The Anakavur Process

We have already seen in this blog a write-up dated August 2011 on the peer group work done by volunteers Thangam and Babu. As a follow-up of that effort, Purisai volunteer Babu has organized a larger meeting on the 14th December 2011 in the village Purisai. Given below is an account of what Thangam and Babu has done:

The children who were trained by us earlier on the problem of iron deficiency anaemia and how to address the same had shared the information with their peers at the rate of another five children per child so trained by us earlier. Each second-tier peer so trained also observed her/his individual diet pattern and recorded their observations on a daily basis for a period of two months.

We organized a meeting of this larger circle of second-tier peers on the 14th of December 2011 in the Purisai school. We requested the Headmaster Mr. Samuel Rajasekaran to preside over the meeting. There were 40 children-participants from the VIII std level hailing from different villages around Purisai. We requested some of the children to speak about the results of the diet survey. It was quite apparent from their observations that they had successfully influenced their mothers to include more frequently sources of iron in the daily cooking menus for their families. We also took the opportunity to once again highlight the main points relating to locally available food items which contained iron in good quantity and renewed our plea especially to the mothers to include such iron rich food items which were available locally and were either low cost or no cost sources so that the problem of iron deficiency anaemia could be successfully tackled.

We find that this method is capable of spreading important messages more easily and faster than taking training sessions in smaller groups. The other new point is that we find that the teachers of the school evince interest in health care subjects like this. Given this positive sign, we hope the school may now take further initiative to spread the message to cover a much larger number of students.

Water, Sanitation and Hygiene is an area, where in spite of appreciable efforts to implement national programmes, their public health outcomes have been quite elusive. Making water available in villages is one thing; but ensuring that it remains safe until it is consumed by the end-users is entirely a different one. While fair progress has been achieved in the former aspect, the same cannot be said of the latter. This is mainly due to the fact that attempts to bring about behaviour changes in matters like keeping the water tanks clean, the water lines clean and the ultimate water receptacles clean have proved to be daunting tasks. There are several local cultural perceptions that determine water and sanitation related behaviour. One such, for instance, is the belief that water tanks should be always kept open so that there could be free circulation of air and exposure to sunlight, which are thought to be sufficient to keep the water safe for drinking. This has resulted not only in such tanks becoming breeding grounds for mosquitoes of the anopheles type, but also they get infested with a lot of other parasites. In this background, what our volunteer, Thangam, has done in her village Cheyyatrai Vendran is remarkable. Here is an account of what she has done:

Even though I have received training on the subject of water, sanitation and hygiene, it has been a rather desultory process for me to make even the members of my family practise safe beahviour in this regard. It has been harder still in the case of the village community. I attended recently another training programme on the subject and I repeated what I learnt to the children’s group of Cheyyatraivendran. Something clicked this time! The children suddenly remembered that the overhead tank in the village was never closed on top, making it vulnerable to infestation including the dumping of food wastes by crows, other birds and animals. They remembered having seen remnants of cooked fish, dead rats and other insects inside the water tank. Even though the local Panchayat workers used to take and throw them out, no efforts were made to make the water safe enough to drink.
So, I invited the newly elected President of the local Panchayat, Mr. C. Gunasekar, to participate in my next training class on the subject for the children’s group. He obliged and listened carefully to what the children had to say about the contamination of water in the overhead water tank of the village. He took the matter seriously and immediately promised to look in to the matter and do the needful. I am glad to note that he has since actually started work on closing the water tank on its topside. I feel thrilled at this because something that has never been done all these days has been done now thanks to the initiative taken by our children’s group!

C. M. Thangam.

Today’s children are the assets of tomorrow’s world. Therefore, investments for human development should start with investments in children. The Human Development Index (HDI) developed by the UNDP places India at the 134th rank out of 187 countries. This inequality-adjusted index combines economic prosperity with education levels and life expectancy. Therefore, it may be taken as a more accurate indicator of human development than the more well-known economic indicators such as GDP or per capita income. India’s rank at the lower rung is a cause for concern.

