“The pain started in the afternoon,” says Sevanti Chimote. Still recovering from the harrowing experience of losing her baby, the young mother continues, “We called a jeep from Harisal and it arrived at 10 p.m.”

Harisal may be only 26 km away, but a good part of the road, 16 km, is an extremely bad stretch. The drive, as a result, can take up to two hours.

Ms. Chimote, who left at night on November 22, accompanied by her family, soon started bleeding. Doctors later said it was an ante-partum haemorrhage. She was given saline at the primary health centre in Harisal, but the bleeding did not stop. She had to be driven to Amravati, the nearest city in Maharashtra, a journey which takes up to three hours.

Her five-year-old daughter plays around her, unmindful of the tragedy. Ms. Chimote was in hospital for three to four days and had to be given two bottles of blood. The doctors told her she was severely anaemic and that that was why she lost the baby, premature at seven months.

On December 11, Health Minister Suresh Shetty suspended Amravati District Health Officer K.Z. Rathod for the substandard medicines and delivery kits in Melghat, which had ordinary razor blades instead of surgical blades. A CID inquiry has been ordered.

But it not just the delivery kits; the overall health care in the region is substandard. There were three deaths due to diarrhoea in Kokmar in the Dharni taluk some time ago. One of them, Sonai Betekar (26), died at home after severe dehydration, and her son, one-and-half-year-old Praveen, died a day later. The other casualty was a 12-year-old boy.

The deaths of children in the area are purely due to negligence, says Dr. Ashish Satav of ‘Mahan,’ an NGO based in Dharni. According to official figures, from June to November 2009, as many as 325 children below the age of six have died in the Dharni and Chikhaldhara taluks, which comprise the Melghat region. In Dharni, 48 children died in August, 53 in September, and 42 in October.

In November, of the total 36,264 children below age six in Melghat, only 13,604 were of normal weight. The rest are in various grades of malnutrition. Every year, at least 400 to 500 children below the age of six die in Melghat.

Even in Kokmar, of the 55 children in the anganwadi, two are severely malnourished. The people get work in the nearby forest and repair the road themselves if it gets too bad. After years of demands, a State transport bus now has a service to the village, which is partially lit by solar power. The school has only one teacher who is overburdened. And it is closed most of the time as the teacher has to attend training or meetings. The people have demanded better roads, but no one has listened.

In Chikhaldhara, the office of Fulmati Salame, the Child Development Project Officer, reflects the sorry state of affairs. There is no light, the telephone has been disconnected as the bill has not been paid, there is no vehicle for the staff, and some 25 villages don’t have money for the day care of severely malnourished children. Ms. Salame, the first post-graduate among the Korku adivasis, says the area continues to be plagued by low birth weight babies and severe malnutrition among the mothers as well, apart from infants.

Dr. Satav points to a worsening of the health situation in Melghat. Referring to the still birth in Kokmar, he says that as per the norms of the Integrated Child Development Services, pregnant women have to be given 100 iron tablets apart from regular ante-natal check-ups. “How did they miss the fact that Sevanti was so anaemic?” he asks. “It was a fatal combination: the mother’s poor health, the bad roads and the delay in getting her medical aid, apart from the baby being premature that led to the still birth.”

The children are not properly monitored in schools, and in Keli village, the anganwadi sevika Jaiswal is hardly present. There is no helper either. The villagers have complained about her absence but she is unshakeable from her post. “Why can’t she be replaced if she is so erratic? The anganwadi is closed most of the time and the children are denied their mid-day meals,” says Dr. Satav.

Doctor’s study

While the government keeps claiming that malnutrition has reduced in Melghat, Dr. Satav’s own study indicates the contrary. The infant mortality rate is about 79/80 per 1,000 live births, while it is much less in areas where Dr. Satav has an intervention programme, according to his study. “The Collector, the zilla parishad Chief Executive Officer and the District Health Officer are not interested in health issues. There is widespread absence of staff.,” he points out.

Migration for work and poor health care compound the problems of the adivasis, whose claims to the forest land they have cultivated are not being accepted. The lack of local employment leads to widespread migration during this period, and the families return next year with ailing women and children. And the cycle of malnutrition and death continues.

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