Karjat in the tribal-dominated district of Raigad in Maharashtra is a popular holiday destination for upwardly-mobile Mumbaikars, who sometimes escape to the pristine environs of the Western Ghats for the weekend. After all, being within touching distance of a megacity called Mumbai does have its advantages. Well-connected by road and rail, Karjat is also an educational hub with many institutions of higher learning based here. And, these days, it also attracts a fair share of star power, with top Bollywood directors shooting their movies here and Hollywood production companies like Twentieth Century Fox planning mega studios right here. There’s really nothing that seems to be going wrong in Karjat, or is there?
Now read this. When a non-governmental organisation, the Shabari Seva Samiti, came to this part of Maharashtra in 2003 and decided to check the health status of local children, they were in for a major shock. “We saw that of the 19,000-20,000 children in this ‘taluka’, at least 70-80 died every year of malnutrition,” reveals Dr Neelkanth Phadke, executive president of the Samiti. A health camp organised by the Samiti in 2004 only reinforced this – 1,058 children were detected to be malnourished, 375 of them in the worst Grade IV category.
Although just 100 kilometres away from Mumbai, the commercial capital of India, this was the lived reality in Karjat. That’s when Shabari Seva Samiti’s founder, Pramod Karandikar, 56, who has spent the last 23 years working to empower tribal communities in various parts of India, decided to stay put in Karjat and work on tackling malnutrition.
The interventions began in a conventional way. Health camps were first organised in different villages with the aid of doctors and local volunteers. Once the malnourished children were identified, they were categorised according to severity and treated for any observed illnesses. Through the primary health centre at Kalamb, the Samiti made arrangements to provide the most severely malnourished children with daily rations of ready-to-eat, nutritious snacks like rajgira, peanut laddus, jaggery, dates and ‘chikki’. This was given until the child moved into a non-critical category – typically after they had crossed five years of age.
But even while all this was underway, the activists realised that the Katkari, Dongar Koli and Thakar tribes they were working with – mostly marginal farmers and labourers – had a set of social characteristics that exacerbated the malnutrition problem: Early marriage, malnourished mothers, large families, alcoholism and indebtedness. “Incomes may have improved here thanks to proximity to urban areas and demand for labour, and the people, too, may be better educated, but formal education has done little to improve nutritional awareness,” explains Dr Phadke
So an awareness campaign was devised with the focus on the community women because they were seen to be potential agents of change. To help the interventions take off, a team of 18 dedicated adivasi workers was formed. They interact with families on a daily basis, cajoling, teaching and, sometimes, even haranguing them to adopt healthier ways of life.
This strategy has been in place for a few years and here’s what this team has achieved so far: Starting with the young, the Samiti today organises teenage girls’ health counselling sessions where issues like menstrual hygiene, safe sex, nutritious food and its link with maternal health and healthy babies, are discussed.
Then, to save tribal families from falling prey to money lenders, especially during marriages – no ceremony here is complete without liquor and non-vegetarian meals which is beyond the means of these modest farmers – mass marriages are conducted once a year with all expenses taken care of. This, it was found, also discouraged early marriage, as only couples of legal age can marry at this event.
Impending motherhood is celebrated through community involvement, by holding a common ‘dohaljevan’, a traditional celebration for expectant women. This ritual provides an excellent opportunity to give women tips on the diet to follow during pregnancy and after delivery, with the stress on nutritious foods like pulses and vegetables. And ferrous sulphate tablets make the perfect takeaway gift.
But only urging pregnant women to eat better wasn’t enough, felt the adivasi volunteers. The feeding practices the communities followed during the first two years of the child’s life also needed improvement. Informs Kavita Gandhivle, a devoted local worker, “For 12 days after childbirth, the new mothers are just given rice gruel in these parts. The child is breast fed until s/he asks for solid food – that is only after the child starts speaking!” Therefore, at the ‘dohaljevan’ women – and their mothers-in-law – are now advised on a balanced food for lactating mothers, and the best weaning practices.
Somewhere down the line the Samiti’s team became aware of another roadblock – the tough living conditions in these parts that forced women and girls to neglect themselves. “Women have to make several trips to a distant water source each day, each trip taking 30 to 45 minutes. They also work as labourers, leaving their babies in the care of older siblings and grandmothers. Even if the mother wants to feed her child better, where is the time?” observes Sarita Bangare, an anganwadi worker from the local community.
This led to a conversation involving men in women’s work. In a traditional society how could the men be convinced that they must do their share of household chores? A fun, non-pedantic way to answer that question was found. “We organise races where men run with water filled pots on their heads. The fun-filled events are intended to encourage menfolk to help women fetch water,” says Karandikar, reporting that several men have now overcome their fear of ridicule and have begun helping in water collection.
Karandikar finds satisfaction in these small but perceptible changes. The Samiti’s involvement with local people is a work in progress, and every opportunity for communication is explored: There is a library for women, and a ‘pustak handi’ is put up on the occasion of Krishna Janmashtami, where children are presented with books – both initiatives intended to expand horizons through reading.
These days Karandikar spends a week every month at the squat one-storey Samiti centre in Kashele village, a nodal point for monitoring and organising its wide ranging activities that cover 187 villages. “People are resistant to new ideas, especially if they come from unfamiliar people. They become receptive only when trust is established, when they consider us one of their own,” he says.
Karandikar has many reminiscences to share, “We often came across children with severe health problems. There was a small girl who had cataract in both eyes, and her parents had no idea that her condition was curable.” The Samiti made arrangements for her operation and she regained her eyesight. Interventions like this, Karandikar believes, establishes goodwill and makes people more receptive to exhortations on nutrition.
It’s been nine years since the Samiti came here and Karjat is changing fast. “While there are no malnutrition related deaths among children anymore, the incidence of malnutrition among them has also come down to 30-40 cases, most of them in the moderate Grade Two category. Improved incomes and government food supplementation schemes have contributed to this positive development,” says Dr Phadke.
The Samiti’s work has won commendation from the Maharashtra government, and it has been invited to expand its efforts to even more severely affected areas like Nandurbar district and the Wada tehsil of Thane district. It seems little Karjat can show mighty Mumbai a thing or two about delivering well-being to the poorest of the poor.