Reaching out adivasi women and children with nutritious food and immunization at their doorstep

Alka Gadgil

The district of Nandurbar from Maharashtra houses two mountainous Adivasi blocks – Akkalkuwa and Dhadgaon. Here, the basic amenities like potable water, electricity and transport are scant. Women have to tread few kilometers every day to fetch water and electricity is conspicuous by its absence.  

Along with the topographical hurdles, the local communities face difficulties in accessing health and education services as well. A number of schools, Primary Health Centers (PHCs) and Anganwadi Centers (AWCs) are housed in makeshift structures. The existing number of health workers, teachers and Anganwadi Workers (AWWs) holding these facilities together, aren’t adequate to cover the entire target population. Many vacant posts have not been filled for several years now forcing teachers and health workers to take up multiple responsibilities. The lapse in the health and education infrastructure is further hampered by other existing problems in the region.

River Narmada runs through the district of Nandurbar, and these two blocks receive crashing monsoon. As agriculture is monsoon dependent, after the harvest, families migrate to other districts for livelihood. This annual exodus for subsistence from the hinterland of Akkalkuwa and Dhadgaon begins after monsoon starts receding.  The middlemen start visiting the villages for booking the workers and an advance is given to the farmers. Families migrate to the neighboring states like Gujarat and Madhya Pradesh to seek work in the factories, brick kiln or sugarcane fields. During this migration period, women and children don’t have access to the health, immunization and food security programmes.

Year 2018 district data shows that 8361 under five children, 351 pregnant women and 477 lactating mothers had migrated from these two blocks to different places. When the migrants return to the village, the AWW and Public Health Nurse have to tend to the underweight and malnourished children, anaemic pregnant women and adolescent girls. The vicious cycle of doing and undoing continues.  

As the Covid-19 pandemic and a total lockdown hit the country the workers lost their jobs. Women and children were not able to access the immunization, nutrition, education and other services provided by the state as the health workers and teachers were involved in Covid-19 tasks. The farm laborers who were dependent on sugar fields and brick kilns for their survival had to return to the village. Their food security was challenged.

Covid-19 pandemic turned their miseries into a nightmare. While the farmers toiled in the field and had a good harvest, the transportation of the crop was affected by the pandemic. In spite of all the measures offered by the government, there were restrictions on movements of people and vehicular traffic. Sugar cane factories and brick kilns to which the workers relocate were not running to their full capacity. Concerns have been raised regarding the negative impact of the pandemic on the farm economy.

Covid-19 pandemic and the measures to contain the spread of the virus jeopardized the routines and has resulted in loss of livelihoods of millions of farm labors. Efforts to mitigate the transmission of the disease are disrupting food systems, upsetting health and nutrition services.

UNICEF global report states that in addition to the 690 million undernourished people in 2019, at least another 83 million people, and possibly as many as 132 million, may go hungry in 2020. World Food Programme’s (WFP) Global Monitoring of School Meals During Covid-19 School Closures report states, “As of July 2020, an estimated 370 million children are missing school meals.  With these added shocks, children’s dietary quantity and quality are expected to deteriorate below the already poor situation that existed pre-COVID-19, when only 29 per cent of children aged 6 to 23 months were fed a minimally diverse diet and only 53 per cent received the minimum meal frequency”.

In July 2020, UNICEF, with the Food and Agricultural Organization and the World Health Organization issued a call to action in The Lancet, warning of the ‘pandemic’s potential to worsen the preexisting crisis of malnutrition and tip an additional 6.7 million children over the edge to become wasted during its first year.  This is in addition to the 47 million children affected by wasting and 144 million affected by stunting in 2019 before the pandemic’.

Taking note of the negative impact of lockdown, the district administration of Nandurbar reached out to the children and women as the entire population was grounded and available for timely intervention. Seeking help from other schemes and programmes, the administration was able to supply essential food items to all the households at their doorstep. The pre-monsoon health check-up of women, pregnant women, children and adolescent boys and girls was undertaken in the Adivasi zones. Anganwadi workers reached out to the children at their doorstep for delivering nutritious food to children, pregnant women and lactating mothers. The entire district machinery sprang into action to fight malnutrition among the Adivasi.

While Covid-19 pandemic disrupted the food systems, upsetting the health and nutrition services the world over, Nadurbar’s district administration act of reaching out to the target group with food and immunization at their doorstep needs to be lauded.