#1 (22 Sep, 2017)
This is the story of Sahanuj Molla, 2 years and 8 months old, and suffering from malnutrition. Sahanuj belongs to a poor and economically backward family from Kashipur village, Sunderbans (Bishnupur GP, Mandir Bazaar Block, South 24 Parganas). A home visit by health workers by CRY supported project SSDC revealed that the child not only weighed less, but was also malnourished. It was also observed that he was suffering from common cold continuously as well as diarrhoea.
Once identified as a malnourished baby, the SSDC workers kept Sahanuj under special observation. SSDC health workers accompanied his mother when she brought him to the Growth Monitoring session. It was there that it got confirmed that Sahanuj was a Severely Acute Malnourished (SAM) child and so, he was admitted to the Nutritional Rehabilitation Center run by SSDC. His weight at the time of admission was 8.5 kgs, MUAC-12.8 Cm, Height-81 CM and a Z Score of less than 2 SD.
As a corrective measure he was provided an institutional based nutritional care by the trained doctors and staff nurses for about 15 days at NRC. His mother was educated on child nutritional care and feeding practices. She was also taught the food preparation process. When the child was discharged from the NRC, he was already showing positive trends on his nutritional status. After this, the child was provided with clinical follow up several times by the trained doctors and nurses.
With the help of the institutional based care, close follow ups by health workers and his mother’s focus on nutritional food, care and affection, the child has achieved its normal nutritional status gradually. Now, he weighs 9.6 kgs, is 81 cm tall, has a MUAC of 12.8 and a Z score of less than 1SD.
#2 (12 Sep, 2017)
‘Kitchen Garden,’an initiative by CRY for underprivileged children
In a bid to provide fresh and healthy food to children and expectant mothers, anganwadis in remote areas of Gariyaband and Korba district have set up kitchen gardens in their backyards .The aim of this initiative is to address malnutrition in one of the poorest states of India.
India had observed the National Nutrition Week which usually occurs in the first week of September (Sept 1 to 7). Child Rights and You (CRY), a prominent NGO which works for the welfare of children, has implemented a unique initiative called ‘kitchen gardens in Anganwadis’in the state of Chhattisgarh.
The aim of the initiative is to address malnutrition in one of the poorest states of India.
In a bid to provide fresh and healthy food to children and expectant mothers, anganwadis in remote areas of Gariyaband and Korba district have set up kitchen gardens in their backyards. Mostly populated by tribals belonging to the Gor community, the only access to these areas is through unpaved roads.
Kumar Nilendu, General Manager, Development Support, CRY, Western India, said,“We decided to set up kitchen gardens mainly to promote the idea of providing nutritious and fresh food (including local fruits and vegetables) to anganwadi children between the ages of 3 to 6 years.
He added, “We wanted to diversify the food basket so that malnutrition could be combated in one way or the other and hence the idea of having a kitchen garden seemed apt.”
Further elaborating about this innovative concept, Nilendu said , “The experiments resulted in motivating the anganwadi worker to such an extent, that they also started to grow vegetables in their own house land and bring the vegetables to serve the children in anganwadi,” said.
Anganwadis generally purchase and transport vegetables from local markets to prepare mid-day meals which are later fed to the children and expectant mothers.
This unique concept will not only reduce the time spent in the logistics involved but also help in providing fresh produce right in front on one’s eyes.
The work on kitchen gardens began three years ago by CRY and its project partner Lok Aastha Seva Sansthaan (LASS).
LASS has been working in 22 anganwadis in 12 villages across Gariyaband district in areas of malnutrition and education and also in providing complete nutritional diet to children and expecting mothers.
Volunteers working with CRY said that beyond the reward of home-grown produce, gardens not only provide easy access to fresh and nutritious fruits and vegetables, they also help in the health and environmental aspect as well.
The diversified and highly nutritive vegetables and fruits along with native cereals locally grown are affordable and cost effective solution to hidden hunger and malnutrition and is a low cost sustainable approach for reducing malnutrition.
Six anganwadis were selected for the project which started three years back. The NGO wants this model to get replicated elsewhere also.
