Within just a month of his birth, symptoms of malnourishment were seen in the son of Mathura Bhoi in Nuapada district. Instead of taking the child to the nearest community hospital in Boden block, the family preferred his treatment by a local quack for curing what they called as “Kala Sira’ (visibility of longitudinal black coloured vein in the stomach). The quack burnt black bangles and the tip of a red-hot bangle was mildly pushed at several points on the baby’s stomach. The family is from Alabhatta village of litisergi panchayat under Boden block of the tribals-dominated district.
The child’s grandmother Aaila Bhoi said, “After the Kala Sira appeared, the child continued crying and stopped sucking breast milk. For these diseases, we prefer the local treatment as that’s been the practice. And now, our baby has fully recovered.” However, a grassroots social activist, Anandini Sarangi, has a different story to tell. “There is a case in the nearby Bakulikhunti village where a child died after such kind of treatment. From my observation, I can say these types of treatment are not safe. We are convincing the people here to consult doctors in such cases.”
Dr Satyaranjan Das who has worked in various tribal districts said, “This is a disease due to scarcity of protein and vitamins in a child. Such cases should immediately be referred to paediatricians.”
However, the same family had gone to the Boden Community Health Centre (CHC) for delivery of the baby. The family did not have good experience with the hospital. As the case got complicated, the family was referred to the Khariar block CHC. The family had to pay a sum of Rs 500 for transport charges which is supposed to be free under the JSSK (Jananai and Sishu Suraksha Karyakram) of the National Rural Health Mission (NRHM). The family could not also receive a cheque of Rs 1,400 which is supposed to be given to the mother under the Janani Suraksha Yojana (JSY).
On one hand while several schemes like JSY, JSSK and Mamata have attracted people toward safe institutional delivery, the lackadaisical functioning of the health infrastructure and personnel has created a sense of mistrust among the people in the interior pockets.
The infant mortality rate (IMR) in Nuapada district is 56 per thousand as against the State average of 62 in 2011 as per the Annual Health Survey.
“We are imparting training to the ASHA and Anganwadi Workers and the ANMs to bring role clarity and generate coherence in their functioning as these three are the key functionaries at the grassroots to reduce malnourishment. We are hopeful that the training on attitudinal change will have a salutary bearing on their functioning,” said Dr Ajit Panda of AYAUSKAM, an NGO that works in the area.