Can a minor girl get an abortion in India?

Things that minors should keep in mind : 

A minor girl is someone who is below the age of 18 years old.

Under the Medical Termination of Pregnancy (MTP) Act 1971, a minor girl needs written permission from her guardian to get an abortion

The MTP Act defines guardian as a person “having the care” of the minor person. Thus an adult, someone over 18 years of age who accompanies a minor girl to a clinic would be De facto guardian and could consent to an abortion on the girl’s behalf.

Things that providers should keep in mind: 

If the girl’s age and/or marital status are uncertain, the providers can proceed with the termination of pregnancy in line with the provisions of the MTP Act after maintaining complete and detailed records of the case.

It is advised to report the pregnancy as per the legal requirement under  Protection of Children from Sexual Offences (POCSO) Act 2012 and allow the authorities to decide what actions to take.

 

Where to find health facilities for HIV and AIDS patients in Rajasthan?

 

Recently in Rajasthan, RSACS (Rajasthan State Aids Control Society) and Rajasthan prisons headquarters signed a Memorandum of Understanding to launch HIV intervention in prisons of Rajasthan. Now this is a very crucial step towards reducing the prevalence of HIV in the state. In many parts of India, civil society organizations have been fighting tooth and nail with their respective governments to have better health facilities, especially for pregnant & lactating women, HIV positive people and people with tuberculosis. Rajasthan is one of the first states to launch this agreement.

HIV and Prisons

An NGO SAATHI has been instrumental in bringing about this change. Various studies by the United Nations have stated that the prevalence of HIV is much higher in prisons than the general population. Rajasthan has total 127 prisons and other closed settings, including 10 central jails, three reformatories, 25 district jails, 60 sub-jails and 29 open camps. The capacity of these prisons is 32,327 and current occupancy is 32,787. Rajasthan at present has 66,000 people identified as HIV positive and are undergoing treatment. AIDS prevalence rate at the national level is 0.27%, while in Rajasthan it is 0.17%, which is less than the national level. (Hindustan Times, 20th February, 2018). Though the rate is lesser than that of India, its prevalence cannot be ignored. The government has taken various measures to identify and provide treatment to PLHIV.

Therapy Centres, ART Centres, Care Support Centres 

In order to provide care, support and treatment to people living with HIV/AIDS are getting benefited through 23 Anti Retroviral Therapy centers, 25 Link ART centers and 16 Care Support Centers. The free ART initiative was launched from October 2005 in Rajasthan. The main objectives of these centres are:

  • To provide prolong life and improve the quality of life among PLHIVs through CST services.
  • To Reducing the viral load in AIDS patients by taking ART regularly.
  • To Reduce HIV transmission by positive prevention concept.
  • To improve the HIV-TB coordination for early management of HIV-TB co-infection.
  • To provide care and support through counseling and care support centers.
  • Management of opportunistic infection & availability of sufficient O I drugs.
  • Post exposure prophylaxis for health care personnel working with PLHIVs.
  • Early infant diagnosis to reduce chances of spread the HIV infection in baby.
  • Reduce stigma and discrimination related with PLHIVs among Health Care Personnel as well as society level.

Following are the services available at these ART centers are free of cost:-

  1. Counseling
  2. Investigation
  3. CD-4 Test
  4. ARV Drugs
  5. O.I Drugs
  6. Knowledge of Social beneficial Scheme
  7. Condoms
  8. IEC Material
  9. Knowledge about network people
  10. Referral to Care Support Centre & other related units

 These are the Anti Retroviral Therapy Centres across the state as per RSACS:-

Though the government has taken various steps to ensure that PLHIC have access to various ART centres and get treatment but the situation remains grim for pregnant women who are HIV positive. Many newspapers have reported in the past decade how the doctors do not cases of pregnant women who are HIV positive despite the strict guidelines by the Medical Council of India and the Government to not devoid any pregnant women of the delivery services. There are safety measures that can be easily taken by the doctors and nurses while delivering a child of an HIV positive woman. The recent budget announcement in Rajasthan did not talk much about health. HIV was not mentioned at all. A better monitoring mechanism is required for all these centres to function effectively and regular counselling and training of doctors and all the health service providers must be mandatory. We need more sensitized doctors at the health facilities, especially government health facilities because getting treatment from private hospitals is an expensive affair. There is a dire need to reduce the out of pocket expenditure of people on health so that they do not get pushed under below poverty line as we all know that the second biggest reason for poverty in India is expenditure on health!

