Nutrition and Child Care

depend on the land for food and other essential things. Each family on an average has six children. Most of the people lack basic education, housing, sanitation, water and electricity facilities. Almost all the men and women do coolie work and it is their main stay. It is a male dominated society where the position of women is very low. People are very conscious of their caste and do not encourage inter-caste marriage. Neverless, class discrimination is not very obvious.

The level of nutrition is very low in almost all the villages and therefore the prevalence of under nutrition and malnutrition is very conspicuous. The existence of poor nutrition varies from village to village differing in degree from Muslim and Christian villages on the one hand to the Hindu villages on the other. The level of malnutrition is a direct reflection of the low economic status of the individual families which again is influenced by the size of land holdings, number of children in the family, etc. The type of food consumed is also determined by the type of land, utilization of improved techniques of production, and availability of water. Cultural or habits of longstanding also affect the level of nutrition. In most of the villages there is a complete absence of clinics. There is one clinic in the village of Sylvepura, and a Government hospital in another village, at Hessaragatta. Health care systems in these villages do not have rural or curative biases. Workers of the community are involved in the health care sys tem, and the problem of health is intimately related to the problem of economics and politics.

Ragi is the staple crop grown in. and around the villages and the food stuff made out of ragi is consumed by all the villagers irrespective of religion, caste and economic status. So ragi occupies an important position in the nutritional level. The variety of foods made out of ragi are consider ed to be very nutritious and energy giving. Unfortunately there is no other crop as a substitute to ragi since the land is not suitable for the cultivation of any other crops. The scarcity of water prevents the growth of staple crops like rice etc. for ragi crops are known for survival without water for a long period of time in a not very fertile soil. Rice is grown occasionally on tracts of land nearer to ponds and lakes where there is a continuous supply of water when needed. However, the wide consumption of ragi, in whatever quantity it is taken, does not fulfil the vitamin requirements needed for an individual. It will be surprising to

note that food stuffs made out of ragi, are eaten three times a day in different quantities. The only crop people can afford to buy, if they have means to buy, is ragi.

Chappatis from ragi flour are also made but are not very common in the diet of the villagers. For the preparation of chappatis, oil is required and since oil is expensive most people make ragi balls in stead. Moreover side dishes should be prepared to go with chappatis even though sugar or jaggery may be rarely taken. Maise or cholam is also grown a-long with ragi in almost ail the villages. There are two types of cholam grown - one is the ordinary one and the other the hybrid variety. The hybrid variety corn or maize is turned into flour and corn balls are made out of it. But more often ragi flour and corn flour are mixed to make paste or balls. Chappatis are also made out of this flour. This type of food, made out of corn, is usually taken by the people who own no land to cultivate, or those people whose harvests are not sufficient to last till the next harvesting season. Maize is not only cheap but also easily available. The ordinary corn crop is grown mainly for cattle and sheep consumption.

Wheat is available in smaller quantities but not widely used. Its use is more for the making of sweets, etc. Oil-less chappatis made out of wheat flour are not common in the villages. Uppitu or uppama is another dish made out of partially powdered corn. This variety is more expensive than the ordinary ragi balls since a good amount of oil is required along with mint and corriander leaves and turmeric powder and dhal or grams.

The large consumption of ragi foods emphasises the fact that it is associated with strength and stamina and considered to provide nutritional re quirements, whereas rice is associated with status, the staple food of the rich man. Rice is more expensive than ragi or cholam and is always preferred to ragi because it is tastier, and the consumption of it is a sign of economic well being. Notwithstanding, this does not mean that rice alone is always consumed by the rich people in a predominantly ragi growing area. However, it is a grain appreciated by the higher classes.

Rice is generally taken after the ragi balls are taken, which is again nothing but conforming to an existing convention, for in addition to what has been mentioned above, it also leaves behind a better taste in the mouth than ragi. While it may be

fashionable for the people to admit that they like to consume rice in larger quantities than ragi, it is a fact that people's tastes are deeply conditioned by the type of nutrition observed during their child hood and this is not easily changed. Yet there are some cases where, due to the easy mobility and access to the city, the eating habits have not only changed to some extent, but new recipes are tried out in the homes. In certain villages, that are situated nearer to the highways, and where approach to urban areas is unrestricted, rice is taken more than ragi. In most of the villages however the consumption of various rice foods like idly, dosai etc., is very seldom to be noticed. But the intake of rice increases as incomes rise. Rice is consumed once or twice a week by many of the people to break the monotony of consuming ragi three times a day throughout the week.

Curries made of mutton, beef, pork and chicken are rarely made. Beef is eaten only by Harijans, Christians, and Muslims. But people in one particular Christian village do not consume meat, and pork is eaten as often as beef in other villages. Among the Hindus only the Harijan caste eats beef. The cows are considered sacred by the higher caste Hindus and this sacredness is manifested by its everyday worship and the washing of faces with the urine of cows. There are very few Brahmins in the villages and they don't eat any type of flesh. In other ways the usual diet does not differ from that of other castes. Our survey shows that most of the people who come into the meat eating category consume either beef, pork, mutton, or chicken at least once a month. However, the number of times beef is consumed exceeds that of pork, chicken or mutton. Beef is quite cheap and for many mutton consumption is out of the question for it is costly and only the rich can afford to buy it. Any one consuming mutton frequently is considered to be of high economic standing. But most of the Hindus eat mutton during the times of festival, and for many it is the only time when they can taste it.

