a new initiative

In a remote part of Salumber block in rural Udaipur district, something new, but important, is happening. Two small clinics have opened, which are staffed by nurses round the clock, and visited by a doctor once or twice a week. Basic laboratory tests are also done here. The premise of these Amrit clinics (as they are called) is that access both in terms of cost and distance are huge barriers to health care, and therefore if low cost good care is provided close to the people, they will utilise the services. Charges are Rs. 50 per visit, good for a week of repeat visits, for any complaint, no matter whether it is trivial or serious.
This is coming true with a vengeance. The clinics have run now for barely three months, but have a busy time serving a range of sick patients. Diabetic keto-acidosis (caused by too much sugar in the blood), advanced leprosy and tuberculosis, cancers, hypertensive patients, severely anaemic adults and children - these are just some of the patients who are seen here. The very large number of previously treated TB patients (or those who have discontinued treatment half-way) is worrying. Antenatal clinics are held in the periphery on a fixed routine, and pregnant women are seen at the clinics as well. Having women nurses at the clinic has encouraged women to come forward with gynaecological complaints that had gone unreported earlier.
Much of the work of the initiative revolves round linking up the patients with the Government health system to access drugs and facilities as much as possible.

Malnourished child with pneumonia brought to the clinic by his father. Father washes dishes in a hotel in Baroda.

Swasthya Kirans (health workers) learn how to plot weights on a growth chart

The initiative also trains illiterate women health workers to do growth monitoring, recognise growth faltering, and also about young child nutrition. They follow up the children in their village and hold women's meetings where cooking demonstration is done about the type and consistency of food that must be given to little children.

Most of the villages served are inhabited by Meena tribals, where the men have migrated to Gujarat to work. Women left behind to head the household and do all the work in the fields and in the home and to labour, have little time left to look after their young children. Consequently, high malnutrition rates are the norm. Adults have a low BMI (body mass index) as well, signifying undernutrition.

Hasdeo river

view upstream from the bango dam on the hasdeo river, on the way from bilaspur to ambikapur, end of april this year.

priti and muskaan

The sisters, two years after joining the hostel at Karangabahla in Chhattisgarh.
Here is an earlier picture of them.

tendu fruit stall

on the way to ambikapur last month, we came across this fruit stall in the middle of the forest, just before Chaitma.

Fruit stall in the forest - tendu and papaya

 
the small yellow tendu fruit are delicious to eat, difficult to find in the towns now, and taste a bit like chikus. a very fibrous fruit, the fibres are arranged very artfully inside the crusty skin.

we got a handsome amount for ten rupees, and gorged on them till we were full.

The fibres of the tendu fruit after removing the skin

news of an execution

yesterday morning i read on the internet about an execution. it was a long-awaited event by many in our country, and greeted with a range of emotions, ranging from a sense of satisfaction of justice finally having been done, to a sense of glee. we had proved that we are not a "soft" state, after all. 

but i have a sense of disquiet. given the judgement and verdict in the highest court of the land, which said that though the evidence against the accused is only circumstantial, given the nature of the crime, the collective conscience of society would only be satisfied if capital punishment is awarded to the offender. is this any basis to take someone's life? arundhati roy states it more clearly here.

in addition, what worries me is the manner in which the execution was carried out. after years of delaying a decision on the mercy petition, and keeping the convicted man on death row (which amounts to torture, according to the same highest court in our country), it is rejected, the family is given no time to come and meet him one last time, and now they are denied the body for burial. is there no dignity in death for a person killed by the state? does his family have no rights at all? - they are all innocent victims of the whole process. one of the righteous on TV argued yesterday that since he did not think of the families of the victims when he attacked Parliament (he was not one of the attackers, incidentally), his family does not deserve any such consideration in turn. but is that a reason for the state not to be humane? where are we headed as a nation?

Birds in the backyard

A peahen and a grey hornbill seen this morning in the woods behind our house in Bhopal.

not poor?

Kalibai, pregnant for the third time, weighs 35 kg at term. A resident of Manpur village of Udaipur district in Rajasthan, she is among the many women in this region whose husbands migrate to Gujarat to work. These women headed households survive on remittances sent back by the men. Living on a diet mainly of cereal (rotis of wheat or maize), with little pulses and oil, and almost no vegetables, it is no wonder that Kalibai is severely malnourished. A lone buffalo provides a liter of milk daily, which suffices for tea and for the children to drink in her joint family of five (eight when the men are back home). She gets to drink one small cup of milk daily as she is pregnant. Yet with her husband sending back nearly Rs. 3000 per month, the Planning Commission would probably consider her family one of the privileged rich of our country, as they get to survive on more than Rs. 26 per capita per day.