 

S.no. Name of ARTC/ FIARTC Address

1 SMS Medical College Jaipur Basement of Dhanwantari OPD, SMS Hospital, Jaipur Ph. 0141-2518630,2572290

2 Dr. S.N. Medical College, Jodhpur Infectious Disease centre, Kamla Nehru Chest & TB Hospital, Jodhpur – 342 002 Ph. 0291-2751161

3 S.P. Medical College, Bikaner Ground Floor, OPD Building, Near ANC Clinic, PBM Hospital, Bikaner – 334 003 Ph. 0151-2201119

4 R.N.T. Medical College, Udaipur MB Hospital, Opp. Trauma Ward, RNT Medical College, Udaipur Ph. 0294-2419403

5 Govt Medical College, Kota New Medical College, Hospital Kota, 0744-2471391

6 J.L.N. Medical College, Ajmer Near Orthopedic Ward, J.L.N. Hospital, Ajmer 0145-2633426

7 Govt. District Hospital, Alwar Govt. District Hospital, Alwar 0144-2346033, 2345087

8 S.K Hospital, Sikar S.K Hospital, Sikar 01572-251093, 271856

9 Mahatma Gandhi Hospital, Bhilwara Mahatma Gandhi Hospital, Bhilwara 01482-232641

10 Bangar Hospital, Pali Bangar Hospital, Pali 02932-226059

11 Govt. District Hospital, Barmer Govt. District Hospital, Barmer 02982-230369,230041

12 Govt. District Hospital, Jalore Govt. District Hospital, Jalore 02973-225090

13 J.L.N Hospital, Nagaur J.L.N Hospital, Nagaur Ph: 01582-244822

14 Hardev Joshi Govt. General Hospital, Dungarpur Hardev Joshi Govt. General Hospital, Dungarpur Fax No.02964-230203

15 RBM Hospital Bharatpur RBM Hospital Bharatpur. Ph: 05644-220054

16 BDK Hospital Jhunjhunu BDK Hospital Jhunjhunu. Ph: 01592-235025

17 Civil Hospital, SriGanganagar Main OPD, Civil Hospital, SriGanganagar. Ph: 0154-2970507

18 Govt. District Hospital, Sirohi Govt. District Hospital, Sirohi. Ph: 02972-220065

19 MG Hospital, Banswara MG Hospital, Banswara. Ph: 02962-248283

20 Sawaliyaji Govt. District Hospital, Chittorgarh Sawaliyaji Govt. District Hospital, Chittorgarh. Ph: 01472-241744

21 RK Govt. District Hospital, Rajsamand RK Govt. District Hospital, Rajsamand. Ph: 0295-2222885

22 DB General Hospital, Churu DB General Hospital, Churu.

23 Govt. District Hospital, Hanumangarh Govt. District Hospital, Hanumangarh.

Following are some useful important links for people who are seeking more information on HIV in Rajasthan:-

 

Article by: Tushita Mukherjee

Tushita is a dreamer. Outer space and astrophysics attract her a lot. She loves both machines and trees. She is currently working with an NGO. In her free time, she likes to read books and sing. She is particularly fond of Rock and Hindustani Classical music. Clicking pictures of people is something she is exploring these days.

Where can I get an abortion in Hyderabad?

If you are unable to find the service, please do write to us.

Write to us at hiddenpocketsinfo@gmail.com
Call us at +918861713567

 

 

Family Planning Association of India (FPAI) Hyderabad :

  • FPAI Hyderabad, 6-3-883/F, Topaz Building, Punjagutta Office Colony Lane,Punjagutta, Hyderabad, 500082

We have been mapping FPAI Clinics in different parts of India. We went visiting the FPAI Hyderabad Branch and it was one of the biggest independent branch we have seen. It was an independent building, in the middle of the city. It had a lovely park outside the hospital. Interestingly enough there was a diagnostic Centre right below it.

The registration fee is Rs 50. There would be a minimal cost for further procedures required.

We went inside the first floor of the building. It had a lot of patients and their families sitting right outside the Out Patient Department section. There were 2 surgeries that were conducted that day. We meet the person in charge who was willing to show us around.

