By Diana Coulter
KHUNTI, India 21 August 2010 – Bilkani Sangha shakes her head in amazement when she recalls how she first fed her newborn baby. Gesturing with jangling bangles, she remembers dipping a cloth into warm goat’s milk mixed with honey and jungle herbs, then slowly dripping the concoction into her tiny child’s mouth.
She wasn’t allowed to breastfeed her son for almost two days until all the “dirty, useless” colostrum could be squeezed from her breasts and discarded. And, as a new mother, she wasn’t given any food to eat for three days, just turmeric water, as she went through “narak upvas” or “hell fasting,” a purification ritual that left her almost too weak to finally start breastfeeding.
If her newborn lost weight, started to “kai” (vomit), or had “paikhana” (diarrhea), then people would have just blamed bad luck, not unsanitary feeding practices, Sangha, 50, recalls.
“Those were the old ways and they were very bad for babies,” she says. Her son, now 25, survived but she knows a number of other children who started downward spirals into severe malnutrition and even death in this manner.
“That’s why I’m happy teaching mothers in my village on how to do things properly. I tell them breastfeeding is the best and only way to feed new babies,” she says.
Thanks to Sangha and about 9,000 other “anganwadi” or female health and childcare workers in villages scattered across the Indian state of Jharkhand, about 1.3 million families are now getting support for proper breastfeeding practices.
This help is possible because of the generous funding of IKEA Social Initiative and its partnership with UNICEF, the state and Indian governments.
Certainly, there is great need. Jharkhand is the poorest state in India. It has the highest number of people living below the poverty line and second highest population of tribal or indigenous people (about 30 per cent). Even today, more than half (54 per cent) of the children younger than three here are malnourished.
In India, rates of acute malnutrition or “wasting” are twice as high as the average in sub-Saharan Africa, and ten times higher than Latin America. Currently, an estimated 25 million children are “wasted” in India, 53 million are underweight and 61 million chronically malnourished. Typically much of this happens in the prenatal and first two years of a child’s life, damaging growth, brain development, eventual school performance and adult productivity. Most of these kids are born to the poorest families.
Meanwhile, Jharkhand is a place of stark contrasts. The state’s name means “tree territory” and its leafy, undulating landscape with massive rock outcrops provides some of the country’s richest mining for iron ore, coal, bauxite and diamonds.
Recently, this disparity between rich and poor has spawned political unrest such that 18 of 24 districts are now considered red zones made dangerous by government dissenters called Naxalites.
The upheaval has made its way to Sangha’s village of Phudi in Khunti district, another red zone, but she tries not to be distracted from her mission.
At the moment, she’s counselling new mother Taramani Devi, 30, with a two-month-old baby girl named Lalita Kumari. The baby is tucked under a fold in Devi’s olive-green sari as she breastfeeds. At times, only the baby’s feet can be seen shaking tiny silver bangles around her ankles. The family is of the indigenous Mahto tribe. Sangha tells Devi to lean back against the hut’s mud-plastered wall and be comfortable. They chat about proper arm positions and the child’s nipple latch.
“Before, women used to just walk around and work while they breastfed,” explains Sangha. “They didn’t think about how the baby was feeding or whether it was enough.”
Because of earlier sessions with Sangha, Devi knew to start breastfeeding within one hour of her baby’s delivery. She also made sure to eat lentils and rice for her own strength and milk production. In this way, the child got “extra protection” from her colostrum, which Sangha told her was akin to the baby’s first immunization.
Gazing at her four-year-old son, Karthik Mahto, who is nibbling nearby on tiny fruit gathered from the jungle, Devi says her second child is already stronger than her first. “Lalita is growing so well because she’s breastfeeding with me from the beginning,” Devi says proudly.
Sangha and Devi’s counselling relationship is one link in an intricate chain of support for women and children that’s extending slowly across India.
In Jharkhand, the program is called Dular, which means care and love. It started a decade ago and has expanded to train networks of volunteer village women, called LRP’s (local resource people), to help community anganwadi workers like Sangha reach out to mothers and families with information on improved feeding and child care. It’s a cycle of assistance that starts with prenatal counseling, moves through birth, breastfeeding and babyhood, and continues until women have their own children.
At present, funding by IKEA Social Initiative is supporting UNICEF and the government through a three-year project, started in 2009, to further extend the program to 22 million Indian children. An essential element will ensure an additional two million newborns properly initiate breastfeeding and continue exclusively for six months to improve infants’ survival, growth and development.
Now, the Dular program is running in five districts of Jharkhand and a recent evaluation found plenty of success stories. It showed mothers in Dular villages were almost three times more likely than other women to exclusively breastfeed newborns and avoid old practices. They had significantly (four times) higher rates of colostrum feeding, and the percentage of underweight children was much less, too.
Certainly, Seema Devi has already seen dramatic results as the anganwadi worker in her simple farming village of Purio Purvi, population 767. According to her careful records kept in a simple notebook, a decade ago only 18 per cent of village women started breastfeeding within an hour of their babies’ births. Now 95 per cent do this. While only 16 per cent exclusively breastfed for six months in 2000, now 82 per cent are.
“Regular breastfeeding is no longer a problem here. It is a fully accepted practice now,” Devi says with obvious pride.
Breastfeeding is the best and most basic way of preventing malnutrition and boosting resistance to disease, notes Dr. Prakash Gurnani, UNICEF Chief of Field Office in Jharkhand.
“What could be better than a simple, home-based solution that costs nothing and improves so many children’s lives?” he says. “It’s so wonderful to have the IKEA Social Initiative here, because now so many communities are opening up to better health and nutrition practices for their children.”