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From the cradle …

A newborn is placed in the incubator at the SNCU in the Tribal hospital. A study reveals that birthweight of infants is comparatively low among tribal population in Attapadi. Preterm birth and low birth weight heighten the risk of potential physical and mental problems.  

Rangi is devastated. She has had six miscarriages over the last seven years; the most recent just around a month ago. Grief-stricken, she laments, “Doctor tells me that I’m anaemic and grossly under-weight at 40 kg. He recommends adding egg, fish or fresh vegetables to my meals, but how can I possibly afford that with my husband’s meagre daily wage income? I have been eating rice and tomato sambhar for as long as I remember three times a day.”

I was in Vellaikullam, one of the 192 oorus (hamlets) in the Attapadi, the only tribal block of Palakkad in Kerala. Forty-seven infant deaths in 2013, 22 infant and 37 unborn infant deaths in 2014, and nine more so far this year… the statistics from Attapadi are disturbing, even alarming. Malnutrition, defunct Anganwadis, inadequate healthcare for pregnant women and extreme poverty due to alienation of tribals from their land are some of the reasons attributed for this dire situation.  

I met Ponamma in Nelipathy. She is one of the five women in that ooru who lost their children to malnutrition in 2013. She tells me, “I didn’t receive the Janani Janma Raksha financial assistance of Rs.1000 (for 18 months) that all pregnant women are eligible for. Maybe if that had come on time, I would have had nutritious food. With four children to feed and 20 kg of ration rice, malnutrition is inevitable. If I could’ve consumed keera, paali, munne, chakkara, tav (all leafy vegetables) during my pregnancy, I wouldn’t have lost my twin children in 2013. After my infants’ death, a lot of ministers met me and promised access to nutritious food, but I never heard from them ever again.”

Ponamma’s situation is not unique. In 2013, following the 47 infant deaths, Rs. 400 crores was announced by the Union and the State Government to tackle malnutrition. But as per RTI data, schemes worth only Rs. 40 crores have been implemented and only one-third of the announcements have actually reached the grassroots level.

In 2013, Thampu, an NGO that works with the tribal population, studied children below six years of age and 132 mothers living in 42 oorus of Attapadi and found that all were malnourished and some were cognitively impaired. Later in 2014, another study asserted that none of the schemes announced following the death of infants in 2013 were operational. The weight and other health indicators of the 40 children examined were well below the national average. Yet another study by the Government pointed out that 87 per cent of the adolescent girls were malnourished.

In the remote Adivasi villages, the roads are non-functional, water supply irregular, transport infrequent and mobile clinics non-operational. Thus women are forced to choose home birthing. Potable drinking water is not available at Anganwadis, chools or Primary Health Centres in any of the 192 hamlets.

Kali, the moopan at Vellikulam, sat me down and helped me trace the history of Attapadi villages. “Our ancestors farmed and consumed 69 different navadhanyas and 60 types of leafy vegetables. There was no disease, malnutrition or the death of infants. When the Attappadi Tribal Development Block came into existence in 1962, there was large-scale immigration to the area from other parts of Kerala, TN and Karnataka. Our ancestors sold some of their land to migrants while the rest was usurped by powerful corporations, dooming our generation to utter poverty. The many forest laws before and after independence also took away our right to land. When Kuppan, one of the villagers, tried to file a case against those who seized his 50 acres of land by guile and started an organic farm, he was threatened with death, thus forcing him to give up.”

As per a survey conducted in 1982, 64 per cent of the Adivasi farmland had come under the control of others. The Recovery of Lost Land Act of 1975 and Forest Rights Act, 2006, failed to recover the lost land rights to the Adivasis. The loss of land to others, the waning of the indigenous farming methods and the desertification of the area pushed them to depend on Public Distribution System for survival.

However, not all is dismal. The success of the Government tribal specialty hospital in Kottathara is noteworthy. Following the 47 infant deaths in 2013, the hospital was renovated; a special newborn care unit (SNCU) was set up. Seventeen doctors, including specialists, were posted; of which 12 are available regularly in tribal mobile clinics. On an average, 20 monthly field medical camps are being organised in primitive tribal areas, thus making micronutrients supply, systematic antenatal care and field level public health activities accessible.

Special adolescent health programmes in hamlets and hostels are now administered. Home delivery reduced in Attapadi drastically; in March, 2015, there was none. Nutritional rehabilitation centres have been started at Agali, Sholayur and Pudur for the children suffering from Severe Acute Nutrition; this brought down the SAN numbers from 299 in April, 2013, to 64 in April, 2015.

But the success story of the tribal hospital notwithstanding, there is a long way to go before the situation in Attapadi starts looking up. Thampu has a few recommendations.

The Forest Rights Act, 2006 has to be implemented for all oorus in Attapadi in a time-bound manner, to envisage the social and development rights and resolve the problem of their alienation from their own landholdings. For now, the number of days of employment under NREGA has to be increased, and corpus funds have to ensure that wages can be distributed on a weekly basis.

The Special Public distribution programme including food grains, pulses, salt and vegetables has to be incorporated. Additional nutritious breakfast for pregnant women, children and adolescent girls through functioning community kitchens and Anganwadis can boost the nutritional status in the villages.

The state of Anganwadis is deplorable. Out of the 174 Anganwadis, 130 have no drinking water and are in dire need of repairs and 66 are without toilet facility. These must be rectified and the model Anganwadis announced by the Government in 2013 must be implemented.

The Adivasi areas should be brought under the limits of PESA Act so that the social, economic and cultural heritage of the tribal population can be protected. A holistic effort to strengthen Anganwadis, education infrastructure facilities, public health care and public distribution system is only way to mitigate the gross child rights violations that continue unabated and end infant deaths in Attapadi.


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Printable version | Nov 24, 2021 12:28:42 PM | https://www.thehindu.com/features/magazine/sindhuja-parthasarathy-finds-that-a-lot-more-needs-to-be-done-to-stop-the-spate-of-malnutrition-deaths-in-attapadi/article7429398.ece

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