7, March 2010
By Swati Shinde
Pune, India
Poor Health Of Young Mothers, Lack Of Medical Facilities Among Causes
These are the findings of a recent survey carried out by city–based non–governmental organisation Masum and Shramjivi Janata Sahayak Mandal (SJSM), Satara, in different wadis at the Mahad–Poladpur talukas in Raigad district.
Other than the high child mortality rate, the study also reveals that all deliveries are handled by traditional birth attendants even today, since there is not a single hospital located in the region. Interestingly, this area falls very close to the Pune–Mumbai expressway.
Speaking to TOI, founder and chairperson of the SJSM Bal Kolekar said, “This survey proves that the health care of the Katkaris has not improved, despite the so–called progress of our society over the last thirty–odd years. The maternal mortality rate, infant mortality rate and child mortality rates are very high here.”
Kolekar fears that if this situation continues, “then there is a clear danger that the present Katkari community will enter a phase of declining population.”
The reasons found to be behind the current pitiful state of the Katkari women here are basic anaemic conditions during pregnancy and motherhood; hunger and malnutrition of women and children; prevalence of non–institutional deliveries and insufficient care during pregnancy; insufficient access to primary health centres; auxiliary nurses and midwives (ANM) and anganwadis; lack of awareness regarding health issues and prevalence of untrained traditional birth attendants (TBAs).
Ramesh Awasthi, founder trustee of Masum, said, “The sorry condition of this tribe can be attributed to social customs, like child marriage and pregnancy immediately after marriage. Girls in this region get married by the time they are nine or ten years old. Usually, by the time a girl turn 12, she gets pregnant. The tender age coupled with poor health prevents the first child from surviving. We observed that four children survive and two die. The surviving children mostly suffer from under–nourishment.”
According to this study, reported causes of death of infants were low weight at birth, fever, pneumonia, measles/mumps, diarrhoea and a few cases of tetanus.
Meanwhile, the SJSM intends to undertake a project for the Katkari community keeping two objectives in mind — improving livelihood means of the Katkaris and development of health care. Its one–year–long pilot phase will be conducted in Mahad and Poladpur, for which considerable ground work has already been done. In these two talukas, the SJSM has not only put a project infrastructure in place, but created a network of more than 100 self–help groups of women (both tribal and non–tribal), five tribal co–operative societies and a cadre of tribal youth volunteers.
Kolekar said, “We will undertake a comprehensive health project in these two talukas, principally aimed at improving the health of women and children. Our current experience with various health projects has shown that this is not only essential but also achievable.”
The Findings
- One third of all children born die either as infants or in their early childhood
- Out of 139 women surveyed, about 121 women have lost a minimum of one or more children, 55 women have lost two or more children, while 19 women lost three or more children
- 41 women (30%) had one or more still births or perinatal death (during delivery)
- Causes of death as reported were low weight at birth, fever, pneumonia, measles/ mumps, diarrhoea and a few cases of tetanus
- Anaemic condition among Katkari women during pregnancy and motherhood
- Hunger and malnutrition of women and children
- Prevalence of non–institutional deliveries and insufficient care during pregnancy and antenatal stage
- Insufficient access to primary health centres and anganwadis
- Lack of awareness regarding health issues and prevalence of untrained traditional birth attendants
- Social customs like child marriage and pregnancy immediately after marriage.
The Katkari tribe mainly resides in Thane and Raigad districts of the state. The members were designated as a primitive tribal group by the Government of India in 1975–76, on the basis of pre–agricultural level of technology, very low literacy and declining/stagnant population. The total population of the tribe in the state is about 2,25,000. While it is the seventh largest tribal group in the state, it is also the most deprived and threatened. The vulnerable condition of Katkaris has come about because they are semi–nomadic and landless workers, in search of livelihoods. Traditionally, they manufactured Kath (Catechu) from the Khaire tree (Acacia catechu). Prior to the British rule, they were independent forest workers making Kath at their will, but following the contractor system in forest extraction, they were reduced to wage labourers bonded to exploitative contractors. After catechumaking deteriorated here, they shifted to making charcoal. When charcoal making was banned in 1985, the Katkaris found their livelihoods as brick kiln labourers and this has been their mainstay since then.
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