'Healthy, Affordable and Accessible Nutrition' for Tribal Women and Children

Dr. Antarjeeta Nayak
Founder Director, ARDF

Introduction

Our foundation [Abhibyakti Research and Development Foundation (ARDF), Odisha] is committed to perform all the research and development work outreaching every aspect of children and women. Moreover, we are focused in extending our service to the rural and tribal population. Odisha is a state, rich in cultural heritage. The state has the third largest population of scheduled tribes in India. But, whenever we talk about the development or upliftment of tribal, we generally mean introduction of new developmental projects, inauguration of new schemes for tribal, industrialization or any pseudo development ventures in the tribal areas, which very often destroy their natural habitat, rich culture and their simplicity. So, even after multiple government policies and programmes sought to develop tribal communities by focusing on their livelihood, education and health and despite seven decades of special treatment, even today, tribal continue to be the most undernourished segment of our society. When the whole world is fighting against corona, tribal are struggling hard and fighting against malnourishment and starvation deaths. In the fight against mal-nourishment and undernourishment, women and children are the frontline victims. ARDF has been working for tribal in Odisha, especially in Sundargarh district for many years. When we talk about working for tribal, unlike others, we simply don’t mean sitting in an air conditioned room, hours before the computer analyzing some secondary data, reviewing any policies for finding the problems and some solutions for the tribal. We are focused for a sustainable growth and development of tribal, especially the tribal women and children. Unlike others, ours is a lengthy approach of working for tribal. We generally try to visit each and every tribal, exploring and knowing their strength, weakness and difficulties, understanding their need, analyzing their problems, evaluating their crisis, and proposing in-depth and sustainable solutions for the same.

Why Nutrition & Nourishment Matters for Tribal Mothers/Women and Children? : A Field Review

The number of people affected by malnutrition is startling. Globally, an estimated 149 million children are stunted (chronically undernourished) and 50 million are acutely undernourished (wasted), with undernutrition a direct or underlying cause in 45% of all child deaths. In addition, 40 million children under 5 years are overweight and 678 million adults are obese ^1&2. The latest available data reveals that 4.7 million tribal children of India suffer from chronic nutrition deprivation affecting their survival, growth, learning, performance in school and productivity as adults (Nutrition India Info).This is what statistics and secondary data states. The genesis of this proposal is through ARDF’s field work, survey and observation.

During the early days of Corona, when schools and colleges were completely closed, online classes were in force. But, have we ever deeply observed the education of our tribal children in and around the Smart City of Rourkela? They neither had the scope and opportunity for online classes nor the offline classes. They were and still now are out of education line. Keeping in view the crisis of the time, ARDF initiated a community based teaching at Pograbahal village (an adopted tribal village of RSP) in the name called ‘Abhyudaya’.

During our course of teaching we explored several learning dilemmas or learning disabilities among the children. Children from class-1-V have low concentration and attention with a poor memory. Children between ages 4-8 have stunted growth. Children of class VI and beyond have reading disabilities and math disabilities. There may be several reasons behind these disabilities, but one among many that we observed and explored is the under-nourishment and mal-nourishment of the children. This journey of undernourishment and mal-nourishment starts from pregnancy and is passed to the child and that continues even after birth through poor, inefficient and insufficient lactation (ARDF has documented this learning difficulty in ‘Decoding the Learning Difficulties-Part-1, which is published in YouTube https://youtu.be/w_UONLg_jdA )

In another on field work of ARDF, we tried to help the needy tribal mothers and children with an umbrella this rain. So, we started to move from house to house in tribal villages like Pograbahal, Kapatmunda, Biringajhar, Dalposh, Kukuda, Bangurkela, and Tumkela. In almost every village and in every house, women, children and adolescent girls were absent. Only the male members and old persons were available at home. On our enquiry, we came to know that the female members and even the children are on the farm lands planting the rice saplings. As it was rainy season all of them were engaged in planting rice saplings. So, instead of moving from tribal house to house, we started to explore and move from one tribal field to another.