The place had a doctor, a counsellor, some operating rooms and a ward as well.

They even had some posters that provided information regarding Medical Termination of Pregnancy and the number of months under which one could avail the services. We met the Auxiliary Nurse Midwife who was present at the clinic and who also showed us some of the rooms as well as some of the services available. At this specific clinic they only provided abortions for up to 12 weeks ( 1st Trimester).

 

(Poster  in Telegu explaining different months within which abortion can be performed)

The different types of services that come along :

  1. Sterilisation (Both Female and Male)
  2. Temporary Methods : ( IUD, Oral Pills)
  3. Medical Termination of Pregnancy
  4. Cancer Screenings

 

Mapping Jaipur and its reluctance to sexual health

Hidden Pockets Collective visited Jaipur as part of our mapping studies and went in looking for government hospitals in Jaipur. A lovely city  which is full of colourful people, we were really looking forward to this study. We visited Prayas, an excellent NGO working on the issue of Public Health and Medicines in Rajasthan and decided to seek their assistance before we started our mapping. This time, we wanted to cover different forms of public health facilities and understand how were people using facilities at different parts of the city.

Every time we ask someone for government hospital, people tend to tell us the name of biggest government hospital in their cities. It was the same case in Jaipur, as asked people around and did some search on internet we ended up looking at SMS Hospital and Medical College in Jaipur. It was conveniently located right in the middle of the city. It was crowded. We entered from Gate number 3 and went looking for sexual and reproductive services in the government , we were guided towards the Dhanvanthri department, Parivar at first floor in Room number 17.  It was right next to free medicine counter.

Then we headed towards a district hospital :Rukmani Devi Beni Prasad Jaipuria Hospital, located in Milap Nagar. We had heard that it had a One Stop Crisis Centre – Aparajita for rape survivors. It was a clean hospital which had a very good ambience for people. It was not at all crowded like SMS hospital and seemed like a good alternative for Sexual and Reproductive Health services. The images on the wall was a refreshing change from the normally sad looking walls of a hospital.

Post this, we headed towards Zenana Hospital, a hospital that was specifically for women and children. It was located right opposite to the Chandpole metro station. It was easy to locate though really crowded. Even though we were able to find services listed on various boards, we just could not find the rooms. We asked people around, even used the fancy not-so working info- booths, we just could not find the rooms for adolescent friendly health clinics, and other services.

We were really surprised by the number of posters for wifi in the different government hospitals. It seemed interesting that government was heavily promoting the usage of internet and technology in its various forms in the hospitals. Sadly none of them were in functional phase. 

Our last visit to Sanganer, which was bit far away from the city. We went there looking for a Community Health Centre, Sanganer.  A CHC is secondary level of health care and provide specialist care to patients referred from Primary Health Centres. A CHC is a 30-bed hospital providing specialist care in obstetrics and gynaecology according to the Indian Public Health Standards prescribed by the Ministry of Health & Family Welfare in 2012. So we decided to find this CHC. It was a bit far and we realised nobody really understands the term CHC, but if we referred it as “Sarkari hospital”, we were able to evoke response.

We didn’t see any crowd there as well and we were surprised to see a clean gynaecologist room and a room for counselling for Adolescent Friendly Health Clinic. We also encountered a poster that read in Hindi “Surakshit Garbhapath” which meant Safe Abortion. We were so happy to see a poster providing such positive message in the middle of a small town in Jaipur.

We were really happy with the services available in the Community Health Centre and returned back to our bus ride to Jaipur. On our way back, we wondered about the reason for people to head to big referral hospitals in cities, wasting time and their resources when they have good services in their towns.

We do understand there is a lear gap between implementation of these policies, and also lack of interest on the sides of service providers in assisting people in these smaller health centres, but if we could de-congest the big hospitals and still make this a good opportunity for the service providers. It would provide a great deal of relief for the patients of the related area. Until then, these were some of the hospitals that we visited in Jaipur and generally had a good experience.

Will you visit a government hospital to get health check up?

My first association with a big government hospital was when Amma asked me to go meet a doctor. She wanted someone senior to talk to me, so that I will eat my dinner properly. That was my first memory. Big hospital and lots of people. I was excited, running around looking for a specific room and this all seemed like an adventure. I still don’t have any memory of what exactly did my doctor say, but I retained the visuals. They stayed on and that was what government hospitals meant for me, for the longest time.

