The programme was implemented in Palakkad during 2002-07
Health Department officials who have worked in the Attappady Hills for the last many years say the Sate government has all along been well aware of the serious health problems faced by the tribal population at Attappady and other tribal areas in Palakkad district.
Though the Reproductive and Child Health (RCH) programme was implemented in the district during 2002-07, it was not effectively executed in the tribal areas. Had it been effective, the present crisis that led to the death of 48 infants during the last 16 months would not have happened, they aver.
The ‘executive summary’ of the district sub-project proposal for the RCH programme, prepared by the Directorate of Health Services, Thiruvanathapuram, in 2001 says that “anaemia among tribal women is rampant. Malnutrition is one of the causes of high morbidity, especially among the tribes. Though the infant mortality rate is low, neonatal mortality is still high.”
‘‘During the time of delivery, no special care is given to the mother or the newborn. Institutional deliveries are uncommon among the tribal people. Safe drinking water is not available,’’ the report says.
It says that compared to other districts, Palakkad is backward in all dimensions of health status. It is predominantly a tribal district having a tribal population of 41,4013. Many factors contribute to this state of affairs, such as cultural background, lack of facilities for preventive measures, and customs and taboos. Drug addiction and alcoholism are major problems, especially among the tribal youth.
The report says that the five-year programme ‘‘is aimed at initiating long-term and short-term measures to have quality reproductive health services and to create awareness among all sections of the people.’’
The officials say there were only a few awareness camps, hamlet visits, etc., organised as part of implementing the programme. It did not address any of the basic health problems of Attappady that have now snowballed into a major crisis, affecting the very survival of the tribes as such.
The project was entrusted to the District Medical Officer of Health, to be implemented with the involvement of panchayats. The objectives were safe motherhood, child survival, adolescent rural health services, safe abortion, besides improving infrastructure, providing training, equipment, and supplies, etc.
The project report says: ‘‘The district project will incorporate the ICDS network, especially trained health volunteers and Nehru Yuva Kendra volunteers to propagate the message and create awareness about reproductive health.’’ These objectives could not be achieved at Attappady, the officials say.
The RCH programme report, titled `Service to Tribes,’ says: ‘‘The outreach to the tribal areas of the district is poor. More health facilities have to be created for delivering health support to the tribes. Health educational activities have to be improved in the tribal belts. Information has to be given on nutritional diet, environment sanitation, personal cleanliness, good habits, control of communicable diseases, etc.’’
‘‘The age of marriage has to be raised among the tribes. They have to be informed of the problems, consequences, etc., of early marriage. Awareness is to be created on safe sex…’’According to tribal organisations such as the Girjan Seva Samithy and Thampu, the government was well aware of the health and social problems the tribal people in the district faced, particularly in Attappady as early as 2001. But there was total failure in taking corrective steps.