with “access to toilets” is “safety of women and girls”. Why ‘safety’, you ask?

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SNEHA’s toilet painting campaign

‘Safety’ because:

– groups of men and boys are always hanging around outside public toilets, loitering, drinking, gambling, sexually harassing women and girls.

– men and boys sexually find toilets an easy place to target a large number of women. Men and boys see public toilets as opportunities to stare, ogle, pass comments, whistle, grope, pinch, abuse, rape women and girls.

– women and girls feel uncomfortable, violated, targeted, harassed, denied of their basic human rights of access to safe toilets and a life free from violence.

– women and girls (and their families) feel like the onus is on them to ensure their own safety.

– women and girls are the ones who are forced to find solutions to ensure their safety such as going to the toilet early in the morning to avoid harassment and their harassers or going in a group with friends or with a family member or avoid going to the toilet several times during the day.

The 2011 Census of India found out that nearly 12 per cent of urban households resort to open defecation and another 8 per cent use public or shared facilities. Not only is this a health hazard, but it undermines the dignity of women and girls and makes them vulnerable to harassment and violence.

SNEHA addresses both, the issue of health of women and girls and the issue of gender-based violence in Dharavi, through campaigns, street theatre, meetings, support groups and vigilance groups. We raise awareness of these basic human rights in the community, and encourage and support collective, indigenous responses to combat violations of these rights. SNEHA’s men’s group members also act as vigilantes against sexual harassment of women and girls in public places, which includes the areas where public toilets are located.

Toilet tales from Dharavi

Last month, two sisters from Badaun district, Uttar Pradesh were allegedly raped and murdered when they went to answer the call of nature in the fields at night. Most people in Dharavi do not have toilets in their residence.We asked four adolescents in Dharavi how safe they felt when they visit the nearby toilet. 

Pratibha, 14, studies in class 9

We have a mori at home where we can have a bath and pee. For bathroom (meaning WC), I have to walk about five minutes.  I go just once a day in the morning. I do not feel the need to go after that.

I heard about a girl being molested there. Some boy who was on the way to the toilet caught her. I also heard of a five year old girl being molested there. It became a police case.

If the boys say or do something, it spoils our reputation. Our fathers too.

If I have to use the toilet in the night, my mother comes with me. Or else a friend comes along.
Hetal, 13, studies in class 6

We have a bathroom at home, not a latrine. For that I have to step out and walk for five minutes. We have to pay one Rs to use the latrine. I use it around 2-3 times.

I never go to the toilet alone if I can help it, especially in the night. My mother has told me that whether it is night or day, take someone along to the toilet. She usually comes with me, or else I go with my friend. Only when she is sick, I go alone.

I have heard of rape cases in that area. When I was a child, I was told that there was a bus which stopped there and picked girls for begging.

There are always boys on the way to the toilet. They come around 9 pm every night. They come with bikes sometimes. They say things like – palat ke dekh (turn around and look at me).  I once shouted back at them and said – Ghar main ma behen nahi (Do you not have mothers and sisters at home)? My mother had told me never to confront those boys, but I was very upset that day.

It is not fair that we do not have toilets at home. One of my friends did not use the toilet all night because her mother was not at home and her friend refused to come. Her stomach started hurting.

Boys have nothing to be scared of. They are the ones who trouble us. We girls have to be careful.

 

Kruti, 18, goes to college.

I do not live in a nice area. Many people who I grew up with left the area. It is not safe for girls. Many people in my area already have bathrooms inside their houses. There are hardly any people using the public toilets any more.

Till recently we had a horrible public toilet. It used to be so dirty. I would not like to go there. I would wait for half an hour to an hour to just use the toilet. Many times I have been late for school. Now we have one toilet for every ten houses. It is easier to keep to it clean and I do not have to wait long to use it.

I go to the toilet alone. It is just two minutes away. On the way to the toilet, we always find men around. Sometimes they just say something obscene and walk away. Men play cards or match (cricket) near the toilet. They always make comments.

I do not pay attention if someone makes a comment. If I confront that person, people will point their fingers at me only. They will say she must have done something to provoke the boys. It is best not to say anything.

One girl I know confronted these men who were passing obscene comments. But when she went home and told her parents about it, she was told – Tujhe hi sahi se jaana chahiye (You should have stepped out decently). They told her that she should not have worn jeans and T shirt.

I felt bad for her. She did not wear those clothes to show anything or provoke. She just stepped out to go to the toilet. In any case, even if you wear a dupatta and leave, you cannot hide your body. The men are going to comment anyway.

There is no light near the toilet or inside the toilet in the night. The bulb just does not switch on. We have to take a torch. It is just fully dark. I have to take someone along if I want to use the toilet at night.

My mother has always told me not to talk to my friends near the toilet. If I go to the toilet in the afternoon, I feel weird. There is no one there.

 

Vineet, 14, studies in class 9

The toilet is just one minute away. There are men smoking cigarette and drinking liquor there. My father has told me not to talk to anyone there. I am a little scared of them. They could beat me up if they want to. I always go with my father.

The toilet is sometimes very dirty. I have to wait for it for about 45 minutes to an hour. I sometimes get late to school. I do not go to the toilet even if I want to sometimes. It gives me a stomach ache.

I have seen girls being molested near the toilet. It is horrible. The boys sometimes pull their clothes, their hair. We try intervene sometimes. But, such incidents scare me. These incidents should not happen.

