Attappady is in the news once again for infant mortality. In the month of November, two babies died in the hilly region in the Western Ghats according to official reports. Unofficially, the numbers stand at four. Among the dead are Suneesh and Geethu's three-day-old child, who died on November 25. The baby had pneumonia, reportedly a complication of Geethu's malnourishment during her pregnancy. "They had enough food in the house though," says Sunil, the couple's neighbour, citing the 35 kg of rice and wheat the residents get from ration shops every month, along with lentils. "But they didn't have anything to eat."
This irony is at the crux of government interventions in the region to improve nutrition levels. Whether its central government schemes or state government ones, the agencies have provided the region with lentils and grains — sambar and rice. But the largely tribal residents of the region don't eat sambar and rice. Originally hunters, the community's staple foods are millets, vegetables, and meat. But this simple reality has been ignored by policy makers with their centralised idea of 'food', say activists and experts.
Further, the government has adopted a 'charity model' instead of an 'empowerment model' to address the issue of malnourishment in Attappady — which, according to some residents, has only created new issues instead of solving existing problems.
Attappady has always been considered synonymous with malnutrition and poverty. In 2016, Prime Minister Narendra Modi infamously compared Attappady with Somalia, which invoked a huge controversy. Tribal rights activists in the region claim that 10 children have died in 2021 in Attappady. Between 2013 and this year, around 120 children have died according to government data, but the people there say the number is much higher. The state Health Department attributes milk aspiration, congenital diseases, pneumonia, and premature birth as causes of infant deaths in Attappady.
To address this, the state government started community kitchens in the district under the Kudumbashree programme in 2013, as an immediate solution for malnutrition issues in the region. There are over 150 community kitchens across Attappady’s three blocks — Agali, Sholayur, and Pudur. The aim is to supply food for 25,000 people. But this charity model to improve health statistics hasn’t entirely worked for two reasons, say the people in the region.
Firstly, the food prepared in the kitchen is not what the people here eat. Even ration shops in the region only provide wheat, rice and lentils, instead of the millets that the residents eat.
Secondly, stepping into a ‘charity house’ for every meal is not what people want. They want to be empowered to cultivate their own food instead, and want the government to provide them with land that’ll help them have a livelihood. “We don’t want to be spoon-fed,” says Vadukkiyamma, a local tribal leader who heads a women's movement, Thaykkulasangam. “What we need is proper attention to our problems. We don’t want community kitchens,” she says.
“How long are they going to run community kitchens?” asks Murugan, another tribal leader. “People have now stopped cooking in many households, and the little money they earn is being used for alcohol, which is creating more problems,” he says.
Suresh PV, a tribal activist and chairman of the Attappady Action Council, points out that the infant deaths in the district are the result of a series of injustices done to the tribal residents by the state since 1951.
In 1951 90.26% of the total population in Attappady belonged to Scheduled Tribes. But by 2001, the settlers from outside became 51% of Attappady’s population. In 1975, the Kerala government passed the Kerala Scheduled Tribes (Restriction on Transfer of Lands and Restoration of Alienated Lands) Act, promising to restore all their lost land. But in 1999 there were some amendments in the Act, bringing relaxations on land ownership in the region. Many tribal residents lost land after they leased out to higher caste zamindars. A major portion of the land was also taken over by the state as forest areas and revenue lands, as the tribals had no documents to show that the land belonged to them, Suresh explains. This disenfranchisement has led to the health crisis in the region, he says.
“In fact, the state has no authority over land in Attappady,” Suresh says. “This land should actually be owned by tribal people. In the 1951 census, 90% of the population here were tribals. But in 2011, it came down to 30%. We are being shrunken. There is no land for us to cultivate. We are being colonized with no income, and are not able to compete with others,” he says.
Explaining the history of the current food regime in Attappady, Suresh says, “In 2013, when more than 30 children died, the central government took initiatives to find a solution. Under the National Rural Livelihood Mission (NRLM), Seema Bhasker — the project officer — was assigned to study the issues in Attappady and implement a sustainable plan. She did that very well. The project had proposed how to enhance the traditional agriculture of tribals in Attappady.”
“Under a scheme called Mahila Kisan Sashaktikaran Pariyojana (MKSP), they proposed incorporating around 5000 tribal women in agriculture projects, with Kudumbashree as the nodal agency. The proposal focussed on cultivation of different millets and vegetables,” Suresh recalls.
But while the Union government allotted Rs 16 crore for this project, it didn’t take off due to laxity of state government officials, Suresh alleges.
In 2018 Seema Bhasker, was sent back to Union government services, allegedly because the state government has some issues with her. Back then, 663 tribal Kudumbasree units in the region were delinked from the Kudumbashree scheme, and they had protested. Seema Bhaskar was the officer on deputation from the Union Ministry of Rural Development. The tribal women had alleged political vendetta in transferring the officer. Many tribal women and activists in the area still recall the great work done by Seema Bhasker which wasn’t implemented because of politics.
Meanwhile, the state government, too, has started many projects to cultivate millets in the region. But it’s only benefitted a few people, say residents.
Vadukkiyamma, the leader of Thaykkulasangam, points to alcoholism as a major disaster haunting Attappady apart from landlessness. “Many people now eat food from community kitchens and use their money to get alcohol. Youngsters and aged are equally into alcohol. There are even cases where pregnant women consume liquor. How do we expect to get healthy babies and mothers?” she asks.
“Nobody is ready to work on this issue and provide awareness about or treatment for alcoholism. We strongly believe that this habit is a major reason for the health problems,” she adds.
Though some of the other tribal leaders don’t agree with her, many tribal women say that this is a serious issue that authorities have to pay attention to. “Alcoholism will lead to more unhealthy practices. We have cases where pregnant women have been subjected to domestic violence, unhealthy sexual practices and so on,” Vani, one of the residents of Attappady says.
The Government Tribal Speciality Hospital (GTSH) Kottathara is the only government hospital that provides decent treatment to the tribal community in Attappady. Though there are private hospitals nearby, most people cannot afford them. However, over the years there have been a lot of allegations against the GTSH. “It has turned into a referral hospital — any patient with even minor complications is referred to some other hospital,” Murugan says. “So pregnant women will have to travel at least 100 kilometers to reach a good hospital. Every day you can see queues outside GTSH for ambulances.”
Suresh alleges that there is no experienced pediatrician or gynecologist at GTSH. “Sometimes there are some young doctors, they come as part of training. There are no permanent, experienced doctors here. There is equipment for scanning here, but no professionals to operate them. So what else is going to happen here?” he asks.
Dr Prabhu Das, the former medical officer at GTSH Kottathara, had earlier told the media that in the case of Suneesh and Geethu’s baby, there were complications in ultrasound scanning conducted in October and they were asked to go to Thrissur Medical College hospital, but they did not go.
“In many cases these women are advised to go to medical college hospitals as there are no experts here. But people here cannot afford it,” says Vadukkiyamma.
Recently, a tribal welfare officer had revealed to the media that Rs 12 lakh was given to EMS Memorial Co-operative Hospital & Research Centre in Perinthalmanna from the tribal welfare fund to treat patients who are referred from Kottathara tribal hospital, instead of using the money to develop GTSH Kottathara itself.