Health

Village Planning has lifesaving impact for the Tea Tribes in Assam.

By Meital Rusdia

The Chabua Tea Estate is a sprawling bed of green colored only by the bright saris of the tea tribe women who work in the fields of this North Assam district of Dibrugahr.  The women are mostly from Scheduled Tribe communities, and trace their lineage back to remote corners of Jharkand, Bihar, Orissa and Chattisgahr.  Yet, for generations, they have been plucking tea leaves eight hours a day six days a week earning about 42 rupees daily, or approximately one U.S. dollar.  The women and their families live in modest one room houses on the estate itself and depend on the clinics and childcare services provided by the estate owners, many of which are not always available or up to standard.

The work on the estates is labor intensive and the communities are tight knit, yet what is most lacking in their lives is knowledge of basic health and hygiene practices that can have lifesaving impact for themselves and their children.  To fill this empty knowledge void “village planning” is a process whereby four UNICEF trained facilitators, two men and two women, who have passed an intensive 14 day training course, go out to village communities and initiate dialog about these basic health and hygiene issues, bringing with them invaluable information.  The facilitators spend five days at a time in the villages, in which they begin by asking the communities to identify some of the issues that are most concerning to them.  Common themes that come out in discussions within the tea tribe communities are: maternal mortality, early marriage, excessive alcoholism, and lack of access to basic healthcare.  The communities provide the four facilitators with food and lodging, and warmly welcome their guests and the village planning process that they are serving as the catalysts for. 

In their trainings the facilitators are taught not only the key UNICEF health and hygiene messages but also how to communicate them effectively with the communities on the tea estates in order to really bring about behavior changes, such as exclusive breastfeeding, HIV prevention, hand washing and educating girls.  Tutumoni Borah, age 25, a newly trained facilitator, is confident that she will be able to speak convincingly to both men and women about important issues affecting their lives, “This is an opportunity to serve all society.  I will now be well equipped to change the mindset of others as well as my own mindset.”  For Borah, the key objective is to empower the communities she spends time with in order to help them take improving their lives into their own hands. 
 
Most of the discussions take place in the evenings when both men and women have completed their long days work in the field.  At the Chabua Tea Estate the village planning process was currently underway and in its third day.  The facilitator, Sukhila Gohain, age 24, said 60-70 people attended the meetings of whom the majority were women.  Rupa Saonra, 25 years old, a field worker in the tea estate and the mother of three small children was one of the most attentive and vocal attendees.  “It was great to learn all these new things that will help my children,” Saonra said.  She wasn’t able to exclusively breastfeed her three children because she worked long hours in the field and wasn’t at home to provide them with this essential form of nutrition.  Luckily they survived, but many children in their tender years on the estate would have not have survived, due to diarrheal diseases that result when unsafe water is mixed with powdered milk.  Breast milk is the safest and most nutritious option for children and on this tea estate safe water is not always an option. 

For Saonra, the discussions on health and hygiene for her children came as a first experience for her, as she had not been informed previously about many of the things she learned in the sessions.  For example, most women in the community have home deliveries, not institutional deliveries.  With the village planning discussions Saonra and other women learned what could actually be done in a hospital to save a mother who is having delivery complications, and also, why young mothers whose bodies are not sufficiently mature for pregnancy are more at risk of maternal mortality.  Like Saonra, Anima Das, a young mother aged 18, saw a growth chart for the first time in her life and had her two year old baby weighed. She was enthusiastic about these and other new concepts she picked up in the discussions, “I loved learning about why we need to use Iodized salt,” Das said. “And even though I never studied, now I will send my daughter to school when she grows bigger.”  

Only a few kilometers away at the Bokel Tea Estate, where the village planning process had been introduced a few months back, community volunteers from the tea tribes themselves, like Ruby Das, age 17, and Meher Ali, age 30, were still hard at work reinforcing what the facilitators had taught them.  “I want to continue reminding people of the important things we all learned because when my community benefits I will also benefit,” said Ali.  With a total population of 2747 people living amongst 580 households, these two volunteers have a great challenge ahead.  Ali says that since the village planning process came to the Bokel Tea Estate, many babies have received their tetanus shots and birth certificates, who otherwise wouldn’t have.  But Ali knows the impact will take time. “Sometimes the results can show in days and weeks, but long lasting changes can even take years,” Ali said. 
   
Yet with great determination and consistency, the community volunteers continue to organize follow up meetings once a month.  If possible, the original facilitators and their supervisors attend these meetings in order to demonstrate the long lasting commitment needed to make real social change happen. 

Meanwhile, out in the fields at the Bokel Tea Estate, the women were chatting away as they filled their bags with fresh tea leaves.  These days they could only pluck ten kilos of tea, but in the rainy season from April to November a day’s work could bring in 30-40 kilos of ripe tea leaves.  Renu Rabidas, age 30, says the biggest impediment to implementing the health and hygiene lessons she had learned from the village planning process in her community is a lack of time.  “I work in the field all day and when I get home at night I cook and clean.  There is no time to manage the health and hygiene needs of my family,” said Rabidas.  Her husband is ill and when he is well he works as a day laborer.  At the moment she is the sole earner for her 6 children and due to high cost of school uniforms only the eldest can go to school.

UNICEF started its village planning work in the Dibrugahr district of Assam one and a half years ago with the help of NGO’s and faith based groups.  While there are still many challenges, particularly in changing long-standing behavior patterns of the tea tribe communities: where women spend many hours each day away from the home, where alcoholism has been a culturally accepted phenomenon, where labor intensive work and minimal wages have resulted in systemic poverty, still, there is significant progress in each small lesson that leads to a healthier life for children.  Where hand washing becomes a family practice; where the age at marriage is postponed and HIV prevention is understood; where exclusive breast feeding replaces powdered milk and a girls’ education is valued.  Through the village planning process, these are small bits of knowledge imparted that have lasting impact on generations to come, and most importantly, they become life decisions made by a community that has been empowered to take their future into their own hands.