#3 (04 Sep, 2017)
7 month old Anwesha is the only child of the Halder couple. This family lives in the Mandir Bazar block of South 24 Parganas in West Bengal. Born to fruit seller Ashok Halder and Sutapa Halder, who is a housewife, this child was saved from the typical problems in the social fabric of the area because of timely intervention by the workers of SSDC, a CRY partner.
Most children in this area have suffered from the cultural norms of the district which led to delayed immunization. Populated predominantly by minorities, this district is marked by family ignorance and less importance given to children and pregnant mothers by the family or immediate caregivers and many prevailing superstitions. They refused to think that immunization as a process was at all important. Age old customs and beliefs made them think that these processes were a waste of time, effort and energy. It was the destiny of the child and the family that decided whether it should survive or not.
Since such malpractice came to notice to the CRY partner, the organization has worked extremely hard to facilitate immunization for all women from the early stages of pregnancy. Through various awareness programmes, incessant discussions with every villager, efforts to win the trust of the communities, explaining the benefits of the healthcare processes and being there in times of need helped them overcome the huge barriers set forth by traditions.
Sutapa Halder also received such attention from the workers of SSDC. Joining hands with the Mahila Mandal in the village and the ASHA and AWW, several visits were made to the Halder household to keep her under close surveillance during the ante natal and post natal period. The young pregnant mother was well informed and aware of the immunization schedule through these home visits and her attendance at all the scheduled immunization camps during her pregnancy and post natal period were ensured. The workers would even accompany her to the camps if required. They did not leave any stone unturned to ensure a healthy pregnancy for Sutapa.
In this effort, CRY has partnered with SSDC in the entire process of providing inputs to the organizational staff, in their advocacy efforts with the government service providers as well as in maintaining the necessary data.
Today, it’s a treat to watch little Anwesha grow into a beautiful, healthy and happy baby who has a family that is aware of its rights, responsibilities and the avenues to reach the services entitled to them. As per ICDS standards, she is in the normal grade for her age. This intervention has not only brought health to the mother and the child, but a whole lot of happiness to the entire Halder household.
#4 (29 Aug, 2017)
#5 (22 Aug, 2017)
#6 (14 Aug, 2017)
#7 (10 Aug, 2017)
The red tomatoes at the Anganwadi
This is the story of the three remote hamlets residing on the peripheries of the Bheembandh forests in the Haveli Kharagpur block of Munger, Bihar. These three villages of Motitarhi, Kenduatarhi and Doodhpaniya now sport one ICDS centre catering to 40 children, and two mini ICDS centres catering to 20 children respectively.
“Laal tamatar khayenge, Laal laal ho jayenge, Mummy mera naam likhado, Anganwadi jayenge”
The 40 children in the ICDS centre of Motitarhi will greet you with this song that is aimed to encourage parents to send their children (below 6 years of age) to the Anganwadis. This ICDS centre runs in the verandah of a rented hut. The owner of the house has graciously agreed to even rent the kitchen for the AWC worker and Sevika to cook Mid Day Meals for the children. All three of these ICDS centres have been functional for the past one and a half years. Today, between the three of them, they have been able to cover all the children in the three villages and the parents are now happy with the services children and pregnant mothers receive from the centres.
A few years back, the reality was not so promising. The village had an Anganwadi Centre which was neither accessible, nor operational, and children used to suffer from visible lack of nutrition. It has taken CRY supported project partner Disha Vihar an advocacy effort of more than eight years to get these ICDS centres sanctioned. Umesh Manjhi and Moti Manjhi, residents of Motitarhi, relate how Disha Vihar’s intervention have reactivated the old ICDS Centre and linked the children of the village with it. “Now all our children go to the Anganwadi Centre every day; and Anjali Bahen, the Anganwadi worker, washes their hands properly before they have lunch; and makes sure they have a stomach-full,” said a beaming Moti Manjhi.
Even then, a look at the centres will tell you that they are definitely not ideal. “I try my best,” says Merry Anjali Marandi, the AWC worker, with a half-smile, pointing at the bunch of children, “But there are loads of challenges. We always run short of funds, as the inflow of money is very irregular… moreover, as we don’t have a building of our own, we have to pay Rs. 500 per month, as rent for this shack. We don’t have electricity either.”