Both the quantum and quality of services delivered under the crucial sectors of health, nutrition, education, water supply, sanitation and environment as also for mainstreaming of gender in all such activities are far from satisfactory. The ‘Nine is Mine’ campaign underlines the urgent need to address these concerns. Stated in brief, this campaign states that six percent of GDP should be earmarked for education and another three per cent for health. There are also nine specific demands made, namely, compliance with Rights to Education Act, age-specific education to all children under RTE, equitable and inclusive education without discrimination, progressively upgrading the standards of education in all government schools, all children out of school to be brought in to schools alongside elimination of child labour, provision of wholesome and regular mid-day meals, provision of comprehensive health coverage to all children, provision of adequate and appropriate toilet facilities and provision of safe drinking water facilities in all schools. Viewed from a quality angle, equal stress must be laid upon addressing micronutrients malnutrition in utero as also in infants and children. Similar stress is called for in enhancing the quality of teaching in schools through suitable capacity building training for teachers as also upgrading the infrastructure available in schools. Only then, the performance indicator for human development for the country would register improvement. Further, the value of achieving excellence in whatever one does must be inculcated in children from early on.

With a view to building awareness on these concerns and to highlight the need to pay more attention to the qualitative aspects of care of the children, particularly in the areas of health care and education, the National Children’s Day has been celebrated by two of our volunteers, namely, Muniyandi and Thangam on the 14th of November 2011 in two villages of Anakavur. Here is a brief account on what they did on that day.

Celebration in Nedungal Village – by K. Muniyandi
The event was got up in the village temple and it went on for an hour from 6 PM. There were 25 participants from the children’s group of the village. In addition, 20 other children from the local school participated in the event. There were also 15 mothers who were there and they evinced keen interest in the proceedings. The event started with a prayer song by Danasekar. After a brief introductory talk by Muniyandi on the importance of the Day, the children were formed in to two groups – Group A, consisting of students from the 4th to the 7th standards and group B, consisting of students from the 8th to the 10th standards.

Muniyandi then conducted two quiz sessions, separately for Group A and for Group B. The questions for group A were selected from the information already given to the children about the different countries of the world. The quiz for group B was based on the earlier training given to the children on nutrition, heath and hygiene as also on English words taught to them earlier. The children participated in the quiz programmes with a lot of enthusiasm and interest. Prize winners have been selected from both the quiz programmes. They will be given the prizes in a separate event later when Venakt Sir visits Anakavur.

The children then performed two special skits prepared by them for the occasion, namely, one on life skills providing education and the other on the adverse impact of pollution. Both these skits were performed well and were appreciated by all those present.

The event came to a close with the distribution sweets to the children, followed by a vote of thanks.

Celebration in Chinnasengadu Village – by C. M. Thangam
Thangam organized this event in the village Chinnasengadu. There were 63 participants including children and adults.

Thangam stressed the following points relating to proper child development in her talk addressed to the parents:

• The need for inculcating the habits of personal hygiene in children
• Encouraging children to continue their studies up to higher education levels
• Child care should start early on even from ante-natal stage and continue through delivery, post-natal
stage, infancy and childhood
• The importance of early childhood education
• Importance of life skills, general knowledge and English

She also explained how the activities of the children’s group were woven around the above themes. The parents listened intently to the contents of the talk and responded by saying that the activities of the children’s group were indeed quite useful for the proper development of their children and they requested Thangam to continue her good work for the benefit of the local children.

In her address to the children, Thangam focused upon the following points:

• Continue education and avoid dropping out at any stage at any cost
• Participate in the activities of the children’s group, which will provide opportunities for acquiring life
skills education including general knowledge and knowledge of English

She then held a competition for the children showing them flash cards of wild life specially prepared for this occasion and asked them to name them in Tamil and English. In fact, the children felt very happy about this type of game and participated very enthusiastically in it.

On behalf of all volunteers, children’s groups, youth groups and women’s groups of Anakavur process, we wish all well wishers and friends of Anakavur a HAPPY DIWALI!

