Melghat district in Maharashtra is present 800 kms away from Mumbai, the financial capital of India. This hilly region is inhabited by tribal people and is mostly under developed. When a group of us read a news article in The Hindu recently about the malnourishment deaths among children in the district, we researched on the issue and found out that these were not one-off happenings in the region. Such deaths have been prevalent for about 10 years now. So we went to the place on a weekend to know more about the situation prevailing there. The following is a detailed report of what we experienced. Before leaving Mumbai, we had contacted an NGO called ‘Khoj’ which was doing considerable work in the area and after getting down from the railway station, wewere escorted to Paratvada, a small town by Jeep, sent by Khoj. We were very impressed with the kind of work that Khoj was doing. The lady, who started it, along with her husband way back in July 1997, was doing stellar work in defending the rights of the tribes against the policies of the government. After discussing the problems prevalent in the place for about three long hours, we refreshed and started out on our journey into the hills and the villages within. We started at 3 p.m Saturday in a Mahindra Armada and were accompanied by the driver and a guide who worked with Khoj. The way up was very scenic and it felt like we were traveling in
When talking to people at Khoj, we found out the structure of government health facilities in these villages. There is a PHC (Primary Health Centre) for every 1000 people. Under PHCs there are sub-centers. There is one sub-center for every three of four villages. There is a nurse, who is known as ANM (Auxiliary Nurse Midwife), for every four or five villages and she goes around these villages every day attending to the patients. Since she has to cover a lot of villages, she goes to one village every day. In every village there is appointed a ‘pada’ who takes instructions from the ANM and administers medicine to the patients till the next time the ANM comes back. In addition to all this, there are mobile vans which run around the villages treating patients.
We reached the first PHC at about 6 p.m. We went with an open mind and were not biased with the talk going around that the doctors were bad and that they did not care about the patients. In PHCs free treatment is provided for some types of illnesses. They are
- Tuberculosis
- Leprosy
- Snake bites
- Dog bites
- Malaria
We spoke to the sole doctor for about an hour. He revealed that in the place where there were approximately 350 villages, there was not a single pediatrician and this when the maximum number of malnutrition cases occurs amongst children. He was temporarily posted to the hospital till a replacement was found for the earlier doctor who had quit his job. This new person did not even know why the boy was admitted in the hospital. He turned around and asked his compounder why the boy was there.
During the conversation we found out some of the reasons that doctors dislike working in the villages. First and foremost is the pay packet. Doctors feel that considering their qualification and the environment in which they work under, they deserve better pay than that they currently get and this applied particularly in the case of doctors who had qualified in specialized areas like Pediatricians. These people can earn in thousands in a single day if they work in cities but when confined to these villages, where the average income of a family is about 6000 to 7000 rupees every year, they earn very little. But we failed to understand why these doctors don’t quit their jobs or why they joined in the first
place. They show least care or sympathy to the ill but promptly collect their salaries when a new month is born. Secondly, the conditions of work are not exactly great. There is very little voltage in the evenings and virtually zero telephone facility. Cell phone signals do not penetrate the mountains here. There are other reasons like plain old laziness and apathy to working. When we asked what the solutions to these problems were, the doctor strongly believed that the people should be migrated to cities. “The amount of money spent on education, health care, and transport in this place could be spent in creating job opportunities in cities which would guarantee the livelihood of these villagers.” What he did not appreciate was the fact that these villagers have been living in the place for centuries and they would rather be happy where they are rather than scrounging for food in cities.
Diarrhea and Pneumonia are common disease here. “Parental negligence is a major cause for many of the diseases present in this place. Mothers don’t know the importance of breast feeding. Both parents leave for work every day after feeding their children a just roti or two which will have to enough till the time they come back from the fields which is usually late afternoon.” The truth is that government run “Anganwadis” - centers which take care of children while the parents are away - do not function effectively. These places provide food to children everyday. But there is no place for the children to eat the food. So they take the back home where it gets shared leading to lessening of the nutritive content and hence problems of malnutrition.
“Family planning is virtually nil here. Each family has a minimum of three children. Some years back it was as high as seven, but recently it has fallen down to three, but that still is so high.” This is true. Family planning is indeed non-existent. As far as the villagers are concerned, more the number of hands, the better it is to till their lands and herd their cattle. But one good thing is that there have been no reported cases of female infanticide. Neither are there any child marriages. While we were leaving there was another remark that the doctor made, “Jungles are not for people. They are for animals and we should leave them alone.” Considering the fact that the people here have been living with the animals for centuries together, there could not have been a more false statement.
