Children - Terre des Hommes

121
Status of Anganwadi Centres and
Children’s Health
As part of our study, we enquired about the status of child
protection institutions like anganwadis and primary schools.
Not all villages are covered by the anganwadi centres. In some
places we were told that there were only mini-anganwadis
which is almost equal to not having an anganwadi. For
example, Burkhundwah village does not have an anganwadi but
is covered by the anganwadi in Potanga village. The anganwadi
worker stated that she has 125 children in her register although
the capacity of the anganwadi is only 40 children. Obviously
only children from Potanga village access it as infants and
little children cannot come to the main centre. Although the
record shows only five children as being malnourished, the
worker admitted that majority of the children she visits are
malnourished. As the anganwadi has no infrastructure, the
anganwadi worker is running it from her house. Only 20–25
children attend the anganwadi regularly as most of the children
are taken to the mine site by their parents.
expressed concern over the fact that most of the women
are malnourished and the likelihood of complications in
deliveries, infant mortality and children being born with
low birth weight, complications after delivery and ill-health
during the first year of birth are high due to this. Besides,
the condition of the roads is so bad with pot-holes made
by the constant movement of trucks that it is dangerous for
pregnant women to travel by these roads.
In Potanga village, the discussion with the anganwadi worker
revealed the terrible health condition of the children. Of the
40 children who are enrolled in the centre (which still does not
have any infrastructure and activities are conducted under a
tree), five are absolutely (grade IV) malnourished, and 15 come
under the Grade II and III categories of malnourishment. Of
the seven births recorded in the current year, only two have
been institutional deliveries.
The anganwadi worker stated that the main health problems
of the children were skin diseases, malaria and TB but there
is no medical facility, hence a lot of dependence is on local
healers whose traditional knowledge is also getting diluted
by external influences, and people said they were not totally
confident in these healing practices.
The ANM of Jarjara when interviewed shared her health
records with the team. She serves a population of 18,350 which
has 23 anganwadis in all. According to her records, atleast 20
per cent of the reported cases of TB come directly from people
working in mining activities and this has impacts on children.
Not only adults, children are also very malnourished, with
absolute malnutrition cases among children reported by her
being 500–700, and among children between the ages of 3
and 6 years, she has reported more than 1,000 cases. There
is no PHC in the vicinity and the anganwadi worker stated
that the ANMs and health personnel do not regularly visit
the anganwadi to conduct health check-up for the children.
The poor conditions of the roads due to mining trucks and
lack of public transport to this area serves as an excuse for the
health personnel not to visit the villages.
The local communities do not have access to any of the CCL
hospitals but have to mainly depend on private practitioners
in the town. Due to the difficult geographical terrain and
lack of access to transport, very few women are able to go
to the PHC for institutional deliveries. The worker also
Displaced women, with children at their side, scavenging for coal, the only
source of livelihood today, Hazaribagh (Photo September 2009)
Three to five cases of TB have been identified recently in
Burkhundwah village and the people attributed this to the
mining activity of CCL. The women in this village complained
that alcoholism has become a serious problem after mining
started and said that 80 per cent of the income is spent on
alcohol by the men. Because of this the women said that they
have to work harder to make a living and therefore, are unable
to find the time and stamina to take care of their children.
They also stated that because the men do not share their
majority earnings at home, they are unable to cope with the
rise in prices of food commodities and are not able to maintain
even a basic diet for their children.
The CCL officials denied that there are any cases of TB or
silicosis among mine workers, whether permanent or casual,
and said that the company was taking precautions to prevent
these diseases. They attributed the health problems to
consumption of alcohol by the workers.