A training programme for skill development was conducted by Venkat in July 2011 for the Youth Group of Anakavur Block, which has been formed and run by Muniyandi, the volunteer. This programme was thought of mainly to bridge the gaps in life skills education which the youth of the villages miss out as compared to their urban counterparts. The focus of this programme was on career choice; how to plan for a career, enter upon it, derive satisfaction from it and be successful in it. It sought to guide the trainees on how to acquire the needed skills to compete successfully in the highly competitive job market. Such guidance is found to be woefully lacking in the education system of rural areas. Muniyandi has attempted a quick assessment of the impact of this training by interviewing three beneficiaries of the pogramme. Here is his report:

R. Rakesh is from Kunnavakkam village and he is currently doing his third year of B.A. degree course in English. When he completed his XII std., he was in no mood to continue his studies further. However, a chance counseling from Venkat Sir made him change his mind and opt for higher studies. He says that he realized the importance of knowledge of the English language in the modern world and hence chose to do his graduate course in that language. He also takes classes for the children’s group of his village. He feels what impressed him most was the skill development training programme conducted for the Youth Group by Venkat Sir. He has found it very useful as an eye opener of the complexities of the job market and the skills that are needed to successfully compete and enter upon it. He recalls the several topics that were covered in the training – writing skills, speaking/conversing skills, creative skills, skills related to decision making, time management, team work and management skills. However, the one thing that has impressed him the most is the skill relating to ‘critical thinking’ and its wide relevance to one’s work situation. He expressed his deep sense of gratitude to Venkat Sir for having given the Youth Group of Anakavur Block a rare opportunity free cost (and without any expectations in return), which one could otherwise get only through attending expensive courses run in the cities, such as personality development course or skill development course.

D. Chinraj is from Akkur village and he is currently doing his B. Sc degree course in Physics. What has impressed him most about the Youth Group Training Programme is the point that in the absence of certain basic life skills it could be an extremely difficult task to compete successfully in the job market and he is thankful to Venkat Sir for having created this awareness in him. Of all the various skills which Venkat Sir had explained in the training programme, the one that has impressed him most is the skill relating to ‘Time Management’. Like Rakesh, Chinraj also feels that this is a very rare and valuable opportunity that is normally available only to students in cities and he feels very thankful to Venkat Sir for having given such a wonderful opportunity to the youth of Anakavur.

K. Srividya from Madipakkam village is studying in the XII standard. She has been a member of the children’s group of her village for the past six years. She also feels that the skill development training programme conducted by Venkat Sir is highly useful for it has exposed the trainees to certain much-needed skills to cope with the challenges of finding a suitable job after completing studies, thus taking them beyond the routine class room instructions and examinations conducted at schools. In this sense, the training programme has indeed filled in a gap that is there in what is taught in schools. She is particularly impressed by the fact that certain basic skills are needed to cope with life situations including the efforts to find a suitable job. What has impressed her most is ‘creative skills’, which help in the development of one’s thinking and mental development. It helps one to develop the needed skills to cope with the challenges of life. She further feels that this training has helped the trainees to bring out the best in their personalities. Like the other two youths, she too feels extremely grateful to Venkat Sir for having provided such an excellent and useful opportunity to them absolutely free of cost.

K. Muniyandi.

Every year the World Breastfeeding Week is celebrated in the first week of August to bring in to focus the importance of breastfeeding the children for ensuring their proper physical and mental growth and development. The key messages relating to breastfeeding are also disseminated regularly by the extension educators of the health department and the nutrition department all over India. Similar efforts are undertaken by NGOs involved in delivery of health care. In spite of all these efforts, the indicators of breastfeeding in India, as revealed by the National Family Health Survey (Round III) are not very encouraging. Only 23.4% of the mothers interviewed were found to be breastfeeding their newborn babies during the ‘golden first hour’ after birth. According to experts, just by enhancing this activity alone, sizeable newborn deaths could be averted annually. Again, such a step could save 22% of all neonatal (0-28 days) deaths. Further, it has been estimated that this could also help the achievement of the Millennium Development Goal (MDG) No.4 of reducing mortality of under 5 years old children by nearly two-thirds by 2015.
Similarly, exclusive breastfeeding of the babies for a period of six months is considered a must for avoiding infections to the babies, for strengthening their immune systems, for strengthening their guts adequately, for developing in them a feeling of psychological security and self-confidence and for ensuring proper brain growth and development. There are again evidences to prove that breastfed babies tend to have less dental caries in early childhood than babies fed on formula milk. There is also evidence to show that exclusive breastfeeding acts as a deterrent to obesity and connected ailments in later life including diabetes and cardio vascular diseases. However, as per the results of NFHS-III, only 46.3% babies were exclusively breastfed.
At the third stage, complementary feeding is to be introduced to children from age 6 months onwards up to age 2 years, along with continuation of breast milk. Here again, NFHS III found out that only 55.8% of children in the age group of 6 to 9 months were found to be given solid mushy complementary food. This stage is very important as about 90% of brain development of the child is completed at this age.
Ms. Thangam, our volunteer from Cheyyatraivendran village has been an avid communicator of the messages relating to breastfeeding of children to the women of all the villages where she works. Besides training the local volunteers of the area where she works, she has also been celebrating the World Breastfeeding Week every year. In fact, a report has already been posted on this site (dated September 21, 2011) on how she and Volunteer Ms. Jeeva from Thavasi village celebrated this year’s week in the village Thavasi on the 7th of August 2011.
She has now attempted to make a quick assessment of the impact of her above programme on the women of Tavasi village. Here is her report:
I selected five women of Tavasi village who attended the World Breastfeeding Week Celebration in that village on the 7th of August 2011 for purposes of this impact assessment. They were: Vatsala (23 yrs), Sumati (28 yrs), Jeeva (23 yrs), Sasi (20 yrs) and Shakila 24 yrs). I asked each one of them 10 questions relating to breastfeeding and I have summarized below their responses:

1. By what time the newborn baby should be put to the breast of its mother?

Of the five respondents, only two were able to say precisely that it should be done within the first hour after birth (40%). One was vague saying that it should be done immediately after birth, another stated it should be done within 1½ hours, and the remaining one said that colostrum should be given immediately after birth.

It may be seen from the above responses that there is still some vagueness about what should be done and when it should be done.

2. Why is such an action necessary?

Three respondents (60%) felt that breast milk contained anti-bodies that could strengthen the baby’s immune system. Another felt that it would keep the baby healthy. Yet another felt that breast milk contained the needed nutrients for the baby.

3. Should the newborn baby be fed with any other concoction or stuff than the mother’s milk? If yes, why?

Four out of five respondents (80%) felt that nothing else than mother’s milk should be given to the baby. However, one of them stated that her family members fed her baby with donkey’s milk as they believed that it was good for the baby’s health!

4. For how long should the child be exclusively breastfed?

Four out of five (80%) felt that exclusive breastfeeding should be done for a period of six months. One of them felt that it should be done for about to 4 to 5 months.

5. Why should this be done and who gave you this information?

Two of the respondents gave the source of this information as the World Breastfeeding Week Celebration. Two other attributed this to the Health Sub-centre and Anganwadi (Nutrition Centre) staff. One just said that she knew it already but this celebration reinforced her information. None of them said anything about why this should be done.

6. What should be given to the child beyond six months?

All of them specified different kinds of food that could be given as complementary feeding, such as well-cooked and mashed greens, lentils, boiled rice, etc. One of them stated ‘solid mushy food’.

7. For how long should breastfeeding of the child continue?

Only one of them said ‘up to two years’. Others were not specific and said things like ‘for more than two years’, ‘up to three years’ and ‘up to two-and-a-half years’. The message regarding breastfeeding to continue up to 2 years needs to be conveyed very specifically and clearly.

8. What are the advantages of breastfeeding to the child?

Almost all of them have mentioned the main advantages, such as, strengthened immune system, proper physical growth, proper development of psycho-motor functions, strengthening of guts, acquiring a sense of security and self-confidence, better brain development and better learning capacities.

9. What should be the minimum birth weight of a newborn baby?

Three of them (60%) gave the correct response of 2.5 kg. One gave the figure as 3 kg. One stated that she had no idea.

10. How can one find out the growth status of the child?

Three of them (60%) gave the correct response, namely, ‘through monthly weighing’. One thought that the doctor should be consulted to find this out. The other one felt that if the child gained height that would be an indicator.

From the above analysis, it may be gleaned that overall, the awareness level on breastfeeding after the World Breastfeeding Week celebration 2011 is satisfactory. However, there are certain crucial areas on which I have to work with re-doubled vigour in the coming months to convey the right messages, clearly and convincingly. The areas needing such special attention seem to be:

• To remove the vagueness about what should be done about breastfeeding the baby after birth and when it should be done.
• To remove the still persisting belief in some people that donkey’s milk could be substituted for mother’s milk.
• To prove clarity about the exact duration of exclusive breastfeeding and the reasons for doing this.
• Similarly, to provide precise information of the period for continuing breastfeeding beyond six months.
• To convey the precise minimum birth weight recommended for the newborn baby.
• To underline the importance of monthly weighing in order to know the health status of the child.

