This weekend, four friends and I, took an 11 hour train ride
to Dibrugarh district in the north eastern most corner of Assam. The mission?
Nutrition outreach camp. Loaded down with formula, multi-vitamins and essential
medications we climbed aboard a 3 tier sleeper car for our weekend adventure.
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| Our Team! Showing off bottles of coconut oil we gave away as fat supplements |
We headed to Chabua Tea Estate, said to be the first tea estate in all of
India. We arrived to a little col-du-sac of European style bungalows nestled
within dense tea gardens. The hospital, a well maintained structure left over
from the British rule, was about a 6 min walk through the tea plantation.
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| Tea Laborers headed to work |
Tea gardens are mostly employed by seasonal workers, often
transplants from other parts of Assam looking for a way to earn wages. Laborers
spend long hours bent over in the intense Indian sun, hand cutting the leaves
of acres and acres of tea plants. Hazards of the job include dehydration,
poisonous snakes and at times even leopards.
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| Tea Laborers |
Laborers and their families generally live in tiny mud
thatched houses provided by the estate. Wages for working 7 days a week 10 hrs
a day are approximately 1,000 RPS a month or $16 US dollars. Pregnant mothers
are exposed to pesticides and are often malnourished themselves. These
conditions predispose them to having babies with birth defects among which are
cleft lips and cleft palates.
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| Cleft Lip baby, moderately malnourished with chicken pox |
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| Child of the Tea Gardens fresh from a bath |
Children of the laborers are at extremely high risk for
malnutrition. For starters, their parent’s meager income is often insufficient
to provide them with the adequate food. Tea workers on average have about a
fourth grade education and are often unaware of basic childhood nutrition needs. In
addition, children with clefts have a much harder time breast feeding and
drinking from a bottle. Many require spoon-fed formula, which as you can
imagine takes time and patience. Unfortunately with both parents working, this
tedious feeding process is left up to an elderly grandparent or an older
sibling who might only be 6 or 7 years old himself. All these factors make it
extremely challenging for children on tea plantations to get the calories they
need to thrive.
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| Screening patients in the hospital lobby |
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| This little one has finally gained enough weight for surgery! She'll be getting her lip operated on soon. She had a horrible case of scabies. |
We had a total of 15 families from the area show up for our
nutrition camp. Some traveled hours by bus to reach us. Despite our fatigue
after the long journey we quickly got to work weighing and measuring the children.
The World Health Organization (WHO) has created a method of identifying
children at the greatest risk of dying from malnutrition by plotting them on a
curve based on their measurements. According to WHO, children whose height plots
at a -3 are severely "stunted", meaning they have been malnourished for such a
long time their body is no longer growing.
Children whose weight plots a -3 for are
considered medically “wasted” which means they have a very high risk of dying
from starvation.
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| Alice at work getting the essential measurements. |
Of the 15 patients we saw this weekend 50% were plotted as
-3! This means half of the patients we saw were either so chronically
malnourished their bodies refused to
grow or they were so thin they had a 60% risk of dying from
starvation.
Several of the families told
me their children go to bed hungry at night because they don’t have enough food
in the house. Desperate mothers admitted to diluting formula with 3 to 4 times
as much water as they should be just so they have something to offer their
crying babies.
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| Onima giving medication and nutrition teaching to a family |
One mother brought us her 4-month-old baby who weighed 1.7
kg, that’s about 3.7 lbs! The poor baby was literally a skeleton. The baby had
a cleft lip and a cleft palate making it impossible for her to breastfeed. The
family was too poor to buy formula so they were spoon feeding her a diluted
rice paste donated to them by a government health center. The baby looked as if
she was in agony. Every rib was visible and her skin was literally hanging off
her like a baggy pair of pants. After talking with the family they told us two
previous children in the family had died, one at 3 months of age and another at
birth. I knew that if we didn’t intervene quickly this baby would also die. We
pleaded with the family to take the baby straight to the hospital for admission
and emergency care. When children are this malnourished they require very
careful re-feeding so the body does not go into shock from the sudden calories.
This process needs intensive monitoring by a physician.
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| Severely malnourished 4 month old baby weighing only 1.7 kg |
The following afternoon we visited tea labor family’s home.
Their baby Sudhir is an 8 month old boy with both a cleft lip and a cleft palate,
who is severely malnourished. Sudhir’s parents, both day laborers, collectively
earn less than $2 a day. This income has to feed and clothe, Sudhir, his two
brothers and his grandparents.
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| Sudhir and his mother welcoming us into their home |
Sudhir’s mother was hesitant to show us her humble house.
She told us she was embarrassed by the conditions in which she and her family
lived. After some convincing she led us to a modest mud hut composed of two sleeping
rooms, a larger room for cooking and a small side room holding a few modest
possessions and family puja. The house was tidy and neat and the mud floor was
surprisingly clean. They’d recently burned it to prevent dust from coming up. The
entire family sleeps on two beds. They cook from a small hole in the ground and
the smoke fills the tiny house as they do. You can imagine how this might lead
to respiratory infections among other illnesses as the children, play, sleep,
eat and gather in such a small space without a chimney.
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| Main sleeping room (2 beds for 6 people) |
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| Kitchen with cooking fire |
I spent the train ride home reflecting on the past 2 days.
We saw so much suffering in such a short time. I thought about lives of those
precious children and what kind of future they’d have. It’s hard to keep from
feeling overwhelmed by it all. The problem of food insecurity is so vast here
it seems insurmountable. India has the most severely malnourished children in
the world accounting for 34% of the global total. It doesn’t matter how well
you teach families and how many vitamins you offer, without food the children are
still going to starve. It’s heartbreaking that we live in a world where despite
both parents laboring 10 hours a day for 7 days a week under the hot sun they
can’t even afford to feed their starving families.
We are going back to Chabua Tea Estate Hospital next month
to check on our little group of patients. I can only hope our meager drop in
the bucket is enough to make a small difference in the lives of these precious
little ones.
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| 5 year old girl who is severely malnourished. She needs to gain weight before she can have her cleft palate surgery |
If you have a heart to donate to this cause I'll use whatever money you send to buy medications and nutrient dense foods for these little children. All donations are tax deductible. To donate
click this link
