It seemed like an anomaly in the data when we looked at the temporal pattern of malnutrition in the Dharni tribal subdivision in the Amravati district of Maharashtra. A peak in April in the number of children with Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) surprised us. Common sense of nutrition discourse dictates that the peak should be during the monsoon, when diarrhea takes over, or in winter, when hypothermia is the devil for children. We double-checked our data and went back to previous years; this only seemed to confirm our findings. Every year, for at least the last three years, the numbers peaked in April. And, this was not a small spike. The numbers suddenly increased more than fivefold, with two tribal blocks having more SAM and MAM children than the rest of the 12 blocks combined. Numbers continued to steadily decline throughout the year before peaking again in April.
What was happening? After some discussion, we realized that several families were returning to Dharni from migrated places in March for Holi (the biggest festival here), then returning to fulfill contracts, only to return “permanently” in the kharif season when it begins. the harvest (there was a smaller peak in June). Our subsequent searches revealed a more direct correlation in Nandurbar, a tribal district in Maharashtra, where a 2018 UNICEF study had followed the same cohort of children, before and after migration. The numbers of SAM quadrupled, MAM 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 became the buzzword during the Covid pandemic in cities. However, rural migration has continued for years. Especially in tribal areas, due to lack of industry, problems with forest rights or their implementation, and lack of irrigation facilities, migration extends from six to eight months of the year.
The first question I asked myself was if people stay in another place for more than half a year, isn’t that place their home? Multiple government schemes—to strengthen education, health, connectivity, water supply, electricity—operate on the assumption that people will stay in the villages to reap the fruits of what this capital and operation will sow. This assumption fails in areas of high migration and the understanding of an interrelationship between long-term nutrition, migration and livelihoods (including, above all, MGREGS) goes awry.
We decided to work on our findings last year and asked a few questions: Where were people migrating from the most? How much? What were the places with the highest density of immigration? We got some answers, but they seemed vague. It was noted that in our nutrition surveys, the lack of data on migration inflated the denominator (number of children being measured), especially as new births were added up, resulting in data that did not accurately reflect the situation. Since we were in the middle of the migration season, we decided to meet these migrated families.
Three things that changed everything I have understood about migration came out of the field visits. The clearest recollection I have is of an interaction with a brick kiln owner who shook his head when I asked “Kitne bacche honge idhar (how many children are here?)”. He said, “Ham bacche nahi ginte kyunki voh idhar kaam nahi karte (we don’t count the children because they don’t work here).” No wonder, then, that there was an invisible group of people, especially pregnant/nursing women and children, who were of no “use” here. We met many families. It was also important to come face to face with our own prejudices. We believe that migration is a bad thing, but here there were several families that received guaranteed wages; the word “guaranteed” is especially important because many people told us they would be happy not to work here if they were assured of MGREGS work at home.
The second learning occurred when we met a nine-month-old boy who was due to receive the MMR vaccine but missed the dose because it was not his due at home, and by the time he returned, he would have missed that. Our assumption is that this six to eight month time frame should leave many children and pregnant women unvaccinated. This is not due to a lack of health or nutrition infrastructure or indifference, it is due to a lack of knowledge that these beneficiaries are here. Most of these brick kilns are located 1-2 km from the villages and until there are indications of some contact with the government, it is difficult for both donor and recipient to get in touch.
Portability as a concept is not new. But my third learning was that we have to start thinking about a system that is not completely dependent on demand. Our questions: do you take rations from the stores? Do you take your kids to anganwadis? — were answered in the negative. I was not surprised. A hard-pressed migrating tribal population from Korku in a predominantly Marathi belt – think of the bargaining power, especially of women and children. It doesn’t take much to connect the dots.
Our learnings led us to start working on a migration tracking system, as well as to strengthen MGREGS. But these interrelationships need a deeper dive, 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. To reduce stunting and underweight in the long term and improve health, we will need to understand the interplay between nutrition, livelihoods and poverty. A plan that focuses on selecting and classifying the most vulnerable, a strategy that keeps them at the center without silos, could be what we need to take a step forward in improving people’s well-being.
The writer is an IAS officer from the 2017 batch of Maharashtra cadre. views are personal
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