This quick assessment has been an eye-opener for me which would now enable me to focus on the areas highlighted above in my efforts of building awareness among the women of our villages in the coming months and I expect better awareness as also better practice levels among them by the time the next World Breastfeeding Week sets in.

Although the literacy rate of India grew from a mere 12% in 1947 to 74.04% in 2011 (Census of India 2011), it is still found to be below the world average literacy rate of 84%. It is a matter of concern that India at present has the largest illiterate population in the world. The decadal growth rate of literacy between 2001 and 2011 has also been rather slow at 9.2%.There is also in evidence a wide gender disparity in literacy rate, with 82.14% for men and 65.46% for women (2011).
According to the message of Ms. Irina Bokova, Director-General of UNESCO on the occasion of the International Literacy Day 201, the following points, inter alia, come upfront as focus points:

• In today’s knowledge driven societies, lack of literacy is more than ever synonymous with exclusion and marginalization.

In Anakavur Block, the Day was celebrated on 8th September 2011 in two villages, namely, Cheyyatraivendran (by Thangam) and Akkur (by Muniyandi). The following is an account of what they did on that day:

Cheyyatraivendran:

The members of the children’s group and other school students participated in the event, which took place at the local Middle School. There were some special guests, namely, the Assistant Education Officer (Mr. P. Duari), the Headmistress of the local school (Ms. E. Vijayakumari), the President of the local Panchayat (Mr. K. Ganapathi), other teachers and the local nutrition centre worker, besides some members of the public.

A special mention would be appropriate at this point of the fact that this was the first ever event of International Literacy Day held in our village. I feel very pleased with it. I took the opportunity to explain to the audience at some length the points made by Dr. Irina Bokova, Director-General of UNESCO, in her message on the occasion of the International Literacy Day for the year 2011. I further dwelt upon the need to completely eliminate the problem of school drop-outs in our village. I also explained to the audience about the importance of learning the three R’s as also of acquiring life skills.

This was followed by some special skits prepared and performed by the children on the importance of literacy.

After this, I spoke about the Anakavur work and its importance to human development efforts in the block. I drew the particular attention of the audience to the fact that as part of this process, I had been successful in putting back in to school as many as 14 children so far. This part of my work was appreciated by some beneficiary children – Rakesh, Manivannan, Devaraj, Varalakshmi and Selvam. Some parents who had come for the event also endorsed the views expressed by the above children.

The special guests spoke next one by one and all of them were all praise for the Anakavur process and laid stress upon the need for achieving full enrolment and total elimination of the problem of drop-outs.

I would particularly like to thank Venkat Sir, my mentor, who has involved me in this very useful Anakavur process.

C. M. Thangam

Akkur:

I organized a modest event in my village in which all the children of our local group participated. Some local friends also participated in the event. After a brief introductory talk by me on the importance of literacy, particularly the three R’s and the life skills, I requested the children to read out paragraphs from the translated message (in to Tamil) of Dr. Irina Bokova, Director-General of UNESCO.

Each such reading was followed by discussions by the audience on the points contained therein. The discussions were quite lively and the participation by the audience was quite intense.

I also took the opportunity of reviewing the activities of the children’s group and how they were supportive of the development efforts of the village and the block.

K. Muniyandi.

Pictures from Cheyyatrai vendran and Akkur village functions:

Breastfeeding the newborn baby within the ‘golden first-hour’ after birth is increasingly being emphasized now by health experts, besides advocating exclusive breastfeeding up to six months, introducing complementary feeding from six months onwards and continuing breastfeeding up to two years. These are important measures to ensure that the child gets all the necessary anti-bodies via its mother’s milk, besides the advantages of strengthening its guts, providing it with a sense of security, safety and self-confidence, and laying the foundation for its proper growth in to a healthy child, a healthy adolescent and thereafter in to a healthy adult.

At this point, a quick look at the status of breastfeeding practices in India appears warranted. According to NFHS 3, only 23.4% of the babies were breastfed in the first hour after birth and only 46.3% of babies were exclusively breastfed. Here again, the moot question that arises is how really ‘exclusive’ is exclusive? This question arises because of the cultural perception of looking at practices like giving water to the baby during this period and feeding it with various other local concoctions not as violations of the golden rule of being ‘exclusive’ in breastfeeding the baby till it attains the age six months. In Anakavur block, for instance, new-born babies are fed with a local herb called ‘urappan’ as also with donkey’s milk.