There we found many mothers with their children, many children even without their mothers and fathers working with other fellows, and many adolescent girls working together. Even it was drizzling and sometimes raining heavily too, they had no umbrellas with them. As they had to live for the whole day on farms, they sacrificed the umbrellas at home for other members for any emergency. Sometimes, while distributing umbrellas, we coincided with their lunch time. There we found, they had only plain rice and one vegetable fry (which they call ଭାଜି) as their lunch. Even children had that too. The ratio or proportion of vegetable fry to rice is very small. And sometimes they had only water rice with salt and chilly. With this arises the question of nutrition and nourishment. For the whole day they do the physical labor, and even out of home without any rest and all. But the food that they take can only quench the thirst of their hunger but cannot meet the need of a holistic growth and development of a human body. So, in this context, nutrition and nourishment of women/mothers and children, especially among the tribal and in the tribal region, needs serious attention and intervention. Now it’s time, we should move from awareness to action.

From Awareness to Action: Healthy, Affordable and Accessible Nutrition for Tribal Women and Children

With an objective to intervene into the matter of mal/under nourishment, ARDF organized an event on “Healthy, Affordable and Accessible Nutrition” at Pograbahal on 26th September, 2021, to provide means for affordable and sustainable nourishment to the tribal mothers and children.

Very often we have marked that nutrition and nourishment programs are awareness related. The invited speakers come and give their speeches with least possibilities of making an enquiry whether the listeners are adopting them or the tips and suggestions given are adoptive or not. Generally, in nutrition programs people talk about several nutritious foods to be taken. And more generally, these nutrition programs are organized for poor in the slums, rural or tribal regions. But, very often the relation between the reasons why the program is organized and for whom is organized is missed. Actually, what people do, they generalize everything. Poor people are recommended with dry fruits, some fruits that they have never seen as nutritious food to fight with mal or under nourishment. But more often it is ignored or forgotten as how feasible the advices are given to the poor. So, in our program we seriously paid attention to such shortcomings.

The program witnessed the participation of 45 children and 20 mothers. The age of children ranged from 2-9 years, and the age of women or mothers ranged from 18 to 25 years. Three pregnant women and 8 lactating mothers with their infants also participated in the program. We started the program by recording the age, height and weight of the children. We recorded the age, weight of the lactating mothers and their infants too. To begin with the program, Dr. Antarjeeta Nayak, Founder Director of ARDF, informed everyone about the purpose of the camp, and discussed with a practical session with the mothers and women present there about the variety of pulses and vegetables and the vegetables that could be found around them easily and at affordable prices, as well as the nutrient values in them. While she was taking the practical session, we came to know that the tribal women are not able to recognize several dals other than harad and masoor. They do not even know about chickpeas and sprouted moong. So, to make the nutrition available to them easily and at affordable price, she made the children and mothers present over there to practically learn about several home grown plants like turmeric, pudina, coriander, green chili, lemon and lemon grass, banana, papaya, guava and moringa, some leafy vegetables like palak, methi, kosala, and showing them the plants, to boost their immunity and nourishment.

Senior Pediatrician Dr. Paramananda Rath, of Ispat General Hospital (I.G.H), Rourkela explained about several foods and the nutrient contents in them that can ensure a sound health for the mother and a proper growth and development of the child, with several examples and demonstration. He also focused on lactating mothers, and gave an exclusive list of affordable nutritious food to be taken that can enhance a better physical growth and development of the child in the later age, avoiding malnourishment among the children and anemia among the mothers. Dr. Rath also examined the children having several problems like eczema, nasal infection, birth asphyxia, and other fungal infections. Medicines were prescribed for the same. Senior gynecologist Dr. Pratibha Sadangi of Ispat General Hospital (I.G.H), Rourkela advised several pregnant women and other women how to take care of their health with nutritious food. She gave many important information on several foods that should and should not be taken during pregnancy and after getting pregnant for a healthy baby and mother in future. Later she investigated the tribal women with their issues and advised for the same. Dr. Ramakrishna Biswal, Professor of Psychology, at National Institute of Technology, Rourkela, discussed the role of nutritious food in the mental and intellectual development of all children.

