Beruflich Dokumente
Kultur Dokumente
On
Child Health & Survival
Prepared by
An Introduction to Bhil Tribe: Bhil is an indigenous or non Aryan tribe. The Bhils are
recognized as the oldest inhabitant of southern Rajputana & parts of Gujrat. The name
Bhil seems to occur for first time about A.D. 600.The name Bhil is supposed to be
drive from the Dravidian word for a bow, which is the characteristics weapon of the
tribe.
The Jhabua Bhil retains some dim and incoherent outlines of their migration. Damor
were the first Bhil in Jhabua. Bhilali language has been spoken over in great
proportion of the district. The Bhils are brave, versatile & extremely daring. They
have 108 gotras, some of which are Damar, Vasuniya, Muhiya, Maida, Bhuriya
etc.The Bhil population in the villages lives scattered and their houses are quite far
from each other. In jhabua agriculture has been their primary activity of Bhil tribe
along with labour work.
In Jhabua, 93.9 percent of population residing in rural areas and 87.6% of urban
population are surviving with low standard of living. But only 45% of the children are
provided with BPL card. Only 4.5 percent of rural population in jhabua has an access
to toilet facilities while only 1.5% uses piped drinking water1.
Regarding the status of maternal & child health situation is no better as rightly
revealed by DLHS-3. 22 % mothers had been facilitated with at least 3 Ante-Natal
care visits during the last pregnancy. Only 37.6% of women undergo institutional
deliveries and 28.9 percent of women received post natal care within 48 hours of
delivery. Merely 19.4 percent of children (12-23 months) are fully immunized while
14.6 % children (9-35 months) who have received at least one dose of Vitamin A (%).
According to 12th Bal Sanjeevni data of May-June08, 47.6 percent of children are
malnourished in Jhabua district and the monthly progress report (MPR) of Sep09 of
Department of Women and Child Development also illustrates high percentage of
malnutrition with 42% children are malnourished in the district.
Village Agasiya: Agasiya Panchayat consists of two villages Agasiya & Todi. Agasiya is
a small village with total population of about 852 only as per census 2001.But the
village is widely scattered into different hamlets. It is fully tribal dominated village.
Their are 141 households in the village. It is having only one primary school and an
anganwani centre. Nearest town is Thandla which is located at the distance of 23 kms.
But we if go by latest data as available with the Rural Development department the
joint households have now bifurcated to 359 households. Out of them 175 households
were supplied with BPL cards while 184 families were having APL ration cards2.
* This document has been prepared by seema Jain on the basis of analysis and field survey to Meghnagar
block, Jhabua district
1
Source: District Level House Survey(DLHS III) report 2007-08
2 Source: http://nrega.nic.in as on 10 jan09
Village Madrani: Madrani is comparative a larger village. According to Census 2001,
total population of the panchayat is 3678 with tribal population of 2991. Madrani is
the only village in the Madrani Panchayat. It is having 612 households. Madrani
village is spread out in an area of 790hectare.
Again, as per the latest data of Rural Development department the number of
households has increased to 716 households while 329 families are marked as BPL.3
The vulnerable tribal households in Agasiya & Madrani villages are surviving in
meager conditions with no access to decent life. Their agricultural land is mostly rain
fed with no other sustainable source of livelihood. However in spite of such scanty
circumstances more than 50% of the tribal & dalit families in the two villages are not
supplied with BPL cards.
Aganwadi jate hai to daliya nahi milta aur aspatal mai dava bottle nahi milti,isliye
bacche mar rahe hai (When we go to AWC, we do not get SNP and hospitals do not
have medicines, therefore children are dying ). Shama gali gayo tho i.e. Shama (4
years) from Singadiya tola became were malnourished & ultimately he died 12 days
before on 23rd Dec09 with the diarrhea attack ,said Galia, Shamas father. Though
Bhadur (a local social worker) informed AWC about Shamas deteriorating condition
on Nov09 but no action was taken up by AWW. Shama was not registered in
Anganwadi centre so in spite of being malnourished he was neither referred to NRC
by Anganwadi worker nor provided with SNP.
