malnutrition-a growing problem among tribals

Malnutrition is a major health challenge among tribal children across Maharashtra. There are several reasons that have contributed to malnutrition. The most common reason being, poverty. It is true that poverty plays havoc in almost every social developmental sphere in the society. But this does not imply that poverty is the only root cause of every health hazards or development !

There are many questions that arises on poverty, like, what is poverty and how can one overcome unfortunate circumstances ? Which forces strongly influence the people to remain in dire misery? such questions may lead to a serious debate, but poverty is not the sole reason of malnutrition among tribal children.

Regular monitoring of weight of a growing child, providing proper nutrition and immunization, educating mother for child’s illness and it’s consequences, intimate dialogue with mother and home base management of a ill child are a few simple and primary steps that can be taken in to consideration while dealing with the children who are more prone to malnutrition. This could help to change considerably the raising scenario of malnutrition cases among tribal children.

Recently a survey for malnutrition between 0 to 6 age group of children had been conducted by primary health centers ( PHC) and department of integrated child development schemes ( ICDS) Mahad of Raigad district. It was an innovative effort to bring all undetected and hidden malnourished children on the record. One hundred and sixty three cases were brought under treatment from the effect of 16th september 2006. Twenty four cases were of a grade 4 category.

On 13th of september a girl child of a grade 4 category, Pinky Barku Jadhav 3 year from a tribal hamlet of Veer village, had been hospitalized in rural hospital at Mahad. She was also suffering from malaria and a mild dysentery according to the hospital sources. Pinky was discharged from the hospital on 16th of september and had been sent to home after she was examined in a camp jointly organized by ICDS and PHC of that area. Unfortunately, Pinky was succumbed to her illness on 28th september 2006.

From september 17th to 28th not a single follow up was made by any health worker or doctor of primary health center of that area to supervise or monitor the status of the deteriorating health of the child. It was observed that no one seemed to have claimed the responsibility of a poor tribal child who had died of malnutrition merely due to the negligence of medical care and timely treatment.

When Pinky was admitted in rural hospital at Mahad, the doctor on duty said that the child need intensive care under the guidance of a pediatrician and since there is no post of pediatrician in rural hospital, Mahad. “The child need to have shifted to district civil hospital (Alibag) or Mumbai for further treatment” he added. Meanwhile the doctor at Dasgaon primary health center (the hamlet of deceased child comes under this PHC) has whisked off his responsibility and vemently said that the four grade malnourished child should not be treated at primary health center level, he or she should be referred to rural hospital at taluka level.
Rural hospital of Mahad has no such facilities to cater treatment to malnourished children ( specially for grade 4) . Then, what is the sense of referring cases to rural hospital where even basic facilities could not meet the need of a patients? Is it possible for a tribal daily wager to go to Mumbai to get treated his or her dying child? Even this hospital could not provide any transportation facilities to shift the seriously ill child to district civil hospital (Alibag) or Mumbai hospital.

According to Article 39(f) of directive principles of state policy it is the duty of the state to provide opportunities and facilities to develop children in a healthy manner. Is it not right to health a human right? Article 25(1) of the universal declaration of human rights 1948 assures that every one has the right to a standard of living adequate for the health and well being of himself and his family including medical care and necessary social services and the right to security in the event of sickness, disability, old age etc. Right to life is a fundamental right under Article 21 of the constitution.

Health care does not mean mere medical treatment during illness. It means to do whatever medically possible to promote the physical, mental and well-being of the patient. More than rich it is the poor patient who needs such care. They suffer from diseases which are mainly due to lack of health care services of our government run hospitals, basically in rural area (of the state)

The objective of the child survival and safe motherhood (August 1992) program is to improve the health status of women and children and to reduce maternal and child mortality rates. The Jeeja Mata Mission is another program specially designed for mother and children suffering from malnutrition. In these two program, prevention of child mortality is obligatory. These program addresses the major causes of mortality in children that are preventable by available cost effective intervention. Balwadi Sevika records the weight as per her routine duty in a register with the guidelines of child’s weight growth charts in order to monitor the growth or loss of weight of each child that helps to prevent the malnutrition cases. If she fails to maintain accurate weight record, a poor and innocent children could be victimized simply due to negligence.
Children suffering from malnutrition, has been classified into four grades, the third and the fourth grades children are categorized as risk group and those children need more nutritive , care, regular medical check up. Health education and follow up is key to curb the problem. If regularities and consistencies in weighing the child is not maintained, then gain or loss or steadiness in weight of a child could be misinterpreted which may lead to death!

S. P. NAVKAR
Freelance Journalist & Social Worker
9422690658

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