The center of attraction of the event was the instrumental and musical method of creating awareness about the nutrition and nutritious food among the children and the mothers, by team ‘Aspire to Inspire Family’. The team sang several songs n nourishment and healthy foods in tribal language which made an easy understanding among the audience, where children enjoyed a lot.

As one of the ways to easy solution to the problem of malnutrition, ARDF distributed Moringa and Papaya saplings to the mothers present there to plant them in their respective courtyard and share them with the rest village, as a part of creating Poshan Vatika in the tribal village. Further all the participants of the program were provided with “Khichdi” which has the recognition of a wholesome nutritious food. With the distribution, ARDF also demonstrated the process of cooking Khichdi and the benefits of it for both the mothers as well as the children.

Findings: Facts and Figures

If we look into the NFHS-4 data, then we can anticipate the truth that, despite improvements, the undernutrition among STs has remained poor, and much higher than that for all groups taken together. As per the report, in India, 44% of tribal children under five years of age are stunted (low height for age), 45% are underweight (low weight for age) and 27% are wasted (low weight for height). Mild and moderate stunting is similar in tribal and non-tribal children. Our observations from our field work and collected information from the on field health and awareness camp on “Healthy, Affordable and Accessible nutrition for tribal women and children, reveled the same findings as NFHS-4 data. The recorded age, height and weight of the tribal children showed, children at Pograbahal are underweight and undernourished, with a high percentage of stunting and wasting.

Even the program was participated by 45 children, 36 children varying from age-2 to age 9 were recorded for the nourishment analysis. From among 36 children, 25 were boys and 11 were girls. Maximum age was 9 years and minimum was 2 years. As we have collected the height and weight of the children, we calculated the Body Mass Index (BMI) to evaluate the nourishment status among the children (Figure-1).

From the BMI Report, we found all children (36 out of 36) to be underweight. It is really matter of concern.

Again, when we analyzed the status of stunting and wasting, we found 77.8% children are stunted and 75% of children suffered from wasting (Figure-2 & Figure-3).

Further, when we compared the Z-score to measure the severity of stunting and wasting among the children, we found 47.2% of children are very serious and 30.6% of children are heading towards severity, whereas, 22.2% of children were in the median range, and if not taken better care may fall into severe wasting and stunting.

After all the qualitative and quantitative analysis, we can infer that proper nutrition and nourishment of the tribal children is the need of the hour. Even though they look physically sound to our eyes, but the truth is far from the reality. So, if intervention is made in proper time and the children are taken better care of, then certainly some future serious issues regarding the nutrition of the children can be avoided. As such, ARDF, is looking forward to be engaged in several such activities that can enhance nourishment of tribal children as well as tribal women.

Conclusion

It is widely accepted that undernutrition results from multiple causes, which can be categorized as immediate (inadequate diet and disease), underlying (household food insecurity, poverty, poor access to health and WASH services) and basic causes (overall social, political and economic environment). In case of tribal people, additional factors like discrimination, geographical isolation, limited access to public services, cultural differences, among others, add to the existing deprivations faced by them across sectors. Given their high dependence on government provisioning of essential services across sectors, additional efforts are required to overcome some of the challenges that are specific to STs and improve their access to these essential services in nutrition-related sectors. So, we shall not only focus on present, fighting with nourishment issues now only, but will give more importance to the future with sustainable methods of curing the mal/under nourishment problems, with a sustainable use of available resources, and without damaging the nature, and natural habitat of the tribal and the rich tribal culture. ARDF shall work for a sustainable growth and development where every poor and tribal mother, woman and child can enjoy their right to a better quality of life, health, nourishment and well-being.

References

1. Global nutrition report: action on equity to end malnutrition. Development Initiatives, 2020. [Google Scholar]
2. Black RE, Victora CG, Walker SP, et al. Maternal and Child Nutrition Study Group Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427-51. 10.1016/S0140-6736(13)60937-X. [PubMed] [CrossRef] [Google Scholar]

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