On top of all these, the cultural practice of any elderly member of the family and other senior relatives like the maternal uncle feeding the new born baby with sugar syrup is also there. Such practices like feeding of things like sugar syrup to the baby is not only unwarranted, but also they run the risk of high possibility of infection of the new born baby, if such people use their fingers to dip in to sugar syrup or other concoctions and then paste it on to the tongue of the baby.

Our volunteers have been trying their best to address these problems and to promote first-hour breastfeeding, exclusive breastfeeding, introduction of complementary feeding after six months and continuation of breastfeeding up to two years. Ms.Thangam, particularly, has been celebrating the World Breastfeeding Week avidly and year after year in her area. Here is an account of what she did this year in the village Tavasi:

We celebrated the World Breastfeeding Week in the village Thavasi on the 7th of August 2011. Ms. Jeeva, the local volunteer helped a lot in organizing this event. She had managed to gather a group of 35 persons, which included pregnant women, lactating women, other women and adolescent girls of the village.

Both of us spoke about the importance of breastfeeding in ensuring the healthy physical and mental growth of a new born baby. The point we stressed most this time was that the mother should develop the right attitude towards breastfeeding the baby. She should love doing it and breastfeed the baby with a lot of love, care and affection. Given such love and affection, the baby who is thus breastfed would, no doubt, grow in to healthy adult, with a lot of self-confidence, with which she/he could cope with any challenges of life.

Similarly, we laid particular stress upon the need to put the new born baby to breast within the ‘golden first hour’ after delivery. Equal stress was laid upon the need to exclusively breastfeed the infants up to six months. We took pains to explain to the audience what this really meant by stressing upon the point that indeed this meant that nothing else other than mother’s milk should be given – nothing at all; no water, no sugar syrup, no ‘urappan’, no other concoctions, no donkey’s milk, nothing else whatsoever.

We further stressed upon the importance of breast milk for the brain development and strengthening of the guts of the child. A direct immediate benefit of such exclusive breastfeeding could be better learning outcomes when the child gets to the school going stage.

There was a good discussion on these points and the audience participation was quite intense. At the end of the event, several members came and told us personally that they would in future follow as well as counsel others on the important points brought up during the discussions.

Iron Deficiency Anaemia (IDA) has been identified as a major public health problem in India, particularly among women, adolescent girls and children. According to the National Family Health Survey 3 (NFHS 3), 56.2% of women of India in the age group of 15-49 yrs (reproductive age group) were found to be anaemic. Among women who were actually pregnant, anaemia was found in 57.9%. According to the District Level Health Survey (DLHS) 2002-04, as many as 72.6% of adolescent girls in India were found to be anaemic. As per NFHS 3, again, 79% of children under the age of 3 yrs were found to be anaemic. These figures go to prove how serious is the problem of anaemia in India.

One of the reasons for such high rates of anaemia is the low intake of iron rich food by all sections of population. The problem is more pronounced in the rural areas, where even though low cost iron-rich food items are available locally, the people do not include them in their daily diets. For instance, green leaves of moringa spp (see below), spinach and other such edible green leafy vegetables are ubiquitous in the rural areas of Tamilnadu, including the Anakavur Block. However, these low-cost and sometimes no-cost food items are hardly ever included in the diets of the local people for reasons mostly of local cultural perceptions. Given the problems of irregular consumption of iron and folic acid, resorting to locally available low-cost sources of iron-rich food items comes up as a viable alternative to address this problem.

The volunteers of Anakavur Block have been trying to impress upon the local population the importance of dietary intake of iron through the inclusion of the above locally available rich sources of iron. However, since it is not in the local dietary tradition to include these items, it has been an uphill task. While on the one hand, cooking demonstrations are held among women’s groups where new and tasty recipes based on these leaves are introduced with a view to making them popular, on the other, certain innovative measures are also thought of and acted upon by the volunteers to keep up the momentum of this message. Here is an account of such an innovative action taken by Ms. C. M. Thangam, our volunteer of Cheyyatraivendran:

I have been very concerned with the problem of iron deficiency anaemia found among almost all in our block, particularly among women, children and adolescent girls. I am not surprised though that this has emerged as a major problem because being a person from the same area I know how the consumption of iron-rich sources of food that are also low-cost and available locally such as moringa, spinach and other edible greens and leafy vegetables is not part of the dietary tradition of this area. The non-consumption is partly based on certain traditional taboos and partly on taste and to some extent on lack of knowledge on their nutritional properties.