According to many research on tribal health the major tribal Health problems5 in
India can be broadly classified into four categories:
Communicable diseases Malaria, T.B
Gastrointestinal disorders- diarrhea, dysentery
Parasitic infection
ARI
Fever, resulting from malaria is the main cause of sickness found among the children.
Tribal infants in Madhya Pradesh are known to suffer from high sickle cell anemia.
Deforestation has resulted into the depletion of traditional medicines couple with
inadequate health infrastructure with little access to the trained health staff has
further deteriorated the quality of the health of the people.
Malaria is a major public health problem among tribal in India. This disease is
pandemic among infants and pregnant mothers among tribes resulting in high rate of
infant and maternal mortality6.
In MP, there are some districts where the problem of malaria is worsening year by
year particularly the hardcore tribal districts having around 50% tribal population i.e.
Mandla, Dindori, Jhabua. These three districts contributed 57% of states malaria and
60% P.falciparum infection. Jhabua relatively contributes 13% of malaria cases in the
state.7
4
Health and Population: Perspectives and Issues. 2000 Apr-Jun; taken from Indian Medlars Centre
5
Demography & health profile of tribal-A study of M.P. by Dipak Kumar Adak, Biswanath Bhattacharya,
Rohini Ghosh, Anmol, 2003, xvi, 297
6 Taken from Tribal health & medicines by A.K. Kalla and P.C.Joshi 2004
7 Study of Regional Medical Research Centre for Tribals, Jabalpur (RMRCT) under ICMR- Tribal
Malaria, an Update on Changing Epidemiology by Neeru Singh
Thus various researches shows that communicable disease like Malaria and
gastrointestinal diseases like diarrhea is very common in tribal pockets of Madhya
Pradesh like Jhabua. These diseases produces more epidemic results on maternal &
child health in tribal dominated districts when accompanied with anemia in women
& children, malnutrition in children, low birth weight of children, lack of proper
immunization and timely access of health services.
The ill effects of food and nutritional insecurity can be linked to the life cycle of an
individual. With the nutritional status of mother herself being inadequate, the birth
of a child only adds to low availability of nutrition for herself. The child so born is
also having low birth weight. When a child is weaned from mothers milk to other
foods, very commonly the protein and energy requirements are not met. Due to
inappropriate complementary or supplementary feeding practices, the energy gap
widens. This is because for the proper growth after 6 months of age, the requirement
of the extra energy cannot be fulfilled by breast milk alone. This is displayed as
Protein Energy Malnutrition (PEM), which is very common form of malnutrition.
Large numbers of children under six years of age in Agasiya & Madrani village of
Meghnagar are left out of the benefits of the services of Anganwadi centers. Agasiya is
a widely scattered village is divided into 6 phaliya or tolas and is having only one
AWC in Patel tola (hamlet) while rests of the tolas are almost uncovered by AWC.
This is evident even from the differentiation of the survey & registration records of
the AWCs. According to the AWW of Agasiya AWC, there are 150 children under
the AWC as per survey of July 09 but the total number of children registered in
AWC till Jan09 is just 70 children. This means 80 children of Agasiya are not even
registered in AWC.
According to AWW for SNP distribution & other services only Patel tola area comes
under AWC while other area comes under sub AWC in School Phaliya. But it is
extremely amazing that resident of school phaliya even do not know about existence
of sub AWC in their own area. According to Kalsingh Ninama (father of Vijesh died
of malnutrition), Kalash Agasiya, Rajoo and others villagers from school phaliya
AWW never visits school phaliya nor do we get any benefits from AWC. Similar
condition exists in other tolas of Agasiya village.
AWC survey reports of Vasuniya Saat & Madrani AWC in village Madrani 349
children in the two anganwadi centre while actual registered number of children was
239 only. As per AWC records, 27 children are found in grade II while 5 children
were severely malnourished. But no growth monitoring system for unregistered
children. In spite of such high range of malnutrition problem, no child among 39 died
had ever been referred to NRC for special health care & treatment.
Health services are in most dressing state in Meghnagar block. Poor tribal are forced
to approach private doctors in lack of satisfactory health services. Madrani PHC was
functional with no facility for admission or institutional delivery. Only after highlight
of malnutrition issue in media in Dec09, a visiting doctor has been placed at Madrani
PHC on a weekly basis. Villagers have to travel 15-20 kms with no public
transportation facility available to seek government health services at Kakanwani,
Meghnagar or to Thandla (other block).
