I had read about vicious cycle on undernourishment as one of my first research papers for my literature review during my PhD. Never did I know then that I would be back to a village where I would actually come across not one but many families specially women suffering from the condition.
One of my earliest observations during my visits to the villages is the stunted growth of the children (mostly girls).Recalling my most used diagram during my thesis, I decided to check the records of the hemoglobin levels of some of the women.
A severe case of malnourishment
To my dismay many of the women never had hemoglobin levels checked even during pregnancy (even when the government has put a place an extensive system of ASHA and ANMs to look after maternal health during pregnancy and lactating period). This obviously means adolescents girls and other women wouldn’t have ever known about these tests.
The first thing we did in 4 villages in Silora block is to conduct health check-ups for adolescent girls and women. Out of 200 girls and women who came for the check-up in the past 4 months, more than 70% of them were anemic. Haemglobin level 6-8 was so common that I had started considering 9 gm/dL as normal (the normal being 12-15 gm/dL). Also more that 70% were underweight and malnourished. I was pained to find out many 3rd trimester pregnancy with 6 gm/dL which can be life threatening to both the mother and the baby.
Simple Hemoglobin test using color matching in Chota Narena
Medical camp in Junda
The Impact: These mobile health camps have been instrumental in changing the behavior of these women towards their own health. The women have started noting down / remembering their weight and Hb. Many of them even got their relatives from near by villages for the check-up. It has enabled us to understand the severity of the matter and we could sense the urgency of a nutritional intervention for the right target population “the girls and the women”
Medical camp at Chirr
The next challenge: The obvious next step was to spread awareness among the girls and women the importance of a good balanced and nutritious diet. This was met with numerous challenges. There is minimal diversification of food and food is overcooked to taste the palate. The monetary factor also plays one of the most decisive role . Most families in order to save money live on roti and chillies. There is a need of a local product which is not very expensive, easily available and suit the taste buds of the local people.
What I find disappointing is the way how we look at the health status in our country is through mortality rates. Hardly any emphasize is given on quality of life and reduction of morbidity. This is exactly why we are missing out on implementing strategies for a healthy childhood, adolescence and leading to a healthy motherhood.
In the next blog post, we will discuss the nutritional supplement we have been working on and its role in alleviating anemia in rural girls and women enabling them to lead a healthy life