by Aleesha Joykutty
‘Hike vaa’ (come here) said my friend in the wee hours of a cold February morning as I was waking up. ‘Johar’ (namaste) I replied, cautiously with a smile as I tried to remember the Gondi language we were trying to learn last night.
It was a much awaited village visit day for us at NIRMAN camp in Gadchiroli, Maharashtra. We were assigned to Jepra village, one of the largest villages with a population of 3000 in Gadchiroli taluka. It was 9km away from the main Gadchiroli city and far, far, away from my home in Mumbai ( 890km).
We were assigned the task of finding the problems faced by the villagers and bringing solutions for it. We were greeted by the village scenery- hens perching the soil, buffaloes & cows moving in herds driven by farmers, children building mud castles, women fetching water from wells and carrying matkas on their heads.
A panchayat member proudly introduced us to his village and also gave us map directions. Majority of the population were non-tribal(OBCs). There were 2 schools, 3 anganwadis and 1 PHU (Primary Health Unit). Farming and labor were the major occupations. People shifted to labor as farming is seasonal. Majority remained unemployed for most months. Also, the educated youth resorted to farming due to unemployment.
The Zilla Parishad school was filled with students from class 1st to 7th. The school structure and surroundings were beautiful. There were potted plantings painted with themes- ‘each one plant one’, ‘Adopt a tree’, etc. Quotes of great leaders, multiplication tables, and the national anthem were also painted on the walls. There was the fragrance of flowers spread all over the place. “Good morning teacher, Namaste ”, all children sang in unison with smiling faces as we entered a 3rd standard class, obviously we were mistaken for teachers! “Kona konala doctor banaycha ahe? “, all hands were raised up. ” Ani teacher? “, all of them raised their hands once again. Such was their happiness, curious lives who wanted to do and achieve everything in life. These tiny tots bade us goodbye by merrily singing a Marathi poem. The main problem we found was the unpunctuality and absenteeism of government school teachers. But still the children came to school because they were provided with midday meals.
“The more that you read, the more things you will know, the more that you think, the more places you will go.”
As we walked further, we saw a piece of decorative pillar in front of a house. It was a ‘Mundha’ in front of ‘ghotul’- a youth dormitory system of Madia Gond culture where unmarried boys & girls assemble in the evening and play, mix, dance, and sing till late evening. A Mundha is carved by the groom after he is engaged and is kept in front of ghotul during his marriage ceremony, perhaps the best example of skill in wood carving. Jepra was earlier inhabited by the Madia Gonds, an Indian ethnic group that speaks the Gondi language. They have now spread over the other areas of Gadchiroli and Chhattisgarh. Gonds ruled Gondwana between the 13th and 19th century AD. The Maratha power swept into Gondland in the 1740s and overthrew them. The Madias today are more progressed & are doctors, teachers, government employees, and some are Naxalites.
“You are at a village and in this calm environment, one starts to hear an echo.. “
We entered a kutcha house made of bricks with unpainted walls and floors cleaned with cow dung. We saw an old Aaji lying on bed, alone. There was clouding of her eye lens. She had cataract, restricting the amount of light that reaches the retina leading to a decrease in vision. It developed slowly over the course of years. In India, more than 1 million cases are diagnosed per year. When asked why she did not get it treated, she had her own reasons (explanations), “I could manage daily work, Cataract is not mature enough, there is enough time for surgery, there is none to accompany me in old age….. “ We told her the bitter truth that without treatment cataract can lead to complete blindness. She felt herself hushed. We advised her with our med school knowledge to wear sunglasses, eat a diet high in fruits & vegetables and to go for medical check-ups. The National Program for Control of Blindness ( January 2010) targets to conduct 600 surgeries per 100, 000 people over 3 years to clear the blindness due to cataract. We hoped that she would be treated. Her house also had a mushroom farming room where stacks of hay with sprouting mushrooms were hung in a dark and cold room. It was a very good initiative of women empowerment by the Mahila Bachat Gat.
“We swallow greedily any lie that flatters us, but we sip only little by little at a truth we find better.”
A nuclear family consisting of father, mother, and their son happily welcomed us. The windows of their house were small with inadequate ventilation. Uncovered drainage canal with filthy water ran in front of their house. On examination,the child had a pump in the tonsillar region- he was suffering from tonsillitis (Galvi bimari) and so was absent in anganwadi for one week. The man told us that the Gharkul Yojana (Pradhan Mantri Awas Yojana), launched by the BJP: government to make housing accessible for all sections of society at affordable rates was properly implemented in Jepra. PMAY was launched in 2015 and aims to be completed by 2022. It is a credit linked subsidy scheme where the needy are provided with a home loan interest subsidy on purchase, construction, extension or improvement of their home.
