Abhinandh Pradhan, 36, was hoping to welcome a healthy baby into his home but that was not to be. Today his small hut in Dhanekbadi village, located in Daringbadi block of Odisha’s Kandhamal district, is filled with a deafening silence. Five months ago Pradhan’s wife, Nanda, died during childbirth. She was very frail and during her first antenatal check-up she was advised to “eat better” and take iron and calcium supplements.
The grief-stricken husband recalls that piece of advice and shakes his head, “What can we poor people do about the food we eat? We eat what we get, what else?” Families like his subsist largely on a gruel made from mandia, a jungle millet, which is a staple in these parts and is known for its hunger-stemming properties. Meanwhile, Nanda’s health kept declining until one day she died – “just like that”, as her husband puts it.
While Nanda did not survive her pregnancy, Arpita Pradhan, also from Dhanekbadi village, managed to overcome three miscarriages to give birth to a baby with extremely low birth weight and respiratory problems. In the face of severe food scarcity and the lack of medical care, these days she is not only struggling to keep her baby alive but is yet to recover her own strength after her many episodes of child bearing.
There are hundreds of Nandas and Arpitas in the communally-sensitive district of Kandhamal, with a tribal population of over 50 per cent, and with forests constituting almost two-thirds of its land area. This district, incidentally, tops the national table in terms of its maternal mortality ratio (MMR) and infant mortality rate (IMR). According to the Government of India’s Annual Health Survey (2010-11), for every 1,000 children born here, 145 die before the age of five, making it the district with the highest under-five child mortality rate in India, with Daringbadi and Phiringia blocks having seen the maximum number of child deaths in the district. What hardly helps in such a situation is the lack of trained medical personnel. Kandhamal has 50 government-run hospitals and healthcare centres – on paper – but the few doctors working here find it an extremely arduous business to reach out to the impoverished tribal communities living high up in the hills.
Although the Annual Health Survey does not highlight the link between high IMR/MMR levels and malnutrition, clearly the lack of adequate nutrition is a decisive factor in such tragedies, as we saw in Nanda’s case. Wholly dependent for her nutritional requirement on the gruel made out of mandia, a millet that is grown in limited quantities either within the forest or in small clearings near people’s homes, she was clearly ill-prepared nutritionally to face the physical challenge of child bearing.
In 2008, the Institute of Human Development came up with the ‘Food Security Atlas of Rural Orissa’ on behalf of the UN World Food Programme (WFP). The Atlas identified Kandhamal as one of the most vulnerable districts in the state’s “geography of hunger” and highlighted poor rural connectivity, lack of food and nutritional security and access to safe drinking water as central concerns.
Today, the government-run public distribution system (PDS) – that makes subsidised foodgrain and non-food items available to the poor through a widespread and established network of Fair Price Shops – still does not reach many parts of Kandhamal. The authorities have also been sluggish about issuing BPL (Below Poverty Line) cards that entitles holders to 25 kilos of rice at Rs 2 (US$1=Rs 52) per kilo. Observes Srimanta Kumar Khuntia, who works for the non-government organisation, Care India in Phulbani, the district headquarters of Kandhamal, “Serious infrastructural lags and administrative indifference marks the food supply system in these small remote villages.”
This observation is echoed by Somjit Pradhan, a resident of Dhanekbadi village, “Since we get no government supply here, procuring food becomes the most difficult job for us. In our homes, food is always short. People assume that since tribal communities do not actively demand food, we are content on living on forest produce. In fact, it is because the food distribution is so poor that we are forced to depend on the forest for our daily needs.”
But the store of food that the forest yields – whether it is bamboo shoots, honey, wild fruits, turmeric or sweet tubers – dries up once the cold winds blow through these hills that constitute the North Eastern Ghats. During winters and the monsoons, ensuring food security in Daringbadi block gets even more difficult. Explains Trinath Sahu, a coordinator with a local church here, “This block has a mountainous terrain and it even snows in some parts during the winters. When weather conditions turn rough, tribals here don’t even know what to eat. Many households don’t have adequate stores of food and they also unable to gather forest produce because of the weather. Things can turn extremely dire in such circumstances.”
Only 24-year-old Michel Pradhan of Dhanekbadi village knows how she managed to keep her baby alive to celebrate his second birthday through the cold season. Some visiting doctors from the local church helped out by providing her with a milk supplement and protein biscuits. Of course, now that her stock of supplements is over, she and her baby are back to their dependence on mandia gruel.
Every now and then, stories of deaths from “food poisoning” of people in this region trickle into the media in Bhubaneswar or Delhi. Last October, for instance, sources in Kandhamal’s district health department revealed that at least eight people, including four children of a family, who were located in Gudrigaon village in a remote corner of Daringbadi block, had died of food poisoning. But such incidents are usually dismissed in one line of a newspaper report and quickly forgotten.
According to Trinath Sahu, such a callous approach is driven by a view that “tribals can live on anything”. Says he, “The fact that tribal communities have been subsisting on a meagre diet for generations, that many tribal children die before they reach the age of five, that tribal mothers are more likely to die in childbirth than women from other communities, should disturb us deeply. Instead, it is accepted as reality and provokes no action. Surely it is time to change such a mindset?”