Very few families possess sheep and goats and most of them who do sell them in the nearby towns and cities when they are fully grown. This affects the supply and distribution of mutton in various villages and many times adds to the already existing scarcity putting a serious check on the consumption of mutton. There is no scarcity of beef for the animal is slaughtered for food at least once or twice a month in most of the beef consuming villages. In a few Christian villages the slaughtering

is quite frequent. Pigs are also grown in a few villages primarily for meat production. Muslims, as is well known, don't eat prok, as eating it is contrary to their religious beliefs.

Consumption of chicken is restricted to the families who own hens and surprisingly there are very few families who own hens. In view of this small number of hens available, the production of eggs is limited. Like mutton, chicken is also a luxury food. Fish is eaten quite often, depending on the price and purchasing power of the individual families. There is a fair supply from nearby ponds and lakes. Dry fish is quite scarce. Scarcity of milking cows reduces the supply of milk. Very few villagers own cows giving milk and more often, if there are markets available, they sell it. But for those villages situated far away from the market areas there is the problem of transportation, and it becomes a serious problem, in the absence of good road facilities. We also found that the milk the villagers wanted to sell was of poor quality and therefore the milk societies rarely bought it. In such cases either milk was consumed or made into curd and butter milk. The habit of drinking milk is not common in most of the villages.

During the times of festivals, varieties of dishes are made. For many, festival is a time for eating various new dishes, and for others it is an unwelcome event, for they will be forced to spend their meagre savings that are in the form of hens, cows, sheep etc.

The diet of pregnant women is no different from the diet taken by others. There is a variation in the diet given to mothers immediately after the deli very. Ragi balls and rice are not taken for they are considered to be 'cold' stuffs and only coffee and bread will be given for a period of one or two weeks. Care is taken to give mothers extra food to produce milk for the child. When anyone is sick bread and coffee will be given and sometimes rasam, for rasam is considered to have many medicinal values.

Most of the men in the villages consume alcoholic beverages made locally. Toddy and arrack are the common drinks consumed by men. Very few women drink and that only on very rare occasions like festivals, etc. The sales on the consumption of liquor increases during and after the harvest sea son, at festival times and when they get employment. So an increase in income more often leads to an

increase in the consumption of drinks. Increase in the intake of drinks by many men has led to poverty and malnutrition in many of their families. In this situation it is the woman who had to bear the burden and usually eats last when almost everything is finished. At the same time she has to do coolie work in fields and gardens to add to the family's meagre income.

We should be aware of the fact that the availability of any new goods in a village will have a direct bearing on the food habits of the people. Powerful advertisement media like radio, newspaper, etc., play a dominating role in altering food ha bits. Villagers who often visit towns or cities adapt themselves to new food habits and try to follow the same in their homes in the villages. Most of the women give gripe waters to newly born babies. It is conceded that gripe waters do not really have any good effect on the child when taken. But the habit of giving it to children is widely prevalent in most of the villages due to the existence of powerful advertisement in radios, newspapers and personal contacts.

Most of the new born and the small children are vaccinated and quite frequently visit the hospital and clinics situated nearby when they are sick. During the first two years extra care is given to the new born. This is relaxed after this period. More attention is given to feeding which constitutes a major problem. The new born baby is normally breast fed for a period of 2 or 3 years and it is not uncommon to see children even older dependent on mother's milk. Milk is both food and drink. But it is sad to note that many of the mothers suffer from malnourishment, lack of good health and proper housing facilities. And this being the situation most of the children are weak and suffer from many complications. They cannot, take resource to artificial milk feeding for firstly this is not available and if available is too expensive. Most of the mothers here do not understand the importance of the milk feeding stage when utmost attention should be given .to the new born. In most of the families, as soon as the baby's teeth start growing, the baby is put on a new diet. Ragi in various forms like porridge and soft ragi balls are given. Along with this, bread, biscuits and coffee are also given. At the same time it is not surprising to note that bread and biscuits sold are old stocks and once bread is bought, it is fed to the children for 3 or 4 days by which time it has

become hard and infested. As the number of teeth increase they are put on the same diet as that consumed by the adult, e.g. ragi, rice, chappatis etc. Improvement in the choice of food and diet is hardly noticed. Not surprisingly the Christian and Muslim children are quite healthy and incidence of malnutrition is reduced considerably for they consume beef in larger quantity. Ignorance of knowledge on nutrition and poor economic status leads to poor utilization of the existing resources. The pre valence of malnutrition could be eradicated if better ways of utilizing and cooking to retain maximum nutrients were learnt, along with the improvement in the economic situation and availability of high protein food.