A shauchalay was also built by the ‘Swachh Bharat scheme’, but the family still prefers to go in the open to relieve themselves. Open defecation is the human practice of defecating outside rather than in a toilet. People choose fields, bushes, forests, farms, streets, canals etc. According to UNICEF, India has the highest number of people in the world, about 60 million who openly defecate. The reasons are countless like absence of toilets, uncomfortable and unsafe toilets which are of poor quality with no doors, too many people using 1 toilet, lack of awareness amongst the masses about the associated health problems caused, lack of behavioral change as people prefer to be in nature, are the problems. In the book, “Where India goes: Abandoned toilets, stunted development & costs of caste” by Dianne Loffey & Dean Spears, the author tells about the social stigma attached to this problem. ‘If you built it, they will not go’ is the powerful message as the main hurdle in elimination of open defecation in India is the notion of ritual purity. Rural Indians don’t want to empty the pits or tanks once filled and don’t want to live in proximity to human waste. They don’t use affordable latrines as their pits have to be emptied by hand- a herculean task done by Dalits. They are more concerned about ritual purity than germs. India built 110 million toilets.But do people consider using them?
Gadchiroli is situated in the eastern part of Maharashtra, along the banks of Vainganga river. Surely we have heard of Mumbai floods. But to bring to your notice, when India was celebrating Independence day, the Gadchiroli region was underwater! It is one of the most neglected districts in Maharashtra. More than 200 villagers lost their connectivity with the rest of the world. Last year, it wasn’t the 1st time that such a flood affected Gadchiroli. For the last 2030 years, people have been facing a similar predicament every year. People have been demanding an increase in the height of bridges for a long time, but the government has failed to take any constructive steps towards it. For them, the lives of adivasis are not a priority. Every time the issue of roads and bridges is raised, the government argues that they cannot build bridges as it’s a Naxalite area. It is ironic that the same government, with full police protection, can build and run mining projects by cutting down thousands of hectares of teak forests, although it is being opposed by Naxals.Then how do they provide an excuse to not build better roads and higher bridges under police protection there?
There is a high incidence of sickle cell anemia in the tribal population there. Normal RBCs move easily through the blood vessels carrying oxygen in them. Sickle shaped cells don’t move easily through blood vessels, they clump and block the blood vessels. The blocked vessels can cause pain, serious infections and organ damage. Co-inheritance of sickle gene with Beta- Thalassemia, HbD Punjab and Glucose -6phosphate dehydrogenase deficiency has also been reported. Sickle cell disease among tribal populations is generally milder than among non tribal groups with fewer episodes of painful crisis, infections, acute chest syndrome & need for hospitalization. This is due to the prevalence of alpha thalassemia and higher fetal hemoglobin levels among the tribes. In Maharashtra, the sickle gene is widespread in Vidarbha, Satpura ranges in the North and in some parts of Marathwada. The prevalence of sickle cell carriers in tribes vary between 0 to 35%. The tribal group includes Bhils, Madias, Pawaras, Pardhans and Otkars. It has been estimated that Gadchiroli, Chandrapur, Nagpur, Bhandara, Yavatmal and Nandurbar districts have more than 5000 cases of sickle cell anemia.
In the afternoon, we found teenage high school girls who were on their way from college to home. They were quite happy with the sanitary pads provided by the ASHA workers & regularly used them. Thus it reduced their incidence of getting UTIs. Even in today’s age when several menstrual hygiene products are available, 88% Indian women don’t use the basic form of menstrual protection available in the market. Instead old rags, muds, leaves or anything on which they lay their hands on are used to collect blood. Using old clothes and other traditional unsafe methods will hamper mobility and day to day activities of women. Around 23 million girls dropout of schools every year at menarche in India. We felt happy that they used proper sanitation.
despite having bus stops, the frequency of buses & bus timings were limited. This leads to economic burden as the villagers then had to use Auto. Also, Jepra village has only an Arts college. The science college was situated in another village. So, only some took science as the transportation facilities added up to their limitations.