(Names of the adolescents withheld to protect identity)

Need for creches in Dharavi

 

Mohan, about 18 months old spends most of his day in the crib in his dingy slum at Dharavi. The crib is in the corner of the tiny room which has no light. His mother spends hours in the mornings and afternoons working as a housemaid. Almost the whole day, the child eats biscuits soaked in milk.

Apart from gross ignorance about nutrition (many mothers in Dharavi do not even know the word), SNEHA has to deal with the lack of resources that the women face in the area. While many mothers are compelled to work, there is no real solution for lack of caretakers for children. Mohan’s mother says that she leaves her children to her sister-in-law’s care. This sister-in-law who lives a few rooms away already has four children, one of who is just an infant. One can safely conclude that the children are left to their own devices when the mother steps out.

Many such children of working mothers at Dharavi are susceptible to malnutrition. Children need the care and attention of their mother is always not possible. Many mothers are busy with daily chores and are also working to earn a living by doing off jobs such as selling utensils, embroidery, among others. Few of the other major reasons for malnutrition in children are lack of access to healthcare services, lack of quality of care, lack of good hygienic practices and absence of correct feeding practices.

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Sevikas from SNEHA’s day care centres say that approximately 90 percent of the children in the centres belong to working mothers. The day care centres take in children who suffer from severe acute malnutrition and moderate acute malnutrition. In the centre, children learn to eat nutritious food (they are fed milk, fruits and other snacks), and form habits such as hand-washing, toilet training, among others. The children are also taught songs and rhymes and play with each other during the day. Children who stay in day care centres make great improvements in their health and move to their homes with better habits.

Many of these working mothers are not able to breastfeed their children exclusively for six months, let alone feed them breast milk for two years, which is recommended by the World Health Organisation. Many women resort to feeding the children cow’s milk in bottles. The sterilisation of these bottles is also a question. Many working mothers also resort to feeding easy-to-feed food such as biscuits, packaged snacks such as wafers, crispies etc.

​There is an acute need for creches for children in Dharavi with its compromised health and lack of care practices.Creches can help a child not only overcome malnutrition but also mentally stimulate him or her. Children need an environment which is safe and stimulates mental and motor development.

Scene from a cricket field

Shivani Singh, 18 wondered if she will be able to play cricket. She had come from “all the way” from Kandivali to Dharavi to participate in a cricket match. She was one of the two girls selected by SNEHA to play in the three-team tournament in Dharavi. The three teams were selected from communities at Dharavi, Kandivali, and Ghatkopar where SNEHA works extensively.

“I can dance. I have never played cricket,” said Shivani who goes to college.

Nagesh Kori, 17, another collegiate in her team quipped, “That’s because you’ll never play with us. We play galli cricket all the time.” They were watching their team-mates open the batting against Ghatkopar team.

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Shahid Sheikh on the extreme left cannot take his eyes off the match. Rohit Kanojia, Nagesh Kori and Shivani Singh pose for a snap while waiting for their turn to bat

“Rubbish! When did you boys allow us to play?” Shivani told him making a face.

In the meanwhile, one of her team-members, Rashida Shaikh, 18, gets out on the first ball. As per the rules, it was compulsory for one girl to open an innings.

“You please don’t get out like this,” said Shahid Sheikh, 17, Shivani’s teammate. He rolls his eyes when Shivani asks him questions related to the rules of cricket.

Soon, Shahid was cheering for Rohit Kanojjia, 19, who had stepped in to bat for the team. Sure enough, Rohit hits many sixes and fours much to the glee of his team members.

In the third over, Mayuri Mhasde, 15, a puny girl from Ghatkopar team started bowling (it was compulsory for the girls to be given one over in the match).

Rohit happily hit the first two balls for four and a six. In her third ball, she bowled him out. Rohit looked at the wicket in disbelief. The team eventually made 138 runs.

Mayuri was however, disappointed. “I could have taken another wicket. It turned out to be a no-ball,” she said.

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Mayuri Mhasde on the left and Kajal Yadav next to her talk about their love for cricket

She has been playing cricket for over two years now. “We play every day between 2 pm to 4 pm. Even my sister who is a complete recluse plays with us,” said Mayuri.

Her sister, Sonali, 18, who studies in college, also plays cricket, and is part of NCC cadet. “I want to join the army after I finish my graduation,” she said.

Another girl from Ghatkopar but from a different locality, Kajal Bhandare said that in her locality, girls are not allowed to play. “My brothers take me everywhere. So I got to play cricket,” she said.

When Mayuri went out to bat for Ghatkopar, she got out soon. “My captain, Shashank Uthale asked me to get out. I can play well. I can hit four easily. Hitting sixes though is tough for me,” she said vehemently. The team got out making less than 51 runs with most batsmen making less than one run.

“What Dada, I told you I can play? Why you didn’t let me?” asked Mayuri. Shashank had no answer.

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The three team tournament was organised by SNEHA on April 2. The intention was to select a winner for a tournament organised by Indra Darshan Society, Oshiwara. The Society runs a cricket tournament every year to help raise funds a non-profit of their choice. This year, they have chosen SNEHA.

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The victorious Dharavi team

After six matches, Dharavi team emerged the winner. The team will represent SNEHA in the Oshiwara match. In this team, both the girls and boys played in harmony. They practiced for days before the match.