Anaemia rampant in women in Bageshwar
A health camp conducted in Sama, 60 km north of Bageshwar in Uttaranchal in November, revealed that anaemia, chronic infections, gout, tuberculosis and rheumatoid arthritis are the common ailments there. And, 80 per cent of the 250 people who had come for the check up, suffered from these.
Most women, due to anaemia, had a blood pressure of 90/60, a level serious enough for a patient to be hospitalised. Besides, anaemia can lead to infant and maternal mortality, chronic low back pain and hypotension. Men of the area were by-and-large found to be healthy, except for a high incidence of gout.
When we started our work in the Bageshwar district, we tried giving a middle-aged woman some dietary advice. She was asked to have milk and milk products, fruits, vegetables and salads. With an incredulous look she said, "Vegetables? They are not available. There are no fruits on trees, nor does the buffalo give milk now."
The suggestion of buying any of the above obviously appears ridiculous. But the problems don't end here. Endemic unemployment, lack of sanitation, alcoholism, high level of violence have crippled villages in the district with the health of the women being a major worry.
After an intensive study, we figured out that worm infections were endemic in the area due to open-air defecation. The solution was to build toilets and get people to use them. Four thousand toilets were made thereafter but it hasn't solved the problem completely.
What surprised us was that while men enjoyed good health, the women continued to suffer. So clearly, there were larger issues--social norms and nutrition being among these. Our survey revealed that a chronic lack of nutrition coupled with back breaking physical labour, such as household chores, collecting firewood and water, looking after cattle and farming, weakened womens' health.
The women worked 14-18 hours a day while subsisting on bread, salt and tea. The greater share of the food was always reserved for men and children. Besides, the government being the only source of employment then, opportunities were limited. This led to endemic unemployment and consequently, alcoholism.
The area around Mukteshwar, however, has changed in the last two decades. The Indian Veterinary Research Institute has been providing steady employment, so do a couple of ngos. Farmhouses also employ people. Infrastructure is much better now with liquefied petroleum gas and piped-water supply available in practically every household. Cattle feed has eased the dependence on grass and artificial insemination has caused a marked improvement in the breed and output of the cattle. All this has had a definite social impact. Alcoholism is also firmly under control and the women look healthier.
To start with, free supply of protein, calcium, vitamins and iron tablets along with intake-monitoring can help put things in perspective. In fact, to say that these medicines are only for women would also be just, given their state there.
With our limited resources we have identified a few groups to start with. We should have some leads to the efficacy of this approach when we do our survey on these groups about four months from now. Educating people and trying to change their outlook on "social norms" would also help in the long run.
Amit Ray is an orthopaedic surgeon with the Arogya Kumaon Chikitsalaya, Bageshwar. He can be reached at firstname.lastname@example.org
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