I discussed this with Venkat Sir and based upon his advice, I have hit upon an innovation, which I have christened as the ‘Peer Group Programme’. I started this programme in Purisai village. There are 30 members in the children’s group of this village. I started off with giving these children intensive awareness training on iron deficiency anaemia during the months of April and May this year. The importance of including iron-rich sources of food that are available in plenty in the villages in the daily dietary intakes of households was stressed upon in this training. The objective of doing this was that these children would in their turn impress upon their mothers to include such items of food in the day-to-day recipes of food prepared at homes. At the next stage, the children so trained in the group were, in turn, asked to train at least five other children in their schools. In other words, the training was passed on to other children or to a ‘peer group’ of five other children. The peer group children so trained were also asked by the trainer-children to record the changes in the dietary pattern of their homes brought about as a result of their persuasion of their mothers in favour of introduction of iron-rich food items in the daily diets of their homes. This exercise was done for a period of a month after their persuasion efforts. I give below a sample page from the record maintained by a trainee peer group child:

There is in evidence an obvious increase in the inclusion of such iron-rich food items in the daily diets. However, the concern now is to ensure that this trend is sustained over a period of time.

The next phase of this innovation will be that the children of the Purisai group and the peer group will try to carry this message to other children studying in their schools. It is proposed to do this after discussing this with the school authorities and involving them also in this programme. This step is expected to increase the coverage of the message considerably.

If the programme gets completed as planned, that would be an encouragement to replicate it in other villages as well. Of course, we also propose to do some impact assessment after a while.

C. M. Thangam
August 2011.

The problem of school drop-outs has been discussed in this blog quite a few times in the past. Since it has several dimensions and calls for sustained efforts on the part of the volunteer to put the drop-out back in to school and keep a watchful eye until the ward completes the course, the task becomes very exacting and demanding on the perseverance and patience of the volunteer. We have already written about M. Devaraj of Cheyyatraivendran village, who dropped out earlier and how thanks to volunteer Ms. Thangam’s efforts, he was put back in to the school. When he dropped out again, it became an arduous task for Thangam to put him once again back in to the school. But she has done it successfully and she narrates below how it was done:

My satisfaction of having put Devaraj back in to the school was short lived, when in the month of March his mother met me and lamented that her son had once again gone back to his old ways of not attending the school. The mother was really worried what with the fast approaching public exams for X std. Initially, I did not know what to do. But then I thought I must try again to set this right. First, I spoke to Devaraj. He was elusive as usual. But I went on listing to him the benefits of education, re-emphasizing the point that it was not too late and that he could still make up for the missed classes and get through the exams. Finally, after a lot of counseling, he agreed to get back to school.

Next came the question of talking to the school authorities and making them agree to re-admit Devaraj in to the school. This was more difficult than anticipated. Even after the promise to produce a medical certificate for the period of absence, the school authorities were not too keen to take him back. Understandably, they were none too happy with his habit of frequent absence from classes. I met the class teacher, the Assistant Headmaster and the Headmaster several times on this matter. All of them were very irritated with Devaraj and his habit of cutting classes for days on end. Finally, I ventured for a fourth time in to the Assistant Headmaster’s room when he was busy with affixing photos of students on application forms for the exam. He got very irritated at my pestering him with Devaraj’s case and in a fit of anger he threw the list of applicants at me and asked me to check for myself if Devaraj’s name was there in the list! Even Devaraj was moved by this act and he urged me not to get humiliated because of him and we started walking out. A strange thing happened at this point of time. The Assistant Headmaster sent a messenger after us and called us in. He then asked me as to why I did not get upset at his action and also wanted to know why I was persevering with the case of a boy who was frequently cutting classes. I replied calmly that I was doing that because I did not want any drop-out from my children’s group, that I was confident that the boy would pass the exams and that he needed some constant goading to attend classes. Thereupon the Assistant Headmaster relented and he agreed to take the bay back again. Now, what is important is that Devaraj has since rejoined the school and has also passed the X std. public exam and now he proposes to continue his education in Plus-2 course opting for the C group. Needless to say that I shall continue to keep a watchful eye on him!