I grew up among Malayali nurses, and right next to my house there was one of the biggest government hospitals in Delhi. With time, I realised nobody really liked going to a government hospital and it was always crowded, no matter what. If god forbid, we had to meet a doctor, we really had to depend on our Malayali roots; we all knew how much it mattered to have one Malayali nurse aunty, who could get us to the right doctor and will save us the torture of waiting in line. The visuals of lines and crowd stayed on, and memories of government hospitals become more murkier in my mind.

With college, there seemed to be a plethora of hospitals around us. Everyone knew the swankiest private hospitals and everybody seemed to have a medical insurance. Amma again coaxed me into  getting a medical insurance and again thought talking to a senior doctor will help, so that I will live my life properly. I had my war against insurance going on, in those years ( it still persists), and I ended up never having a medical insurance. But slowly the narration of government hospitals started disappearing from my family, my aunts were getting transferred to private hospitals. Everyone talked about the private hospitals being the saviour of lives, people even started making separate accounts just for private hospitals, lest one day one might need it.

“We are paying for the convenience”- they said

“ Nature will save me”- I said.

Nature did not save me, and it did not really help that I was a city bred girl who genuinely for the longest time thought milk comes from mother dairy booth. The only hospital I knew was AIIMS, because now I had friends there and that too was a place I never wanted to visit. I no more had any visual memory, I no more had any experience. I was told, government hospitals were crowded and dirty.I believed and continued living in my naturopathy bubble.

When Hidden Pockets started mapping government hospitals, as a researcher it was very difficult to start visiting the government hospitals. All these hearsay, the images I had seen floating in media, and all that reportage, I was not really sure what was I was looking for in these hospitals. The big chunk of my country was using these services, and I was on my journey of finding what was really happening in these hospitals. The aspiration of the burgeoning of middle class and the daily life of lower income group was providing me with enough existential crisis.

Even before accessing the services, I had to wage off another ideological war in my head. Shush all the images of the government hospitals I already had in my mind. I had to give government hospitals another chance. I had to convince myself that government hospitals were just not meant for poor people. My health was not a luxury for which I needed to save, it was my right. My government had to take care of my health too. Too many battles I say.

So I started with my favourite battle:the battle to reclaim beauty narrative, the battle to reclaim all the images I had of government hospitals. I had to go to these hospitals and witness some of these hospitals, sit there, commit to bird watching and look at the bodies that come there.

“Nobody likes a mess” said Aisha, but I was sure, there was something else was happening in our visits to these government hospitals. There were crowds, which I had seen in private hospitals also, but the crowd looked different, the staff felt different, something which reeked of something crude. It did not feel like the parallel city I believed I was living in. Poverty was too stark.

Yes, there are plenty of people who went to government hospitals, it is the only source for solace for poor people and they still believed government will help them. There are huge lines in these places.

One of my biggest shock came, when I realised that OPD fee ranged from Rs 2 to Rs 50. I was used to hearing from Rs 200- Rs 1500. The economic value of my health could be that affordable, was a question that played in my mind for sometime.

With time, our visits became more regular, we have visited government hospitals in various cities of India. Delhi, Chandigarh, Chennai, Cochin, Jaipur, Mumbai, Bangalore and Ahmedabad and plenty more cities to visit. With time, we were less and less apprehensive about government hospitals. We started understanding the process of government hospitals and in most of the cases, even liked the facilities provided. Most of these services were pretty good and there were plenty of options within the government services. I did not have to invest all my life savings in a private clinics to get basic services.

The visuals stayed and the crowd persisted. But with time, I started getting used to the images and realised maybe I had been living in a sanitized version where people of certain groups were not to be interacted. Most of the places were clean, they were not as swanky and clean as a private hospital, but they were clean.

At Hidden Pockets, we are trying to make the process of accessing Sexual and Reproductive health services easier; by finding the exact building where services can be located, by finding out the kind of services availability and by checking if the service providers are friendly. We have even surveyed the places for cleanliness and access with public transportation. The Vision behind this mapping venture was to make the experience as comfortable as possible. 

