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Menstrual Hygiene and Anaemia Prevention Key to Keeping Tribal Girls in School
" At 29, she is aged beyond her years, but you can sense the satisfaction in her smile as villagers of Rajghat come to greet and bless her for her work. Kalpana has helped hundreds of babies in Rajghat "

School dropout Rina Kachhap with her mother Chari Kachhap at her home in the Eastern Indian state of Jharkhand.

By Angela Walker

LALGANJ, India, 1 July 2010 – Rina Kachhap dropped out of school when she was just 13-years-old.

“During my period, there was a lot of blood and I was feeling dizzy,” explains Rina, now 16, her copper painted toenails matching her orange floral kurta. A pendant of the goddess, Sarna, hangs from her neck.

Her village school is located about 22 kilometres out of Ranchi, the state capital of Jharkhand, home to the second largest tribal population in the country.  Although her school had separate toilets for boys and girls there was often no water. “I used to face a lot of problems to keep clean,” she says.

Now Rina spends her days doing household chores, washing clothes and dishes and helping her mother with the cooking and taking care of her three sisters and one brother.

“My parents asked why I dropped out. I was feeling dizzy and not feeling well.” says Rina. “I was stubborn. Now I wonder what I could have done with my life if I stayed. I’ve given up studies so I don’t know what I can do in future.”

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Adolescent Girls Risk Dropping Out

Adequate sanitation has a huge impact on girls’ school attendance. Providing private and separate sanitary latrines in school can increase girls’ enrolment and help keep them attending school as they enter adolescence, said Lizette Burgers, chief of UNICEF India’s Child Environment Programme.

In India overall, 65 out of 100 schools have common toilets. However, only one out of four schools in Jharkhand, Arunachal Pradesh, Assam, Chandigarh, Delhi, Jammu & Kashmir, Orissa and Rajasthan do. Nationally, 54 out of 100 schools have separate toilets for girls, with half the schools in Jharkhand having separate facilities.

Rina’s mother, Chari Kachhap, is dressed in a teal sari decorated with silver, sequined leaves. A gold stud glints from her nose and a bright streak of vermillion darkens her part.

“When she had her first periods, Rina was having dizziness and weakness and would take to her bed. We consulted the doctor who said it was a vitamin deficiency,” she says. “Even after taking vitamin tablets, there was no improvement.”

Then Anganwadi worker Sheila Tirkey visited their home and explained the symptoms of anaemia and the need for adolescent girls to take iron tablets and eat a healthy, balanced diet to prevent the disease. “After taking iron tablets she started feeling better, and now she is perfectly fit,” her mother says. 

Mrs. Kachhap says there has been a major shift in the family’s diet, including eating more leafy vegetables and fruit and trying to have protein every day. “Now we plan it out,” she says. “We have the best meal we can with the money we have to spend on food.”

Community Health Workers Change Behaviour

Tirkey faced resistance from some families when she started the adolescent girls’ group in 2005 where every Saturday girls would come for their iron tablets and learn about health and menstrual hygiene and cultural arts and crafts.

“Many parents asked, ‘why are you leaving work and going to sit and chat. It’s better you stay at home and do the household chores,’” Tirkey says. “I went to their homes and explained to their mothers why it is important to control anaemia. I had to convince the parents, because during menstruation (girls) can fall sick. In the kishori mandal (girls’ group) they can meet and ensure they take the iron tablet. Parents became convinced.” 

The group has swelled to 28 members, and volunteers map the homes in the village, visiting girls to make sure they come to the anganwadi centre to take their iron supplements, as well as promoting breastfeeding and immunisation to new mothers and their families.

Anaemia affects 56 per cent of adolescent girls in India and 70 per cent of girls in Jharkhand. Adolescence is a period of rapid growth. Anaemia limits girls’ growth and their ability to learn and reduces their productivity and earnings later in life, says Dr. Victor Aguayo, Chief of UNICEF India’s Child Development and Nutrition Programme.

Supervised Iron Folic Acid (IFA) supplementation is key to preventing anaemia, says Dr. Prakash Gurnani, the chief of the UNICEF field office in Jharkhand. Tablets are administered weekly to school-going and out-of-school adolescent girls in five districts of the state. As of March 2010, 90 per cent of school-going girls consumed up to 51 weekly IFA tablets and 89 percent of out-of-school girls consumed IFA tablets for 46 weeks in these five districts.

 “We’re reaching out to 2.8 million girls – two fifths in school and three-fifths out-of-school,” Dr. Gurnani says. “In just a few years, this program has changed the face of anaemia in the state.”

New Law Should Keep More Adolescents in School

After she started feeling better, Rina went back to school but her parents later forced her to drop out to take care of her younger siblings.

“We know it’s very important to go to school, but we have a big family,” says Mrs. Kachhap, whose husband farms a small piece of land for six months and then works as a labourer for the rest of the year. “All should get a good education, but if you don’t have money, then it has got to be the boy. All mother’s want their sons to grow.”

In Jharkhand, as in many parts of rural India, a girl is considered “paraya dhan” or property that belongs to her future husband’s family. Her parents bear the expenses of bringing a daughter up and paying for her dowry. Investing in girls, such as sending them to school, can be viewed as money wasted. 

The landmark passing of the Right of Children to Free and Compulsory Education (RTE) Act 2009 will help overcome this traditional prejudice by guaranteeing all children quality elementary education legally.

There were an estimated eight million six to 14-year-olds in India out-of-school in 2009. One in four children left school before reaching Grade 5 and almost half before reaching Grade 8 in 2005. The world cannot reach the Millennium Development Goal by 2015 of every child completing primary school without India.

Rina wants one day to become a member of Jharkhand’s paramilitary service and hopes to take advantage of the new law to achieve her dream job.

“Education is very important,” she says. “If I had a chance I would go back to school. I wouldn’t hesitate at all. I would be happy to go back and sit with the little ones, so that I can learn.”

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