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Malnutrition amongst Maharashtra's tribals: How bad is it?

By Pratibha Shinde

A survey of 22 tribal villages in Maharashtra's Nandurbar district throws up disturbing facts about levels of malnutrition among children. The root of the problem is the absence of sustainable livelihoods

More than 98 children died in three months of 2005, in Akkalkuwa block of Nandurbar district. Of these, 71 children were found to be severely malnourished.

A survey by the Punarvasan Sangharsh Samiti revealed that the government is unaware of the scale of malnutrition in the area. Only 10% of malnourished children figure in the government records. The survey also showed that not only were the children malnourished, their mothers were too. The weight of adult mothers ranged between 40-45 kg.

Girls constituted around half the total number of malnourished children, indicating the precarious condition of these 'future mothers'.

The survey also revealed that although generations of malnourished children are born in this region, the government still does not look beyond the singular health aspect of the problem, on the basis of which mitigation measures are designed. Unless the issue of malnutrition is addressed comprehensively, the tribal community in this part of the country is headed for extinction.

These and other startling revelations form part of a report brought out by the Punarvasan Sangharsh Samiti, which has been actively mobilising the tribal population of Nandurbar district for the last decade. The report, titled 'Maranatach He Jag Jagate', is based on the survey which was carried out in 22 villages. And information obtained through the Right to Information Act.

The tribals of Nandurbar are engaged in a continuous struggle for existence. Malnutrition and child mortality is part of their everyday lives, even as issues related to rights over natural resources and means of livelihood gain greater urgency with each passing year.

Attempts to remedy malnutrition and child mortality by singling it out will not deliver the desired results.

'Maranatach He Jag Jagate' attempts to take stock of the situation and get at the root of the problem. The report analyses the situation on the ground and suggests ways to tackle the problem head-on. Obviously there is the need for firm action by the government and the active involvement of society at large.

Some basic facts about the survey:

  • The survey was undertaken in 22 villages of Akkalkuwa block, Nandurbar district. The weights of mothers in seven villages and two rehabilitation and resettlement sites of the Sardar Sarovar Project were recorded. The facts that emerged from the survey were shocking. In April, May and June 2005, 98 children died in Akkalkuwa block alone and of these 71 children were malnourished. Of the malnourished children, 45 were found to be in the second stage of malnutrition. Meanwhile, the government refuses to accept that the children died from malnutrition.
  • Punarvasan Sangharsh Samiti recorded the weights of children in 22 villages and compared this data with that of the government. The comparison showed that the government has only 10% of the facts related to malnutrition. In effect, it is unaware of 90% of malnutrition cases. According to the survey, the number of third-grade malnutrition among children in April was 127, in May 135 and in June 104; the government records showed only 14, 42 and 17 children as malnourished in this grade respectively. The survey figures for fourth-grade malnutrition, during these months, were 61, 50 and 35; the government figures were 6, 6 and 3 respectively. (The figures quoted here were obtained from the government under the Right to Information Act).
  • Of the 22 villages in the survey, six have been declared 'hyper-sensitive' by the government. The survey showed that the combined number of third and fourth-grade malnutrition among children in April, May and June stood at 100, 104 and 72; the government records showed only six children were malnourished.
  • Of the total number of malnourished children, half were girls. This raises a serious question about the next generation.
  • With this question in mind, the Punarvasan Sangharsh Samiti conducted a survey in six villages and two rehabilitation and resettlement sites in which the weights of fully-grown mothers were assessed. The survey showed that the weights ranged between 40-45 kg. This emphasises the need for a comprehensive study of the ages of young mothers, stage of motherhood and its link with malnutrition. It also suggests that the process of malnutrition begins in the womb itself.
  • The root of the problem is lack of livelihoods. Measures in the areas of health, education, employment and supply do not create sustainable livelihood sources and therefore cannot, in themselves, be decisive remedies to the problem of malnutrition.

Let's take a closer look at the villages covered in the survey.

The 22 villages are spread out in the plains as well as in hilly regions of the Satpudas. Of the villages, Khai, Andharbari, Ohwa, Kaulavimal, Toknapimpri, Maliamba, Kondvapada, Thana and Beti have been declared 'hyper-sensitive' villages under the Navsanjivani Scheme, which is touted as the answer to the malnutrition problem. Of the 22 villages, seven villages -- Khai, Andharbari, Ohwa, Kaulavimal, Miryabari, Valamba and Pimpalgaon -- do not have a yearlong motorable road and are therefore inaccessible. After a point one has to walk to get to the village. Four villages -- Thanavihir, Guliamba, Amali and Pimpalgaon -- are within a periphery of 12 km from the block headquarters of Akkalkuwa, but they are connected to a remote primary health centre (PHC) in Dab, situated deep in the third range of the Satpudas. One has to pay Rs 15 to get to the PHC by jeep; to reach Akkalkuwa one has to pay Rs 5.

Other examples are Ambabri, Andharbari, Bharadipadar and Khai. These villages are connected to the Moramba PHC. To reach Moramba by car one has to travel via Khapar, covering a distance of 17-18 km. Although there is a primary health centre in Khapar, villagers from these four villages have to bypass it and go on to Moramba. The other option to get to Moramba directly is to walk through the hills of the Satpudas for around 7-8 km. This shows up a serious flaw in the state government's policy with regard to the location and coverage of primary health centres. The village of Ohwa is connected to the Horaphali PHC, which is 22 km away. There is no road connecting the village with the centre; people have to walk through the Satpuda hills to get to it. To correct the situation the government sanctioned a health centre for Ohwa in 2004. But, although the tribal development department made provision to build the primary health centre, the health department still has to sanction the plan.

Seven villages -- Andharbari, Kaulavi, Bari, Pimpalgaon, Valamba, Maliamba and Kondvapada -- do not have a public distribution system (PDS) outlet. Tribals from these villages are forced to walk 3-4 km to reach a PDS outlet. Of the 22 surveyed villages, 11 do not have a single job-creation opportunity under the state's well-known Employment Guarantee Scheme (EGS). The residents of seven villages did receive some form of employment but only for a period of around a month.

The survey also covered two rehabilitation and resettlement (R&R) sites of the Sardar Sarovar Project. Although the government claims to have carried out its R&R duties satisfactorily, the situation on the ground is quite the opposite. Of the 634 children surveyed, 378 were found to be malnourished and the number of girls among them was as high as 60%. Of the total number of malnourished children, 119 were in the third and fourth stages. The two sites have separate PHCs, PDS outlets, gram panchayats and four anganwadis each. All the children were in the 0-6 age-group. This shows that they were born after their families were resettled. What conditions are like in the other six sites is a question open for study.

What is clearly needed is a debate on the findings of this survey, from the social, economic, political, cultural and medico-anthropological perspective. Especially, vis-à-vis the government's information on the subject. The report is being made public to facilitate just such a debate.

(Pratibha Shinde is with the Punarvasan Sangharsh Samiti, a tribal rights organisation in Nandurbar, Maharashtra)

InfoChange News & Features, March 2006