Far far beyond the eyesight of our honourable bureaucrats and politicians; lies a place where humans with limbs and hearts like me and you are left to survive and rot.
In 2016, Odisha TV (also known as O TV) showed a video of an Adivasi man carrying the dead body of his beloved wife on foot, from Bhawanipatna Government Hospital to his village, Melghara, 50 kilometres away. It shook the conscience of people. Usually there are a number of SUVs draped as ambulances and mortuary vans around the Bhawanipatna Government Hospital. But along with the luxury to avail that, comes an exorbitant price beyond the capacity of people like Dana Majhi.
Kalahandi district is an epicentre of poverty, hunger, numerous diseases that come with it and starvation deaths. Last month, I had the privilege to visit Thuamul Rampur, a block in Kalahandi that has witnessed highest number of deaths due to tuberculosis, malnutrition and other diseases that are more prevalent in the lower-income section of the population.
Semikhaal is a village in Silet Gram Panchayat. For reaching there, you have to climb high terrains and cross two streams. There is no mode of transportation available. Either you take the risk of going on a bike or get a big four-wheel drive like Thar. It’s a 45 minute journey from the nearest health centre which is run by an NGO called Swasthya Swaraj. It has been working in Thuamul Rampur block since last 5 years in association with Tata Trusts. The village is populated with Adivasis from Kutia Kondh community. Unlike other tribal communities where the socio-cultural roles of women are more important than those of men, Kutia Kondh tribe is patrilineal or patriarchal in nature.
My day started with meeting Sarada*, a mother of 5 kids, the youngest being 7 months old. The baby looked underweight. Upon asking the reason why he looks malnourished, she said, “We hardly have any food to eat. There was a time when we were even denied food as a part of PDS (Public distribution system) as our ration card was revoked.” In many small hamlets, the families depend on subsistence farming for their meals. In order to earn money, they work as daily wage labour.
On my way, I found a lot of women and adolescent girls working as labour for constructing roads. They are paid extremely low wages. Then back at home, when food is prepared, men and boys are fed first while daughters and mother eat the leftover. Hence, their food intake reduces further. Due to less proteins in their meals, the mammary glands can hardly produce any milk, leaving the baby malnourished.
As we walked inside Semikhaal, we realized that every house here has at least one child who is suffering from Severe Acute Malnutrition (SAM). We met Suboti*, a mother who delivered 7 kids out of which 6 are alive. Her 3-month old baby was so weak that on seeing her, I remember going numb. The age gap between her children was less than 1 year. When this gap reduces to less than 18 months, problems such as pre-term birth and low birth weight develop. 3 years is the prescribed age gap by National Health Mission (NHM), Government of India.
When we asked Suboti if she’s planning to have more children, silence surrounded us and she meekly said, “My husband knows.” On asking the same question to a man who has 4 kids – 3 sons and 1 daughter, he replied, “I had another son who died a couple of days after his birth. So, we want to have one more son and then we will stop.” On arguing that the next child could be a daughter, he was in a fix.
The economics of a rural household is simple. They think that more children will result in more hands at work. Sons are considered assets as they will remain in the family and bring food while a daughter is a liability as they are to be married off. Most couples go on procreating until they have at least four sons. Another dynamics that add to family planning is that even if the babies are malnourished or are suffering from SAM child, they hardly take them to a clinic. It is seen as a waste of time, energy and money. Child deaths is a brutal phenomenon that they have befriended over time. Another reason for giving birth to so many kids is that they know that while growing up, some will die. The reasons could be malnourishment or scarcity of resources. The household income doesn’t change. With the rise in number of family members, each one’s share of resources decrease.
Every village is filled with quacks as well as traditional healers called ‘guruguniyaas’. They are entrusted with the responsibility and an opportunity to heal people. Thus, in most cases, the villagers have no trust in scientific methods of healthcare. Despite having tuberculosis, they choose to go to a guruguniyaa rather than coming to the clinics. These healers refer to the disease as an evil possession and go on with his/her wizardry. Even the babies are delivered at home. Due to this, there are large numbers of cases, of foetal and maternal morbidity and hence, high mortality.
In one case, the uterus of a woman had slipped out of her vagina and was lying on the floor along with the baby. She was in an utter shock, and this wasn’t such only case.
In a conversation with Dr. Aquinas Edassery, the Executive Director of Swasthya Swaraj, she said, “Our organization conducts ANC-U5 (Ante Natal Care and Under-five children) clinics regularly once in 2 months at Semikhaal in the community building. Our team consists of doctors, nurses, lab technicians and other staff who reach out to the people in remote, hard-to-reach locations. There would usually be more than 100 under-five children and pregnant women from 6 villages in the vicinity. Last month, when we went for the clinic, we found that the building is occupied. A non-tribal man from the neighbouring Kashipur Block was running a regular shop, and staying there with his family. The larger room, where we used to conduct training programmes for adolescent girls, was occupied by a neighbouring tribal family.” Such cases may seem to be small but they are of utmost importance when we see the adverse impact they’re making on the lives of tribal people.
There are Anganwadi workers, ASHA workers and ANMs allotted in the villages (from other non-tribal areas), making occasional or no visits at all. Even the officers in Block Development Office have really poor attendance, as most of them take their job as a ‘punishment posting’ and try to protest through absenteeism. The schools have buildings (often incomplete) that are operational only during events when uniforms or other gifts are distributed such as Saraswati Puja, Republic Day, Independence Day and Ganesh Puja. The working days are a vacation for teachers and headmasters.
The staff takes the food material meant for mid-day meals. You will hardly find a child from these tribal hamlets who can even do basic addition, subtraction, multiplication or division.
There are numerous projects by Government of India and Government of Odisha for the development of KBK (Koraput Balangir Kalahandi) region but most of them are only present on paper. Roads are built, broken and again built. This goes on, in a loop. Sub centres, primary health centres and community health centres are usually adorned with locks on their main doors. On a few days, you may find a nurse attending patients in there.
In this circus of development, deep inside, an Adivasi does not even know when this world wrote his obituary and left him to rot. I distinctly remember Tilika*, a woman in her early 40s, saying, “They abuse him and he abuses us.” Being a woman at the receiving end of all abuses, the linear chain of exploitation continues. The distress call for me is that while on one hand, in our cities, we have numerous dialogue on ‘Gender Parity’, ‘Equal Rights’ and many movements around feminism but are there any such possibilities here, where the voices of Adivasi women from a patriarchal tribal community like Kutia Kondh can co-exist with the urban and peri-urban narrative of ‘Women Empowerment’.
*Names changed to protect identity.