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Done in by disease
Sleeping on a crowded bed tucked in a 'house' in a faraway alley of Indira Nagar, Rehman and Yazdan are two brothers who look maybe a year apart. A large part of the bed is covered by clothes - neatly folded and stacked to the metal sheet which forms the wall of the residence. The part that is not covered by the bed forms the washing area in one corner and cooking area in another.
Over the bed hangs a swing made by tying a saree from end to end, in which lies an infant. "My cousin's, " explains Parveen Haroon, Rehman's mother.
Yazdan, who is five-months-old, wakes up and looks around. "He is an active baby. Rehman, on the other hand, is always asleep, " says Parveen. With a frail body, a big stomach and head, Rehman suffers from phase II malnutrition. "He is three years and five months old, " says Parveen, which comes as a surprise as he looks only slightly bigger than Yazdan. "He cannot sit properly and keeps ill. He has had two bouts of pneumonia already, " she says. Diarrhoea, vomiting, and fever are common features of Rehman's life.
Rehman, however, is only one of the 991 children under five years of age residing in Indira Nagar, one of the eight communities of the Shivaji Nagar slum area. Around 35 per cent of them suffer from malnutrition.
Situated near one end of the 110-hectare Deonar dumping ground, Indira Nagar is a wonder structure. While a first-time visitor may find nothing out of the ordinary apart from large chunks of soft rubber, which form the floor of the alleys and the houses, the fact is that the Indira Nagar slum is built on a large area of quicksand. "The quicksand goes 15-feet deep. It has been stuffed with lots of stone, cement and rubber. On the surface, our ground is solid, but when it rains, the houses, along with the rubber, elevate a couple of centimeters above ground level. During the monsoon, we have to walk carefully so as not to slip and step into the quicksand, " says Seema, one of the residents of Indira Nagar.
A kilometre and two more communities away, lies the Shanti Nagar shanty, where every third house has a malnourished child. In one such house lives Kehkasha, a one-year-old, who suffers from phase III malnutrition. Kehkasha, who weighs 4. 5 kilos, has six other siblings, two of who suffer from phase II malnutrition. Their 27-year-old mother, Raheema Begum, cannot afford to give more than a plate of plain cooked rice as a meal to each child. Sometimes, even that is difficult to come by. "My husband is a rag-picker at the dumping ground. He picks the waste, stores it and sells whatever he can, " she says pointing to the heaps of white bags in her house. "Generally he earns about Rs 100 to 150 in a day and gets work for about 20 days a month. Whatever we can feed the children in that amount, we do, " says the mother of seven, who refuses to use any permanent contraceptive methods and admits that four of her children were delivered in the same kholi amidst the pile of wastebags.
According to the workers of Apnalaya, an NGO that has been working in the area for 19 years, water is a precious commodity. "There is no municipal water connection. So, people buy water at Rs 15 from private vendors or Rs 5 from tankers for a can of 3. 5 litres, " says Bharti Panderkar, a community development assistant from the NGO. "Most people here do not get a yellow ration card, as they earn more than Rs 1, 500 in a month. So ration too is difficult to access, even though it is supposed to be disbursed at a subsidised rate, " she added.
Inability to feed the kids more than just dal-rice is one of the main reasons behind the high levels of malnourishment among children in this area, according to an Integrated Child Development Services (ICDS) officer working in the area. "The numbers of malnourishment cases are quite high. But, for these children, we have put up anganwadis. There are four of them in Shivaji Nagar, " he says. However, even the anganwadis don't seem to be taking on much responsibility. "The anganwadis work between 10 am to 12 noon. They take in only children above the age of three years and give them food once a month, " says Raheema Begum.
Malnutrition is a bigger problem in the area than the residents think. "According to the official figures, there were a total of 600 deaths of children under the age of five between April and September in 2009 in Shivaji Nagar. Though the actual reason of death is counted as the disease the child succumbed to, in most cases they contracted the disease because they were malnourished and had poor immunity, " explains Dnyaneshwar Tarwade, assistant director of Apnalaya.
Dr V M Sarode, associate professor of statistics, who has done his PhD thesis on the Shivaji Nagar slums, says that only 30 per cent of the women in the area preferred to go to a healthcare centre in case of an illness. "The study has shown that 30 per cent of deliveries too were carried out at home. Only few women with high literacy and relatively better standards of living chose to go to a healthcare centre. At least 19 per cent of infants below the age of three years were found to be suffering from one or the other infectious disease at any given point of time, " he elaborates.
Senior officials in the BMC agree that the Shivaji Nagar area is a hotbed of diseases, especially for children. "We conduct regular arogya abhiyans in that area. But unless the residents themselves take an initiative and follow health, hygiene and contraceptive guidelines, there is hardly anything that can be done effectively, " contends Dr G T Ambe, the BMC's executive health officer, who is in charge of improving the situation.
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