construction trades, skilled women workers earn comparable salaries to their male counterparts. Mahila Housing SEWA Trust's Karmika School helps women in the construction trades in India to gain those skills. Providing childcare has led to income increases of 50% in Kheda and Surendranagar. Food and nutrition SEWA's push for food security brought about programs to deliver food grain in Gujarat. The child care centers established by SEWA have acted during natural disasters such as floods and droughts to provide necessary food as well as other emergency supplies and assistance. The two districts of Surendranagar and Patan in particular have 25 childcare centers in their communities, which were able to respond to droughts, epidemics, cyclones, floods and the earthquake in 2001 not only with childcare but also food, water, and shelter. Health In 1984, SEWA began offering health insurance, which cost their member Rs 85 annually. Health care has become one of their largest projects. Since 1992, Vimo SEWA has provided life and hospitalization insurance for its members and their families for as little as Rs 100 per person. Enrollment topped 130,000 people in 2005. SEWA found that the very poor used this access to health care less than those slightly less poor. Some of the factors include distance to care providers and facilities and the "ex-post reimbursement" nature of health insurance, in which patients must pay upfront and then claim reimbursement. They continue studying the issue of how to bring access to all. SEWA also has programs to improve water quality by training some of their members to repair pumps for wells and campaigning for underground water tanks for drought-prone areas. Childcare In studies in the Kheda and Surendranagar districts before 2006, poor women with access to child care earned 50 percent more. Childcare also encourages going to school for the entire community by improving the view of the value of education, as well as freeing older siblings from childcare responsibility, allowing them to continue their education. It removes social barriers by helping to alleviate the caste distinctions as children of all castes learn and play together. It aids poverty alleviation by allowing mothers to work and earn more. SEWA has childcare cooperatives in Sangini and Shaishav. Housing As of 1989, SEWA bank had 11,000 members. Nearly 40 percent of their loans were for purchasing or improving housing. One requirement of the borrower was purchasing shares in the bank worth