Arjun S/o Binnu Agasiya 2 months was very weak and was severely ill for 15-20 days.
He spitting up large amounts of milk after most feedings. They have taken Arjun to
Madrani, Meghnagar and even to Thandla. But every time they were made return
with the advice that its normal for children to split up milk or just provide with
prescription to purchase medicine from open market. No medicines have been
supplied from Hospital. They have spent around Rs. 800-1000 along with hiring
private jeep for Rs.200 to take child to Thandla health centre. Doctors calls for
bringing the child at their dispensary, where they charge Rs.50-100 as consultation
fee. The child died in lack of proper medical care. Even Arjuns elder brother Karan (4
years) was not even immunized with necessary vaccination.
Pushpa gave birth to Arjun at Kakanwadi CHC but she had not received benefits of
JSY. She gave birth to child before Dewali but was asked to come around Holi to
collect the money.
According to the child specialist from jhabua district nutritional disorders is the major
cause of infant & child mortality in Jhabua district. The systems or diseases which are
commonly prevalent among the tribal children are seasonal respiratory infections,
diarrhea, viral & malaria fever. Children are commonly anemic & malnourished
which when accompanied with worm infestation produces harmful effects on the
child health and many a times on the outbreak of deaths.
According to him, most of the tribal women are anemic with general hemoglobin
level of 7-9 only in maximum cases and the gap between two pregnancies is very low.
As a result low birth weight babies are commonly visible trend in the tribal belt of
Jhabua. This low birth babies when grow-up with inadequate nutrition soon turned
into malnourished children.
Though most of the Bhil tribal inhabiting in Jhabua have small piece of land holding
but this is insufficient to earn livelihood due to scanty average rainfall and lack of
proper irrigation facilities. Most of them are able to fetch only single crop of Maize in
rainy season. Rest of the year land either lied barren or yield very low produce
resulting in high cost of production. In Agasiya village, only 19 hectares of land is
irrigated while 185 hectares remains un-irrigated. Similarly, in 92% land lacks
facilities for irrigation.
Is landholding really a proof of being affluent?
Galia Adivasi and his brother Bhur Singh of Singadiya tola of Madrani village in
Meghnagar block jointly landholding of 4 acres. Galia have large family including
wife and 6 children & so like his brother. But in lack of irrigation facilities, they are
able to yield only one crop in a year. In the current year their land yields merely 4
bags of maize that is not adequate to feed such a large family.
In lie of this 4 acre land, they are provided with ration card for above poverty line
(white card).According to Galia, In lack of BPL card, we need to buy maize at the
rate of Rs.200 & wheat at Rs.300 per quintals from the open market. So we are
forced to do labour work & migrate to distant places.
Another distressing feature of land holdings in Jhabua is that most of the land
holdings are jointly owned by the family of four five brothers. Though the joint
family is separated into nuclear families but landholdings are still jointly owned by
them on papers. As a result in spite of being very poor they are considered to be above
poverty line and so they are getaway from the benefits of welfare services for below
poverty line. Being deficient of subsidized ration, tribal are not even proficient to feed
their small kids. Children are left unfed or half starved. In the long run they are
turned malnourished. This is perceptible through the death of 43 children in a short
span of time.
8 Analyzed during individual & group discussion at AAY & BPL cardholders at Agasiya & Madrani
villages in Jan10
gayi hai, gareeb kaha jaye. (i.e. prices are continuously risings but we do not get
sugar & rice under PDS, so it becomes very difficult for poor to survive).
Delayed payment is also another major issue in Meghnagar block. In 2009, in Agasiya
village work of digging up of lake was undertaken in Oct09 under which individuals
card holder got work maximum 10-15 days of work only9. And even payment of
wages for these 10-15 days of work is still pending till Jan10 for work done in
October 09.According to kalsingh, Sarpanch has kept our Job cards but our payment
is pending for more than two months for 15 days work on talab (lake).