Finding free health services for women: A look at government hospitals in Bengaluru

“How many Government Hospitals are there in Bengaluru? Could you please tell me few names?” I asked a female worker at St Johns Hospital, Bengaluru, who had a big smile on her face and looked approachable. “Umm, Victoria… Vanivilas… Jayadeva… there are a lot of them” she answered. Armed with what I could glean from Google and my limited knowledge of Kannada, I was on a quest: to locate health services for women in government hospitals in the city. Having attempted it before in Delhi as part of a mapping project for Hidden Pockets, which locates services around sexual and reproductive health services. Having done this before in Delhi, we were trying to do the same in Bangalore, to understand what that process was like for women who seek health services and be able to recommend it to women in all situations. But given our rather bleak experiences trying to figure this out in Delhi, my research in Bangalore led to a pleasant surprise.

Bengaluru Urban District is divided into four taluks: Bengaluru North, Bengaluru East, Bengaluru South and Anekal. I went to five government hospitals across the North, East and South taluks. The first hospital I visited was Bowring and Lady Curzon Hospital, a 2-minute walk from the busy Shivaji Nagar Bus. It is much cleaner than the government hospitals I have seen in Delhi, and guards were very helpful, and able to answer my queries.

“Room No27. Yes, that is where she sits,” one guard told me when I asked where I could find a gynaecologist. “Once you procure an Admit Card for Rs10, you can consult a doctor here” he added. I met a few, all young and helpful doctors, who told me that the facilities are provided for free. The patients also looked happy with the services. Out of curiosity I asked one of the patients who was waiting to meet the doctor outside Room No. 27, how the services were and if it was for free. She told me that the check-ups as well as the medicines were free, one needed only to pay transportation costs. She told me the doctors were helpful. To double check, I also spoke to the chemist at their in-house pharmacy. “All medicines are free, but if it is not present in the main medicine block then we sell those medicines at 50-percent-off rates at the generic medical store under “Jana Sanjivini” scheme. This scheme involves setting up of generic stores in the hospitals of Health and Family Welfare and Medical Education,” he explained.

Content with what I saw, I walked towards Government HSIS Gosha Hospital, which is a 10-minute walk from the Shivaji Nagar Bus stand. Nobody seemed to know about it and most of them referred to it as the Muslim hospital. I could spot it on Google maps, but the navigation didn’t keep up with me and I was lost. An hour later, a cab driver was able to point me in the right direction. The hospital had a big entrance and a big board with its name written on it but as I entered it was difficult to understand where the building was. I couldn’t find the entrance gate. The hospital was under construction and I could only find the Maternity ward, rest of the hospital seemed under construction “Gosha Hospital handles all maternity issues which includes pregnancy, women’s health issues, Paediatrics, abortion etc. Rest all cases go to Bowring Hospital which is 15 minutes walk away from here”, a helpful staff told me. Gosha Hospital also follows the same procedure, one needs to get an admit card costing Rs. 5. All the treatment as well as the medicines are free. I could see the admitted ladies were talking evening strolls at the hospital veranda.  I was amazed by the cleanliness of the hospital and the smiling faces of the admitted patients made the hospital look more friendly. This hospital had more of the Muslim crowd. I tried meeting the head of the hospital for more information about MTP but I was denied and was told to get my employee ID card for any information. But the helpful staff was very polite and told me one can come during morning for MTP.

The next hospital in the list was the Victoria Hospital which is located close to the City Market, Fort Road. It was very easy to locate Victoria Hospital since it is one of the biggest government hospitals in Bengaluru. While searching for the maternity ward at Victoria, I found Vanivilas. It is a huge building which has all the services required in a maternity ward. I got to know that the maternity ward is called ‘Vanivilas’ and to meet the gynaecologist one needs to go to Room No. 29. “Patient needs to get an admit card costing Rs.10 and then can consult the doctor. All services are free here,” said one of the female nurses who directed me to Room No. 29. Vanivilas takes care of all the issues related to pregnancy, women’s health issues, paediatrics and abortion. At Room No. 16 one can get free tablets. It follows the “Jana Sanjivini” scheme i.e. all medicines are free, but if it is not present in the main medicine block then medicines are sold at 50-percent-off rates at the generic medical store.

One-Stop Centres

In my mapping study, I was also looking for one stop crisis centres (which we’ve explored previously in The Ladies Finger) in Bengaluru. These centres are intended to support women affected by violence, and to cater to the immediate medical, legal and psychological needs of the survivors of violence. In 2015, the Ministry of Women & Child Development proposed to set up 36 centres across the country with an outlay of Rs 18 crore under the Nirbhaya Fund. In the first phase there should have been one centre per State/UT.

