The high infant and neonatal mortality in Attappady is primarily due to acute protein malnourishment or Kwashiorkor disease while general malnutrition or anaemia is only a contributing factor.
The infants in Attappady are all born with low birth weight and their survival is severely jeopardised because they do not gain sufficient weight despite breast feeding and supplementary feeds. This is because of severe protein deficiency in the primary diet of tribal mothers, which is mostly just starch, Additional Director of Health Services (Health and Family Welfare) N. Sreedhar has reported to the government.
The diet supplied to tribals might be sufficient in calorific requirements, but unless emergency measures are taken to introduce more protein into the diet of lactating tribal mothers, pregnant women and tribal children, the infant deaths are likely to continue, Dr. Sreedhar has reported.
Dr. Sreedhar prepared the report after visiting some of the tribal colonies (‘oorus’) in Attappady, along with G. Sunilkumar, Deputy. Director (Family Welfare), and Rajeevan, State nodal officer for Tribal Health and after a careful examination of the ante-natal records of new mothers and the health status of the infants.
The report specifically quotes the case of Remya, infant born to Jyothimani and Murukan, which is a typical case study of the region.
Jyothimani, a 20-year-old mother weighing 44 kg, was registered as an ante-natal case by health workers in the fourth month of pregnancy. During the entire gestation period, she had put on an excess of just 4.5 kg, whereas, during a normal pregnancy, a woman should have gained at least 10 kg. She has had five ante-natal visits to the doctors and her haemoglobin levels recorded is 9 gm. While this mother is anaemic, the condition is not severe enough to cause intra-uterine growth retardation. Her baby, born one month prematurely, weighed just 1.8 kg. She has survived into 10 months of age now, but weighs just 6 kg.
“’The baby had been slowly gaining weight while she was being breast-fed but after six months, the family introduced supplementary feeds and her weight gain just dropped. The baby now is apparently healthy but she is suffering from Kwashiorkor disease or severe protein deficiency, as most infants here are,” Dr. Sreedhar told The Hindu .
Acute protein deficiency in the diet of adolescent girls and ante-natal women is the primary issue in Attappady, which has led to the death of so many infants, he said.