Social audit is an important tool to monitor the progress under NREGA. It helps to
analyze deviations/shortfall in the implementation & also ensures the accountability
of the responsible officers. Social audit also facilitates for community to internalize
their rights & entitlements under the act. Social audit had taken place in Agasiya &
Madrani panchayat, but community is not aware or informed about it. And the social
audit report number 172100324 & 172100311 dated 20th Aug09 illustrates that no
issues or grievances under NREGA were found in Agasiya & Madrani panchayats. But
the tribal & dalit community of Madrani & Agasiya is very hassle as they are not
getting work under NREGA. They forced to migrate even to Gujarat & Rajasthan in
search of livelihood.
Almost every tribal family from Agasiya and Madrani is forced to migrate to avert
starvation emerging from non availability of work under NREGA within their own
periphery. High proportion of migration is found to have complex effects on
childrens health & nutritional status.
Binnu Agasiya, Galiya, Dilip Dindore, Ramesh Mavi and Ganiya Toli were on
migration to different areas like Baroda, Kota, Surat etc to earn livelihood through
9 As told by the tribal villagers during field visit by VSS team in Jan10.
labour work when their toddlers died. Sivan s/o Ganiya and Bundi s/o Jalu Vasuniya
from Vasuniya Saat were died in Kota during migration period.
According to Bundis grandfather Gour Singh, Rs.4500 has been spent on the
treatment of Bundi at Kota and Rs.7000 for hiring jeep to bring Bundi back to
Madrani. For this they have taken debt from private contractor for whom they work
in Kota. So now Jalu needs to work as bounded labour at Kota till he pays of all the
debt.
The unremitting drought in Jhabua regions of the Madhya Pradesh coupled with the
fragmentation of landholdings and changing pattern and priorities of cropping have
completely jeopardized the livelihoods of the people and landed them into the vicious
grip of debt.
According to the Economic Survey of Madhya Pradesh, in last five years (from 2004
to 2008), the production of cotton in district has reduced from 27225 bales (a bale of
170 kg each) to only 3983 bales.
Local and traditional seeds are totally out of the market now In Jhabua the chemical
fertilizer used per hectare was 20 kg in 1970 and has reached to an astounding 800 kg
per hectare during the Kharif crop of 2009.The use of chemical fertilizers and
pesticides by the farmers in Jhabua to seek maximum benefit of cash crops like cotton,
tomato and chilly is six to eight times more than the official national average and 10
to 12 times more than MPs average.
10 Source: [ksrksa ij jlk;uksa dh ckfjk write-up by Sachin Jain, Bhopal in Dec09 on increasing use of
chemical fertilizers in Jhabua
Conclusion-
The socio economic jaggedness in life of tribal has increased the threat to existence of
children in Agasiya & Madrani. Increased dept, lack of employment, exclusion from
the benefits of welfare schemes (like PDS, ICDS, and NREGA etc) are resulting into
severe consequences of starvation and malnourishment in children.
The future generation of the Bhil is anguished from lethargic systems ignoring the
needs of their growth and development. Large number of children from Meghnagar
block are even kept out of the ICDS services which are specially meant for them.
Immunization is foremost right of every child, but Bhil children from Agasia &
Madrani villages are even debarred of that. Due to high proportion of migration they
are spinning towards malnutrition which further pushed them into the grip of various
diseases. In Agasiya & Madrani vicious circle out broke with the mortality of 43
children in very short span of time because:
In spite of Supreme Court order dated 28th Nov01 for opening ICDS
Disbursement Centre at every hamlet, large number children in Agasiya
and Madrani village are devoid of the benefits of the AWC because there is
no AWC in their hamlet.
Large numbers of children from Agasiya & Madrani are still to get
registered under ICDS. New AWCs in every scattered hamlet should be set
up at the earliest.
Special attention is still required to services like specially SNP distribution,
growth monitoring of all the children and regularization of immunization
in Agasiya and Madrani.
Public distribution system is not ensuring minimum quota of food grains
under BPL and AAY card in the two villages. And BPL list needs to be
reviewed again.
Here NREGA is not effective to put a halt to distressed migration and must
be revived immediately.
All such breach in services are affecting child health and driving them to
malnutrition related disorders.