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Not in a Day’s Work: How Odisha’s Tribal Districts Are Steadily Improving Healthcare

The cultural silos are slowly breaking and united efforts by social, technical and political forces shine new rays of hope.

An 80-year-old woman came to an Anganwadi centre in Baripada block of Mayurbhanj district in Odisha, to monitor the growth of her grandson

This incident was the most positive sign of change in people’s outlook towards health in the region. And the citizens have a six-month-long campaign called ‘Giving Children of Odisha A Healthy Start’, to thank for it.Launched by CRY (Child Rights & You) in collaboration with VCRO (Voice for Child Rights in Odisha), the campaign aims to reach around 5,000 children and 3,000 mothers in 158 villages in 10 blocks of Mayurbhanj, Bolangir, Bargarh, Kalahandi, and Koraput districts to address the issues of infant health and malnutrition.

The campaign is driving a change in perspective by integrating the strengths of the people. The community is slowly opening up, coming out of their huts, thinking and speaking about their children’s future and about the future of maternal care. The cultural silos are slowly breaking and united efforts by social, technical and political forces shine new rays of hope.

The Everyday Struggle

Mountains clad with the greenery of cashew plantations, red soil shining on the slopes of Dunga, couples farming in Kilaput village, and more — but this beautiful surrounding is not the only truth to behold here.

People of the Khilos tribes are residents of the villages in Koraput and the surrounding districts. Life is not at all simple for these villagers. Issues of anaemia and malnutrition are very severe in these districts due to lack of nutritional food. Lack of clean drinking water poses another threat to health. Primary and community health centres are also very far from these hamlets.

The government has extended support through Anganwadis but the delays are simply huge. Project officers claim to have good infrastructure and resources but blame the attitude and behaviour of the resident.

Yet, the lack of sufficient manpower and resources from the government is a naked truth along with the lack of efficient processes to utilise the available resources.

The Deeper Reality:

“We cook two times, 9 AM we have breakfast, lunch at 3 PM and dinner at 8 PM…Mandia is our main food, we eat very little vegetables…non-veg only during festivals or when a guest comes home…,” says a resident of Kilaput village in a meeting.

Women in these tribes work very hard in farms and need food rich in carbohydrates. But their diet is just mandia pech. Protein and vitamin intake is occasional. The hemoglobin levels of mothers are rarely above 9% — a level much lower than the specified standards.

Clean water is not available through bore wells due to low water levels. People use water from streams and boil it for drinking. Children are victims of malaria and diarrhoea, one of the reasons being malnutrition. Tribal marriages within their own clan cause sickle cell diseases adding to the severity of health issues.

“Health is not the priority among the tribal community in this area”, says a doctor from Asha Kiran Hospital. The underlying reason remains their unreliable livelihoods. Tribes move out for months in search of livelihood and movement of pregnant mothers makes the issue more critical. The tribals struggle for their very existence.

The Anganwadi scenario is not very positive. INR 7 Lakh was sanctioned to Kilaput village in 2013 for an Anganwadi building but construction is not complete even today in 2017. The story is not very different from Kasturipada and Titulipada villages of Golamunda block in Kalahari district. The materials provided for Anganwadis are either insufficient or are utilised by government workers for their own needs. Certain Anganwadis are not operational due to a lack of work force. In some Anganwadis, the workers do not report cases of acute malnutrition due to a supervisor’s pressure. This actually leads to the failure of the welfare scheme and if not changed, the new schemes will work the same way.

The Greener Side:

The situation demands work at various levels. Keeping this in mind, grass root level NGOs CRY are VCRO are partnering and will be involved in the campaign, ‘Giving Children of Odisha A Healthy Start’ for collection of data from the respective villages to assess the malnutrition status in children in the age group of 0-5 years, as informed by a CRY spokesperson.

The campaign aims to reduce the rate of child malnutrition below the national average through spreading awareness and through participative actions by communities along with service providers in the villages.

“Our campaign aims at advocacy towards enhanced implementation of policy and scheme’’ said Ashim Kumar Ghosh, The CRY State lead in charge of Odisha.

The greener side of the situation is political will power to support the cause. The state Chief Minister, Mr. Naveen Patnaik understands the grass root reality requiring further advocacy for resources to combat the issue of malnutrition and anaemia. Mr. Patnaik also requested for resources from the Union Women and Child Development Minister, Maneka Gandhi during a meeting at the Odisha Bhavan in New Delhi.

Chairperson of State Social Welfare Board, Ms. Litika Pradhan and the Odisha chapter of National Health Mission strongly support the campaign and believe that it will create a great impact in the long run. Members of parliament, Zila Parishad of Koraput along with sarpanches of 12 panchayats have joined hands with CRY and VCRO extending their complete support to fight malnutrition. Policy by State Government of Odisha to post young doctors in Kalahandi-Koraput is strengthening the health care delivery system.

The campaign is slowly getting to the roots and the community is getting responsive. The first phase of 12 days of the campaign covered 12,345 people from 113 villages of 6 blocks. A good number of mothers are joining the campaign to fight health issues. Now patients go to hospitals for treatments.

People are aware of the role of Anganwadis and demand one for their hamlet.

The battle does not end here. The issue of malnutrition has many gray shades. The question of creating stable livelihoods for people, basic education, addressing myths and misbeliefs are some of the major challenges to combat through the upcoming initiatives.

Everything is set for the change, as nutrition is not just about eating, it’s learning to live!

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CRY - Child Rights and You is an Indian NGO that believes in every child’s right to a childhood - to live, learn, grow and play. For over 30 years, CRY and its 200 partner NGOs have worked with parents and communities to ensure Lasting Change in the lives of more than 2,000,000 underprivileged children, across 23 states in India. For more information please visit us at www.cry.org