When we were done talking to the doctor, we left for a nearby village, Butida, to cross check what the doctor told us. It was 7 30 p.m and the place was as dark as a graveyard. We could hear sounds of crying babies and a barking dog somewhere in the distance. The only lights came from our headlights and a lamp in a house.
When we switched off the headlight, the village was drenched with darkness and we got accustomed to it in a few minutes. After quickly gaining the confidence of the villagers by distributing chocolates and biscuits to the children, we gathered the villagers around and sat down in a circle with an oil lamp in our midst. (The emergency lamp that we had brought along decided to fail at this moment)
We started discussing the health conditions and were not surprised to hear tales different from what the doctor told us. The ANM attends the village only once in 8 or 9 days. Till then the headman has to make do with whatever medicinal knowledge he has. In fact there is a traditional method of curing certain diseases in children called ‘Damma.’ In this treatment, a hot iron rod is kept on the bare stomach of the child. Villagers would not have to resort to such practices if they had proper non costly treatment by the government. If all alternatives fail, these people walk to a private hospital which is 11 kms away.
The crops (mainly soya) this year had failed due to a worm and that left the people with nothing to do till next sowing season. Money lenders charged very high interest rates and that hit the people hard. The part hardest to understand was that there were electricity poles in the village but no power supply. Way back in1986, power was on for a full five days before the village went dark. Since then, it has remained so. These people earn about 5000 to 6000 rupees every year and on an average every family has about 3 children. It was here that I understood how lucky we all were and I keep reminding myself not to complain the next time I fall short of money.
After the long chat with the villagers, we left for a village called Chillati, which was a good two hours drive from. The drive was through a forest and the rough terrain kept us praying against puncture throughout the journey. Finally, we arrived at Chillati at 10 30 p.m. We were warned earlier that there would not be
electricity here too. There i
ndeed was none! We stayed at the office of an NGO there called “Melghat Mitra.” The person who is in charge of the project Mr Madhukar had a lot to tell us the next day, all of which echoed what we had ourselves seen the earlier day. He along with 4 friends of his have been staying in this village for quite some time now and they are involved in many activities like conducting study classes, taking care of the ill etc. (The people in the snap are the ones running Melghat Mitra in the village)Very near the office was a government school which was completely broken down. We entered through the window and found leaky roofs (It was raining heavily then), broken blackboards and dusty floors.
There were about 15 households in the village and every family has about three to four buffaloes. We saw small boys hauling cow dung with their hands and clearing up the place.
Girls were engaged in pumping water and carrying the water pots to their houses. There were a few solar panels in the village and on further enquiry we found out that a few years back, there were about 40 of them. But they were all stolen. Repeated complaints to a police station which was in some remote inaccessible corner of the district had fallen into deaf years. “Bring us the culprits and we will take action,” is what the police had to say. Now in the village there stands a solitary panel which stores enough current to emit a dull light for about 15 whole minutes every evening. We are sure that this was not their initial purpose.
There are a lot of Ashrams run by trusts and other organizations. We went to one such place and soon found out that the proprietors were drunk. About 200 children stayed and studied there and on questioning more, we could find out that the quality of education imparted was not anything to write home about.
Our final stop was a village called “Avaagad.” Here too the conditions of the people were similar to what we had seen in the other villages. There was one NGO which served children food (for free) everyday.
It is the initiatives like these from such NGOs and other informal organizations that give hopes to the thousands of people living in these villages. It is high time that the government starts acting responsibly and gets the wonderful systems present in these areas working. It does not take much money; it only requires will. With such thoughts, we returned to our wonderful hosts, Khoj, had some discussions with them for some more time and boarded the mid night train back to Mumbai. We have some ideas which we are thinking of implementing first on a small scale, in one of these villages and if successful, carry them on to other villages as well.
- Friends from the medical college present at Paratvada could assist NGOs like Khoj or the Melghat Mitra in their health campaigns. The students will also get first hand experience. They can visit the government hospitals which do not as of now look too inviting and give them a complete makeover. This can be done by pasting bright stickers or painting the walls, installing more lights, stressing on the importance of health to the patients etc.
- Saplings can be given to kids for planting. It can be treated as a competition and kids taking care of their saplings well could be treated. By this way, the importance of nature can be stressed.
- Workshops can be conducted to the people to teach them an alternate trade which can be used for their livelihood.
Nice and simple as the above ideas seem, they require people, committed individuals to carry them out. “Alternative means of livelihood is the only solution,” said a villager that night. While the flame was dying down and darkness was once again surrounding us, we made a promise. “We’ll be back.” And this time, we should have some ideas for this underprivileged lot.
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