We move to the village of Mai, where hundreds of families live on the banks of the Ganges. These families, by virtue of living on the riverbanks are not registered under any government. So the children of this village are unaccounted for. However, the ICDS centre that has been running in this village for the past 11 years has been named as a model ICDS centre by the government.
One look at the centre and you will be forced to wonder why! Cleanliness is hard to find in the area surrounding the centre, which is occupied by buffaloes and other domestic animals.The building is the community centre of the village and the ICDS remains closed any time there is a community programme or meeting. Not only this, but the roof might crash any minute, the floors are in despicable condition, a weighing machine has arrived after two years of constant application and follow up and there is no equipment to measure the height of the children nor their status of malnourishment.
The AWC worker who has been working here for the past 12 years will tell you that it has been extremely challenging to achieve just the feat of ensuring that all the children covered get 100% of the services available. Attached to children, she would love to extend the services to all the children in the village, but her hands are tied.
Having worked with children for more than a decade now, she is aware of the importance of initial years in their growth and development. All she can do is hope that someday all the children of Mai will have the access to all the services that are rightfully theirs.
A sheer contrast is the pink building beside the primary school in Shivnagar. This is the new home of the 11 year old ICDS centre of this village. This ICDS centre is fully functional and not only does it have a pukka building of its own, electricity, a kitchen, its own tubewell and a toilet, but also manages to cover all the children in the village. “Take Home Ration" is distributed regularly to pregnant women, and there is provision for Double Ration for SAM children.
But what stands out even here is that, this building has only come up after 9 years of advocacy efforts put in by CRY partner Disha Vihar before which, it was housed in a rented hut like Motitarhi. That too, after concerted efforts from the community to give up the space adjacent to the school building.
When Disha Vihar had begun working in Munger, several anganwadis did not have their own buildings and were functioning from rented spaces. The parents and the community lacked the knowledge on preventive measures. Discrimination on the basis of gender was also rampant. So were the existence of several superstitious beliefs regarding pregnancy, birth and healthcare practices for children. Diligent efforts and continuous advocacy by the organisation and CRY have resulted in making inroads into the community, changing their beliefs and spreading awareness about the importance of care during pregnancy and childbirth for the mother, and the initial years in the child’s life.
Today, a lot of new ICDS centres have been sanctioned in the state and the villages of Haveli Kharagpur are definitely benefitting from it. Needless to say, however, the pace is extremely slow, and poses the question as to whether all the children will ever be covered by the Integrated Child Development Scheme.
Thankfully, though the challenges are many, the efforts continue to be indomitable.
#8 (07 Aug, 2017)
#9 (03 Aug, 2017)
The moment you enquire about the Anganwadi in the Pokhardiha, the villagers start talking about Meena. Meena who almostdied... Meena, who was going to be buried by her family because she was born so frail and weak that they couldn’t feel her pulse. To her family, based out of thishamlet in the remote corners of Jharkhand, the only logical solution was tobury her body. Until this news reached Lilabai, the Anganwadi worker. Lilabaiis said to have rushed to the family, revived the child and brought her back tolife.
She taught the new mother how to take care ofthe little one and kept a routine check to make sure she started growing uphealthy. From pre natal and post natal care to keeping a track of the health condition of every child in the village, Lila doesn’t let the ball drop when it comes to her work. She makes home visits to every household that has a child.
Lila is one of those thousands of Anganwadi workers in our country who get meagre amounts as honorarium and are certainly not obliged to work beyond their duty hours or what they are entitled do. But they do.
No different from her is Mirabai Devi, living a little further away in a village called Dhab. She underwent a training conducted by Rashtriya Jharkhand Seva Sansthan, a project supported by CRY –Child Rights and You where she came to know she came to know that the food that can be afforded with the budget that the Government has allocated for the hot cooked meals in the Anganwadis does not manage to give our children the nutrition they deserve.
