This looked like a data anomaly when we looked at the temporal pattern of malnutrition in Dharni tribal sub-division in Amravati district of Maharashtra. A spike in April in the number of children with severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) surprised us. Common sense nutrition talk dictates that the peak should be during the monsoon when diarrhea takes over, or in the winter when hypothermia is the devil for kids. We double-checked our data and went back to previous years – this only confirmed our conclusions. Every year, for at least the past three years, the numbers had peaked in April. And it was not a small spike. The numbers suddenly increased by more than five times, with two tribal blocks having more SAM and MAM children than the rest of the 12 blocks combined. The numbers continued to decline steadily throughout the year before peaking again in April.
What was happening? After some discussion, we realized that several families return to Dharni from places of migration in March for Holi (the biggest festival here), then return to fulfill contracts, only to return “permanently” in the kharif season when cultivation begins ( the low). was a smaller peak in June). Our subsequent research found a more direct correlation in Nandurbar, a tribal district in Maharashtra, where a 2018 UNICEF study followed the same cohort of children, before and after migration. The number of SAMs quadrupled, MAMs also doubled – at least half of the children migrated. Given the geographical complications of migration as well as the lack of data, such studies have been few.
Migration has become the buzzword during the Covid pandemic in cities. However, the rural exodus has been going on for years. In the tribal areas in particular – due to lack of industry, problems with forest rights or its enforcement, and lack of irrigation facilities – migration takes six to eight months a year.
The first question I asked myself was if people stay somewhere else for more than six months, isn’t that place just as much their home? Multiple government programs – to boost education, health, connectivity, water supply, electricity – assume that people will stay in the villages to reap the rewards of what this capital and this operation are going to sow. This assumption falls flat in areas of high migration and understanding of an inter-relationship between long-term nutrition, migration and livelihoods (including, importantly, MGNREGS) goes awry.
We decided to work on our findings last year and asked some questions: Where were people migrating the most from? How many? What were the densest places of immigration? We got answers, but they seemed vague. It turned out that in our nutrition surveys, the lack of data on migration inflated the denominator (number of children measured), particularly because new births kept adding to it, leading to data that did not accurately reflect the situation. As we were in the middle of migration season, we decided to meet these migrant families.
Three things that changed everything I ever understood about migration came from field trips. The most distinct memory I have is of an interaction with a brick kiln owner who shook his head when I asked him “Kitne bacche honge idhar (how many kids are here?)”. He said “Ham bacche nahi ginte kyunki voh idhar kaam nahi karte (we don’t count children because they don’t work here).” It’s no wonder, then, that there was an unseen set of people – especially pregnant/nursing women and children – who were of no “use” here. We met many families. Confronting our own biases was also important. We think migration is a bad thing, but several families here had a guaranteed salary – the word ‘guaranteed’ being particularly important as many people told us they would be happy not to work here if they were reassured that MGNREGS would work there.
The second learning occurred when we met a nine-month-old child who was due for the MMR vaccine but did not receive the dose because he was not due to do so at home, and at the time where he would return, he would have missed this. Our hypothesis is that this six to eight month period must leave many children and pregnant women unvaccinated. This is not due to lack of health or nutrition infrastructure or indifference – it is due to a lack of knowledge about the presence of these beneficiaries. Most of these brick kilns are about 1-2 km outside the villages and until there is information on a government contact it is difficult for the giver and receiver to enter in touch.
Portability as a concept is not new. But my third lesson is that we need to start thinking about a system that is not entirely demand driven. Our questions — do you take rations from stores? Do you take your children to the anganwadis? — received a negative response. It didn’t surprise me. A Korku tribal population migrating in distress in a predominantly Marathi belt: think of the bargaining power, especially of women and children. It doesn’t take much to join the dots.
Our learnings led us to start working on a migration tracking system as well as to strengthen MGNREGS. But these interrelationships need to be explored, especially in tribal areas, which constitute a higher density of malnutrition. SAM and MAM are the tip of the iceberg when it comes to nutrition. A long-term reduction in stunting and underweight and improved health will require that we understand the interplay between nutrition, livelihoods and poverty. A plan that focuses on targeting and triaging the most vulnerable – a strategy that keeps them at the center without silos – may well be what we need to take a step forward in improving people’s well-being.
The author is an IAS officer from the 2017 batch of the Maharashtra cadre. Views are personal
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