Our next destination was to the Primary Health Unit(PHU) at Jepra, a sub center of PHC. The PHU was well equipped with Injection room, BP room, Delivery room, PNC room, male & female ward with majority of them being locked & unused. The BAMS doctor reported to have a shift from 9am to 12am only. The existing medical officer went to Mumbai for training for the past 2 months, told the nurse and there was an attendant who acted as doctor & prescribed medicines without examination. They had to do this, there was no way out, they informed with guilt upon enquiry. The nurse showed us the medicine store room where dozens of saline bottles, injections were kept waiting to be opened. Just then a father-son duo entered. The young boy suffered from seizures sometimes. They took allopathy medicines prescribed by the doctor Saab but also had immense faith in the taantrik too; as after consulting to the taantrik, his symptoms were more cured than after consulting the doctor. We were bewildered and wanted to find out the magic in the hands of the taantrik that people still prefer to go to and we could incorporate those findings in our practice. The villagers are left in a dilemma when a doctor is unavailable. By taking the MO bond seriously, one needs to work at village level and solve their health problems. Also, we need to empower people by sensitizing them about their right to seek healthcare, their right to complain against unavailability of MO & bring ‘Aarogya swaraj’ (health independence). This would decrease the frequency of their travel to major districts for healthcare. It will ensure that the disease is treated at primary level itself before it progresses to severity, thus decreasing both financial & disease burdens simultaneously.
“Village is the cell of the national body and the cell life must be healthy and developed for the national body to be healthy & developed. “ -Shri Aurobindo
The beginning of the day is incomplete in Eastern Maharashtra without eating Kharra. Villagers in Gadchiroli are participating massively in production, sale & consumption of a highly addictive substance locally known as kharra. It is a powdered concoction containing betel nut(supari), tobacco & calcium hydroxide (choona or lime). All ingredients are ground & crushed together & sold in pouches. The name ‘Kharra’ comes from the grounding sound made during the production of the powder. Freshly ground kharra was selling like hot cakes. The heady mixture is known to give the consumer a ‘high’ & is strongly addictive. So strong is the lure of kharra that even women & children haven’t escaped its temptation. The Maharashtra government declared a ban on pan masala & ghutta, but kharra, considered to be more dangerous, remained unbanned. What’s worse is that Nagpur is the oral cancer capital of the world. According to the data, more than one third of the total number of cancer patients suffered from oral or tobacco related cancer. Maharashtra accounts for 10% of total deaths due to tobacco. When we asked them if anyone in the village suffers from any kind of addiction or ‘nasha’, initially people declined as to them addiction is only related to alcohol or other drugs. Kharra is not even considered as a narcotic substance by them. In the late afternoon, we noticed groups of men whiling away their time by playing cards & drinking alcohol. Alcohol addiction is also a major problem in Gadchiroli. The problems should be realized by sensitization of all age groups, conducting de-addiction camps and inter sectoral approach. This would lead to positive outcomes like a healthy environment in houses and increase the employment rate.
Tendu patta or the leaves of Diasporas metaxylon in which tobacco is rolled to make beedis is a crucial source of livelihood for the poor in this impoverished eastern Maharashtra district.In Summer when temperatures touch 45 degree Celsius, it’s the peak earning time for the Madia. Thousands of tribal women and children are engaged in collecting tendu leaves every summer. Women and children get up at 4:30 am in the morning and walk towards the forests near their village. In no time the forests are transformed into a beehive of activity, with small armies of women and children plucking tendu leaves with assembly-line precision. The plucking session ends around 11 am and the women and children walk back balancing the weight of the leaves on their heads. Back in their villages, the women sort out the leaves and tie them up in bundles, squatting for hours inside their huts. They do the bulk of the work; it is they who bear the brunt of the hot sun and the drudgery. The day’s collection of tendu patta is taken to the market or phad at around 4:30 pm and laid out in long, neat rows that stretch for acres in sun-baked fields or dry riverbeds. Men appointed by private contractors count the bundles and record them in their registers for future payments. The names in the register are those of the men. It is the husbands and fathers of the toiling women and children who claim the money. Although the tendu patta season doesn’t last more than two weeks, each healthy family unit can make a significant earning in this time. Tendu patta thus helps the poor earn enough money to survive the two months before the onset of the monsoons.
We also found a saddle nosed woman who’s fingers & toes were disfigured. She was a victim of leprosy. Her husband threw her out of the house when she was diagnosed years ago and she has been living alone since then. The Vainganga belt is known for leprosy cases. Jepra village also had many incidents of Elephantiasis left untreated due to non accessibility of treatment. According to a survey Chandrapur & Gadchiroli regions are the hub of leprosy in Maharashtra state. The prevalence rate of leprosy should be less than 1 per 10,000persons. In Gadchiroli it is an alarming 5.05.
Such was my experience at one of the most neglected, most backward, Red Corridor labeled village in Gadchiroli but still we saw the most satisfactory, most euphoric, most happy dream of Jepra village – a Doctor sitting inside the PHU cabin treating patients, men working hard in the afternoons for their families, children’s with happy faces, Aaji with her clear vision, teachers teaching whole heartedly, not a single farm or forest occupied by squatting villagers in the morning, last but not the least -a kharra & alcohol free Gadchiroli!!!
“Village is a place where you can find peace, unity, strength, inspiration and most importantly a natural and beautiful life. “