When I enquired about it at Vanivilas, I was instantly told there was one at Bowring Hospital. I did go back, and found the Women Special Ward there called “Mahila Gataka” and found that it works exactly the same as the one stop crisis centres proposed by the Central Government. A unit was devoted to support women affected by violence. The unit had proper check-up rooms, a room for admitting the patient if required. There was provision for a counsellor, a policeman, legal assistance, a person from NGO. The unit was clean and was properly maintained. A staff from the hospital who was probably a nurse, was in charge of the unit. The staff was very friendly and approachable. She took me around and showed me the entire unit. The centre seems to operate on funds from the Karnataka state government; as The Hindu reports, the state has not claimed compensation under the Nirbhaya Fund. Considering I didn’t find a one-stop centre in Delhi, I never expected to find one in Bengaluru and was pleased to be proved wrong by Bowring and Lady Curzon Hospital.

The last hospital I visited was KC General Hospital in Malleswaram. It was easy to find this hospital. Most of the auto guys knew about it. “You can meet the gynaecologist in A Block,” the guard told me. As I stepped inside the A Block and the first thing I noticed was ‘Mahila Gataka’. I was highly impressed. The person in charge showed me the unit. It was exactly similar to the one in Bowring Hospital. There was provision for a counsellor, a policeman, legal assistance and a person from NGO. The unit was smaller than the unit in Bowring Hospital. The doctors were approachable. It was lovely to see how even the hospital guards knew about the unit and how they were ready to guide us whenever we asked. KC General also offers free medical assistance to its patients. In all the Government hospitals, we went, maximum cost incurred was Rs. 10 (admit card).

The whole mapping around Government Hospitals in Bengaluru made me realise that public hospitals in Bengaluru are approachable. The staff is friendly and helpful. The guards were aware about the Women Special Wards (Similar to One Stop crisis centre). I would say that the government hospitals in Bengaluru are doing a good job. Common wo/man should try out the services provided by the Public Health Care. The consultation is completely free and the services are pretty fine.

Practitioners Experience:

The experience I shared above is as an end user. Had I missed out on the experiences by the on-field practitioners who have actually worked with these government health services providers, this article would have been in complete. One of the practitioner felt that these health providers are good but can do a lot better. Patients tend to offer extra payment to doctors, which has also become a forced practise now. The patients should try to understand that government hospital services are all free and by paying the doctors extra they are creating an extra burden for those who actually can’t pay.

Author Profile:

Aisha Lovely George, a researcher and podcaster at Hidden Pockets. Folllow her at @aishalgeorge on Instagram.

We would love to thank The Ladies Finger for helping us think through the piece and helping us curate a better experience.

 

Audio Podcasts

For some of us, audio senses has its own pleasure, and we decided to curate and create some of these stories in an audio format.

Through this audio podcast, get to know about Aravani Community (Transgender Community) and also about the Aravani Art Project.
A talk with Poornima Sukumar, Founder of the Aravani Art Project.

 

Young people from South Asia and South East Asia talking about Safe abortion, Single woman accessing Hospitals and about Government hospitals in general.

Listen to the conditions prevailing in South Asian as well south east Asian countries with respect to sexual and reproductive health. Know about how young women use the facilities in the hospitals, why do they prefer private or public hospitals.

#IWillGoOut was a national level event hosted by a collected of young women across in India, resisting the impositions and reclaiming their rights, and spaces on roads.

Background score: Credit: Destinazione@altrove-paintthesky missJudged

What is sexual pleasure for you? Do women experience this differently? We asked LoveTreats and found some interesting answers.

Pourakarmikas are Bangalore (Karnataka – India) based men and women who clear different kinds of garbage, from food waste to discarded cell phones, from the city’s streets.

Pourakarmikas are fighting for a life with dignity. On 8th March 2017, on International women’s Day they decided to protest at the BBMP head Office. Hidden Pockets joined them.

I want to thank the Facebook page ” Pourakarmikas Demand their Rights ” for providing us with useful content.

Music credit: @nop and destinazone_altrove

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Our City – Namma Pourakarmikas by Hidden-Pockets is licensed under a Creative Commons License.