Melghat: a synonym for malnutrition
Malnutrition is a byword in the forested hills of
the Melghat region inhabited mostly by Korku Adivasis. Every year 400-500
children between the ages of 0 and 6 die in the region, comprising Chikhaldhara
and Dharni taluks, according to official figures from 2005.
The Problem: Thousands of kids die every year in the
tribal area of Melghat (Maharashtra, India) due to lack of medical attention
and nutritional support. Increased incidence and rapid spread of infectious
diseases such as pneumonia, typhoid, and dysentery are primary cause of high
child mortality. Situation worsens during monsoon when the food supplies are
low and the communicable diseases are at their peak.
Melghat is also a place known for high infant
mortality rate. Some reasons for the health crisis in Melghat include lack of
infrastructure, under-equipped and under-staffed public health and ICDS
centres, the tradition of early marriages and early motherhood, lack of
sanitation and clean drinking water facilities and the tribals' blind faith in
bhumkas (quacks).
Failed Operations of the past: When the Maharashtra
government first recorded the figures of child deaths due to endemic malnutrition
in the remote villages of Melghat, shocking numbers were revealed.Almost two
decades later, even though the government figures show a substantial drop in
the number of malnutrition deaths, social activists and health-coordinators
working in the impoverished area say that the authorities pass off such deaths
as still-births.
The reality continues to bite with the data
recorded just before monsoon this year, indicating 509 malnutrition induced
deaths during past year, until March 2011. Every year, hundreds of children of Korku tribe in
the tehsils of Melghat in the Satpura ranges fall prey to starvation and
malnutrition. While the government records indicate figures ranging from
400-525 in the last five years, health activists working among the tribals tell
a different story.
Madhukar Mane, Health Coordinator with NGO Maitri,
which organises monsoon campaigns to prevent deaths in the precarious season,
says: "The figures are certainly better than the late 90s but the numbers
are still very high in the tehsils of Dharni and Chikhaldhara. Government
records child deaths under two categories: still birth and neonatal. What
happens is that they write off several deaths as still births so that the
infant mortality rate (IMR) could be kept under check.
Ray of Hope: mhealth is now bringing about a change
in India. My two adopted ones- Bongu and Priti along with several others are
now fighting malnutrition in their region..I adopted these two angels with the
help of World vision India.
The community health workers in Melghat are given
the latest weapon to fight against the silent killer – malnutrition. It's a
mobile phone pre-loaded with an application called CommCare. "Whenever a
pregnancy is reported, I register the women's name and other details via the
phone," a community health worker explains.
Once the registration is done, the software gives
her the woman’s expected delivery, check-up and immunisation dates. The phone
also has pre-recorded messages on maternal and child health that can be played
for the women.
Once data is collected, it is saved on a central
server of World Vision India, a non-profit organisation that works closely with
the government, which distributed these phones. The information then helps in
monitoring the health of pregnant women, lactating mothers and young children.
The government is now toying with the idea of expanding this successful service
to other districts of the state.
Recommendations: Government need to provide access
to basic healthcare using mHealth/Telemedicine. About 50 per cent families in
Melghat are below poverty line with a high rate of unemployment. Weak mothers
often deliver children in grade 1 malnutrition.
It almost instantly deteriorates to grade 2, and
then 3 & 4. The nearest emergency health care is about 120 km away that
too without a child specialist or medical equipment. About 39 children are
suffering from grade 4 malnutrition while 442 fall under grade 3 here.
Here are some of the basic needs of the people in
Melghat:
- Proper Scientific Nutrition, including Micronutrients.
- Preventive Health
- Mother and Child Care
- Reactivating Comprehensive Education system
- Transportation & Roads
- Availability of permanent Employment Guarantee during the non-agricultural season.
The health of Melghat cannot change overnight. But
tough monitoring and creative solutions along with the State-led ones, the
primary being the crucial Right to Food law, can hopefully nurse it back to
good health in future.
Comments welcome!
References
Dr A. Ghosh- Team BHP
Commcare
http://www.hindustantimes.com/News-Feed/Columns/Spoon-feeding-Melghat/Article1-953028.aspx
http://indiatoday.intoday.in/story/government-fudges-mortality-records-in-melghat/1/153486.html
http://supriyassule.com/en/projects-and-developments/melghat