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During our visit to these small hamlets scattered across hundreds of miles, the same
recurring stories came to be narrated:
A dismal lack of infrastructure is the common thread running through this myriad of
maladies. Due to lack of proper and motorable roads and very poor frequency in fact
near absence, of public transport, it becomes difficult for these residents to commute
and communicate regarding the daily and basic necessities of life. It is not possible
for parents to take the sick children to a Public Health Center, or for a pregnant
woman in labour with complications to get a specialized medical unit with facilities in
time.
We saw a plea for better Education at pre primary and primary levels by
strengthening the Anganwadis and Primary school in close vicinity of the villages
Immediate appointment of doctors for the posts those are vacant for long. They need
appropriate gynecologists/obstetricians and pediatricians. A large number of maternal
deaths occur due to lack of Trained Obstetricians. Similarly, Neonatal, Infant and
Under-Five deaths related to complications from malnutrition need to be prevented by
having regular trained Pediatricians. Changes in the post graduate admission
procedures, non application of Sixth pay Commission recommendations and pathetic
basic living facilities have forced a large number of doctors to shun this region.
There was a demand to have effective implementation of the EMPLYMENT
GUARANTEE SCHEME (ROJGAR HAMI YOJANA) in the region, and continuation of
the NREGA National Rural Employment Guarantee Act, to maintain the economic
well-being of the villagers.
Due to implementation of The Forest Act, people complained about the authorities of
the Forest Department who do not allow them to use certain roads after evening
hours which hinders them while going for labor work and returning home after work.
A serious and detailed discussion over establishing the Community Rights over forest
rather than Individual Rights (as is being done now) is important to restore a sense of
responsibility in people over safeguarding the environment and using the same
sensibly rather than exploiting it for individual benefit.
The day-long deliberation with the accompanying members of NGOs was very
insightful.
Some of the key issues raised by the NGOs were as follows:
1) With respect to Administrative issues, it appears that the Administration in Melghat
Does not show consistency in execution of programs and schemes, in the area of
health, education and infrastructure.
The authorities lack Standard Operating Procedures.
Administration and Management (both Productive and in response to Emergencies
and Contingencies) is not system driven but rather individual authority centric.
Administrative Appointments in Melghat are taken as punishment postings (in terms
of actual transfers to, living and other conditions of the officers and the uncertain and
often prolonged tenure) and that leads to lack of motivation to do substantial and
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quality work. A case in point is the one illustrated by NGO representatives Mr.
Praveensingh Pardesh (I.A.S) who took keen interest and brought about remarkable
transformation in the situation, but unfortunately his successors did not sustain the
improvement, in fact it has further deteriorated.
2) Implementation of Bachat Gats are in fact leading to a divide within the rural female
population causing them to form smaller groups. This threatens the objectives to keep
the population united.
3) Effective implementation of NREGA, as it will be financially beneficial for the local
population and help reduce the rate of migration, which is one of the causes of
consistently high mortality due to malnutrition and maternal deaths.
During our visit we saw few moderately acute malnourished children (MAM) and one
severely acute malnourished child (SAM).
On interviewing their mothers it showed that they need to go to the farms for their
livelihood abandoning their children, sometimes as early as a month after delivery.
They lacked counseling from a properly trained person from Primary Health Unite
(PHU) to guide them about breast feeding and weaning, nutrition and care of children
with malnutrition and follow-up of those cases till recovery.
On visiting a school in a village of Melghat, it was shocking to note the poor
conditions for storage of food grains and poor attendance, including the teacher. On
the other hand in the same premises, the cooked food (Khichadi and Usal) was ready
to serve about 100 to 125 children, pregnant women and lactating women. We tasted
this and found it satisfactory and pretty hygienic. In fact the remarkable cleanliness in
the kitchens and houses of the villagers had us completely impressed.
On a surprise visit to an Adivasi school in a remote hamlet called Reta Kheda, we
found the condition of the road to be extremely poor and it took us 50 minutes to
cover a distance of 6 km. The school had attendance of few students but the teacher
was absent! The local people seemed reluctant to divulge details.
On interaction with the Government Authorities like Project Officers & District Officers,
it revealed that they have not started the work of EGS- Rozgar Haami Yojana but
assured us that they would start the work as soon as possible.
The Doctors seemed to be doing their best amidst all these difficulties. A Pediatrician
who has been working there for one year was worried, as he has not received any
letter of continuation.
In the past, qualified MBBS doctors used to come and work in Melghat as they had an
assurance of Post Graduation opportunity (in-service candidates program) after
completing their tenure in this region. Now, as the government has stopped this
program, so the MBBS doctors have no motivation in working in the Melghat region.
After visiting these remote villages in Melghat and having a heart to heart interaction
with the local Adivasi community, NGO representatives, Health and other
Administrative Officers, we would like to put the following suggestions to reduce
malnutrition and malnutrition related deaths:
Health and Malnutrition: A. Systematic Planning (SOP based), training of stakeholders and Implementation of
the Government Schemes and projects.
B. There should be trained people (Arogya Doots) to reach and track every Adivasi
house for the following:
Maintaining the Health card of each family.
Monitoring concerns related to health with special attention to adolescent girls,
pregnant women, lactating mothers and children up to the age of 5 years.
Arogya Doot needs to give scientific advice and training on simple household food
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