In the concluding part of her series, Shriya Mohan visits Korku tribals in Madhya Pradesh forced to adopt horrific ritual ‘cures’ to treat malnutrition
TWO-YEAR-OLD Ram Narayan Ramesh looks like he has a beer belly. However, the reason his tummy is so swollen that his shirt can’t be done up is severe malnutrition. He has been sick for more than a year. It is morning in Dabia, a village in Madhya Pradesh’s Khandwa district 200 km from Bhopal. Ram sits quietly, playing listlessly with a plastic bucket — he has no idea that the sickle thrust into a fire nearby is for him.
It is time. Ram’s shirt — his only article of clothing — is taken off him. His mother holds him firmly on her lap, face upwards. A village elder takes the sickle — now glowing an angry yellow — out of the fire. A few villagers look on from a distance. Ram senses something is wrong and starts to cry. His scream of pain and fear can be heard right down the alley when the flat of the sickle blade is gently, almost lovingly, brought down on his swollen tummy. Again and again, it is pressed down until Ram has been branded five times. A look of relief spreads across the faces of the onlookers. The chachua, a ritual treatment for Ram’s sickness, is over.
Ram has kwashiorkor, a type of life-0threatening malnutrition. Its symptoms are a bulging stomach, pale hands and hair, listlessness and, ironically, an inability to digest food. He weighs 7.5 kg — 25 percent less than normal for a boy his age. A few weeks ago, he caught pneumonia and started eating even less than usual. That’s when his parents decided to put him through chachua. Ram is part of the Korku tribe. Doggedly superstitious, the Korku carry a frog from door to door asking for water to be poured on it when rains fail; pregnant women are given drinking water washed in their husbands’ left legs to ensure easy childbirth.
But Ram should never have gone through the chachua — anganwadis, or primary child care centres and crèches, are operating in Khandwa. “Anganwadis should dispel such superstitions through health awareness, but the workers rarely do their job well. There’s no monitoring of anganwadis’ non-food functions,” say Seema and Prakash, founder-activists of Spandan, an NGO working to eradicate malnutrition in Khandwa.
Lakshmi Bai, a 28-year-old tribal, squats outside a Nutrition Rehabilitation Centre (NRC) for acutely malnourished children, housed in the district hospital. The centres give their wards two weeks of nutritious food; their mothers are given Rs 200 towards travel expenses and Rs 60 daily towards lost wages. It is 2 pm and there is no shelter from the searing sun. Akash, her 45-day-old child is so tiny that he is lost in the folds of her sari. Wrinkled and wasted, he is too weak even to suckle.
Mother and child travelled three hours by bus and on foot to reach here, but the doctors said Akash was “not malnourished enough to be admitted.” That was two hours ago. “These people come here just for the money. The child looks fine to me,” says the annoyed officer in charge of the NRC. Akash weighs barely 2 kg when most children his age weigh over 4 kg. Inside the 40-bed facility, 39 beds lie vacant.
POONAM VASKALE is the sup – ervisor for 27anganwadis in Khandwa. An MA in sociology, the 29-year-old is paid by the Ministry of Women and Child Development’s Integrated Scheme to ensure that no child or mother is left untreated. She lives in Khandwa and drives her own car. According to regulations, all reports of malnutrition are to be submitted to her every month. Vaskale — the only link between policy and ground zero — is charged with ensuring that severe cases are admitted to the NRC and malnourished ones are better fed. “It’s hard to visit these places with no transport and I’m too busy with paperwork to do any real monitoring. This might be an interesting calling for social workers. For me, it’s just a job. Just one of many entrance exams I wrote.”
People go to nutrition centres for money not treatment, say officers
In distant Bhopal, an IAS officer admits off-the-record, “We don’t know how to monitor our supervisors in remote areas.” During surprise visits, another ministry insider discovered anganwadis didn’t serve food, weigh children or even stay open. “No one has a solution,” he says grimly. To stop malnutrition and remove the perceived need for dire rituals like chachua, funds, plans, trained personnel and facilities need to be in place. They are — but only on paper.
Shriya Mohan is a media fellow of the National Foundation for India