The Government has been doing its bit to eradicate poor nutrition among women, especially for pregnant women, but until mindsets do not change, conquering the disease will be difficult
Adivasi women don’t eat nutritious food during pregnancy and they also don’t take iron pills on a regular basis because there exists a myth amongst them that they will have problems at the time of delivery of the child due to the pill,” said Archana Kisku, who has been working as general nursing midwife at the community health center located at Shikaripada, in Jharkhand’s Dumka district.
“Due to the poverty, pregnant women here cannot afford to have fruits and milk; they have only paani bhaat (stale rice or leftover rice with water) along with drumstick (moringa orsahjan) leaves saag. As a result, they do not get adequate nutrition for their body. Due to lack of awareness and hardships of their work — mostly women work as labourers — they drink much lower volumes of water than what is required.
Due to all these factors, most of the women are anemic. Most of the health centers at the block level in the State do not have blood banks and, therefore, these women have to be referred somewhere else. Almost 50 per cent of tribal women have deficiency of hemoglobin; pregnant women here are found to have only eight grams of hemoglobin in their bodies, while 11-14 grams is found in a normal human”.
According to nurse Basanti Soren, “Anaemic women face a lot of difficulties during their delivery. The child’s head does not come out at the time of delivery, and a lot of pressure has to be applied. The lack of hemoglobin and the lack of nutrition are clearly visible at the time of child birth. Traditionally, Adivasi households do not keep cows; instead, they keep pigs and goats. Due to this, they do not get milk regularly. The doctor advises pregnant women to eat four times a day, but they eat only twice a day. They walk off kilometers to fetch water in ghadas (earthen pitchers) and kalsis (metal pitchers), which leads to miscarriage sometimes”.
Pregnant Adivasi woman Basanti Hembram says, “Even during my pregnancy, I climb on trees to cut branches for firewood. I also eat less drumstick leaf saag as my mother-in-law says, the baby will become fat and I will have trouble in delivering the baby. A day before delivery, we stop drinking water too”.
Dr Bindeshwar Ram, who worked in the health sector in Jharkhand for years, said, “The decline of hemoglobin in the tribal women of the Santhal Pargana region is common, Anaemic women cannot be expected to have healthy children. Nutrition is not given any importance in tribal families, poverty and lack of awareness is also the root of this major problem.”
According to the National Family Health Survey 2015-16, the number of malnourished children is increasing in Jharkhand, 71.5 per cent of children in rural areas aged between six to 59 months are found to be anaemic, 67.3 per cent women in the age group 15-49 years are suffering from anaemia, and the figure rises to 85 per cent in case of Adivasi women. According to the 2011 census, 50,58,212 women in Jharkhand are malnourished.
A malnourished woman giving birth to a malnourished child is a matter of concern. Malnutrition treatment centers are functioning in all the districts of the State. Most of the children, coming to the centers for treatment, are from tribal areas and they suffer from malnutrition. They approach to Dumka malnutrition center for treatment.
The mother of a malnourished child says, “At the time of pregnancy, women eat daal, rice and locally available saag, which is normally made from drumstick leaves in meals, they do not take iron pills and for their delivery also they do not go to the hospital, the child’s delivery is done in the house by the village’s known as dai (midwife).”
State Advisor of the Supreme Court in Jharkhand, Balram, says, “Malnutrition in the State remains a serious challenge, along with the children, the mothers are also suffering from anaemia. In Aanganwadi centers, there is no proper record maintained of how the health of children suffering from malnutrition is monitored. Pregnant women and nursing mothers are also not getting adequate nutrition. The benefits of Government schemes are not being passed on by the State properly. Food safety regulations are being overlooked. In the State, instead of having their deliveries done in the health centers or hospitals, women are using midwives for deliveries. Nutrition standards are not being complied with”.
Replying to a question of malnutrition, Jharkhand Welfare Minister Dr lewis Marandi said, “The Government is making efforts, good results will soon emerge. Chief Minister Raghuvar Das considers malnutrition to be a stigma for the state and is making all efforts to eradicate it.”
According to Dr Jugal Kishore, Director of Safdarjung Hospital, New Delhi, “If any man or woman’s Body Mass Index (BMI) is less than 19, then he/she is a victim of malnutrition; having less than average BMI is considered to be a major cause of death. In India, one in three women are victims of anaemia but in Jharkhand, three out of four women are victims of anaemia, women mortality rate during childbirth is approx 1,000 every year. Tribal children of Jharkhand are malnourished and women are prone to anaemia. The problem of malnutrition is critical in Jharkhand; children at the age of five are the victims of malnutrition. Malnutrition treatment centers have been opened in every district of the State. Supplementary nutritious food is being provided at the rate of eight rupees a day for children from six months to 72 months. Supplementary nutritious food is being sent for pregnant women, but it is not reaching the rural areas. The number of malnourished children is increasing, during pregnancy, tribal women don’t take iron tablets, and they don’t have regular health checkups. If at the time of delivery the doctor or nurse is not available at the health center then the women have no choice but to go to the village midwife for her delivery”.
Rural women are following traditions which have been coming down by ages, due to which children are becoming victims of malnutrition. Due to these rituals and customs, they do not even breast feed their new-born child immediately after delivery. New born babies if not breast fed on time are badly affected on their development.
According to the United Nations Children Fund, the most malnourished children in the world are in India. In this regard, United Nations International Children’s Emergency Fund (UNICEF)’s representative to India, Dr Yasmin Ali Haque, has launched the malnutrition free India campaign, which aimed to make the country malnutrition free by 2022.
The Union Government has determined to remove malnutrition. In order to eradicate it, pregnant women, lactating mothers, will receive an increased amount of nutritional supplements. Nutrition supplements will also be given to children till the age of six years and adolescent girls. But until the mindset of people do not change, conquering malnutrition would be extremely difficult.
It is necessary that the Government also runs a programme to spread awareness of the health of pregnant women along with many schemes and it is also important to work on breaking myths and customs which come in the way of removing malnutrition from the country.
(Courtesy: Charkha Features)