She mobilised every mother in her village to help her build a kitchen garden behind the Anganwadi Bhavan. This kitchengarden grows nutritious vegetables to add to the diet of the children andsupplements their nutrition.
It has also managed to build a group of mothers– a Mata Samiti – who do everything from ensuring that every pregnant woman enrols herself to the Anganwadi, to tending to the kitchen garden, to sending every child to the Anganwadi everyday and stepping in when the worker is unwell.
The toughest journey was probably the one traversed by Pinky Birhor, the Anganwadi worker serving the Birhor community.The Birhors are an extremely closed community. They are a hunting and gathering society who were, till very recently considered untouchables.
One of her major challenges, working with such apopulation, was to get the children to the Anganwadi. The concept ofcleanliness and hygiene was absent from this community as a whole.
Hence for her, the biggest breakthrough was to convince parents to bathe the children every day and get them to wash their hands before their meals.
She also took vigorous training from the NGO,and now not only ensures 100% coverage of the children and pregnant and lactating mothers in the community, delivers all six services to the best of her abilities, but also constantly looks to upgrade her skills as a worker.
The question that arises is why would these ladies go the extra mile to ensure that the Anganwadi delivers the services to the best of its ability. The answer to that, is simple.
They know, through untiring efforts made by CRY supported project Rashtriya Jharkhand Seva Sansthan, that it is the first six years that creates the foundation for a healthy life.
In India, only 50% of pregnant women receive complete Antenatal care and 1 million infants die before they can reach their first birthday (Source Census 2011).
It’s time we looked at strengthening our Anganwadis, because clearly, they can make a difference. A huge one at that!
#10 (31 Jul, 2017)
#11 (18 Jul, 2017)
45% Of Child Mortality Can Be Attributed To Malnutrition, And It's An Emergency
As we celebrated World Health Day this year, it is imperative to think back on the many reports we continue to see on children's deaths due to malnutrition.
Whether it is a hamlet in Palghar district of Maharashtra or a one-room tenement nestled deep within the bylanes of a slum in Mumbai, the alarming problem of malnutrition looms large. Like the 15-day-old baby boy born to Seema, a young mother living in the slums of Shivaji Nagar in Mankhurd—weak and weighing a mere 1.3kg and in an incubator for 21 days. The baby survived because of the intervention of a CRY-supported programme but millions of infants are not so lucky.
Sadly, nearly 45% of child deaths can be attributed to various forms of malnutrition; in India about 50% of deaths in children under 5 are related to malnutrition. Which is why it is time we introspect on the reasons as to why we are still unable to curb this menace, once and for all.
Wasting (low weight by height), stunting (low height for age) and underweight (low weight for age) are the three aspects of malnutrition which affect children both in rural and urban India.
Wasting is the result of acute undernutrition resulting from inadequate intake of food and frequent infections, usually seen in the context of poverty and poor hygiene and sanitation. Around 21% of all children under 5 years of age suffer from wasting in India.
It is imperative here to note the fact that the situation with regards to wasting is "critical" in Mumbai (equal to or more then 15% wasting levels in children are considered to be critical)
NHFS 4 data for Maharashtra reveals that:
- 34.4% children under five yrs are stunted (height for age)
- 25.6 % children under five are wasted (weight for height)
- 36% children under 5 yrs are underweight (weight for age)
- Only 56.3 % children (12-23 months) are fully immunised.
- This situation calls for collective efforts involving all the stakeholders to reduce severe acute malnutrition with particular reference to wasting in Mumbai.
CRY's experience provides insight that this is possible to do if the below mentioned aspects are really focused on:
- 1. Convergence between key departments like MCGM, Health and WCD (ICDS services).
- 2. Rigorous capacity building of the community improves uptakes of ICDS and MCGM services.
- 3. Changes in health choices and practices through focused, repetitive and tailored health messaging, building referral linkages, positive role modelling, use of BCC materials and iterative learning.
Adequate investments in terms of increased budgetary allocations for nutrition and health facilities for mother and child should be the key priority of the government.
Investing in children early on ensures critical growth and development at an individual level and also has a larger effect on economic growth.
Let us pledge to give good health to our children and that can happen only with our serious efforts and concern.