Ragi is the staple food given to children. It fills the stomach but does not suffice the protein and calory requirements of the body, leading to an unbalanced diet. Nutritional deficiencies increase the inclination to infectious diseases. Here many of the children including some adults suffer from the effects of malnutrition and this is instrumental in checking the physical and mental growth of the children. It is not uncommon to see children suffering from scabies, anaemia, diaherrea, night blindness, malaria and pneumonia. Unfortunately each individual gets less calories and protein than calculated requirements, to build immunity against diseases.

The incidence of malnutrition is invariably and directly related to the number of children in the family and its income. Our survey shows that each family has an average of 6 children, varying from 2 to 20. There is no perennial source of income, and the incomes that are earned are distributed to the whole family in the form of food and other essential things. Obviously, when this is done in a large family everyone in the family does not get enough to fulfil all their protein and calorie requirements. This ultimately leads to under-nutrition. It has very serious repercussions on the future of physical and psychological development of an individual. On an average 2 children die in families where there is a minimum of 5 children born. The causes of diseases are in most cases unknown. However malnutrition has been shown to be one of the important causes of early death for it reduces the immunity to diseases and is a major contributory factor to infectious diseases. Few children die of malnutrition per se, but usually mortality rates are definitely influenced by the level of nutrition and medical care facilities, and children are

the ones who usually bear the burden of disease and death.

We cannot be blind to the fact that in addition to the working of men, women also work. Most of the time, after the planting season comes to an end, the men are unemployed and it is during this time that they feel the pinch of economic stress. At this time women will be forced to do coolie work like weeding, washing utensils in well-to-do houses, working in the fruit gardens, etc. Women however work throughout the year to make both ands meet. Unfortunately, they are required to play a dual role - the responsibility of motherhood and the other work outside the home. A lot of women's time is spent on collecting wood, fetching drinking water and cooking for the family. So her share of duty is beyond her physical endurance and she gets overworked. She usually does not get enough food to withstand all the physical work she has to do in the course of a day. This work outside the home which is the inevitable resultant of the poor economic status of the family, has meant that less of a mother's time is available to attend to the needs of children. The children are not only the victims of very poor feeding but are also victims of the effects of poor clothing and bathing. We found that children barely have two sets of clothes and almost all the time they wear them dirty, taking a bath once a month, in spite of good water facilities available in a few of the villages. This precisely reflects not only the extent of the lack of parental care towards children but also the helplessness of parents. They even care less about giving a good education to their children, who are given the work of looking after the cows, buffalos and sheep and goats. People who are poor don't attach much importance to their children's education and care more about maintaining the old standards of living, assigning the same roles to their children followed as theirs when they were young. On the other hand families who are economically well-off not only are sending their children to schools, however, far it may be, but also to the nearest junior colleges to their village. There is not much scope for the improvement of parental care towards children unless the number of children in the family is reduced and the work of women lessened.

Traditional thinking is very strong regarding family planning and birth control. Women suffer most in this direct oppression as they fail to understand the consequences of ignorance regarding family plan-

ning. The number of children they would like to have is not an important factor, but how many they can produce is, and the cultural preference to have more children is blankly reflected in the villages. Subscription to traditional value and customs has not only led to the bearing of a large number of children but also added to the misery of the children by causing poverty and malnutrition. Parental care has to be distributed among a large number of children and the children pay a heavy price. Repeated births and shorter spacing mark the history of most of the housewives. The helplessness and ignorance of women is naturally expected.

No villager has undergone either vasectomy or tubectomy operations and does not wish to undergo such an operation in future, not even the women and men who are young and married and who know some thing about this operation. They associate either of these operations with the loss of physical strength which they are afraid may reduce their productivity in the future. We came across no abortion cases either and people consider it a sin. But we feel that through persuasion, and by rational argument, and by a deeper knowledge on family planning, people may resort to some of the existing devices to reduce the number of births.

The widespread habit during child birth is to get the assistance of a midwife. There are very few women who have gone to hospitals to give birth and then only when there is heavy labour pain and some other complications. But most of the people cannot afford to go to hospitals. They say that even if they go to government hospitals they have to pay for medicines for which they lack the necessary means. The absence of obstetrics and pediatrics is obvious in these villages. In most of the villages the practice of Ayurvedic or indigenous medicine is dying out. The presence of a clinic and a governmental hospital is one of the most important causes for this. People interviewed don't seem to know much about the indigenous medicine.

There is a direct relationship between spacing of children and susceptibility to malnutrition and disease. The longer the spacing between children the smaller the threat of malnutrition, and more parental time is available to care for the child. On the contrary the shorter the spacing between children, and because the child will be removed faster from breast feeding, the bigger the threat of mal nutrition and the less time available for caring.

Spacing of children is of vital importance to both mother and child.

While considering the nutritional level of the individual families we should not however neglect the influence exerted by economic factors related to land and mobility of labour, as these factors help in reflection the degree of affinity between them. The average size of land holding is 1 to 2 acres among most of the villagers. The break up of the joint family system and the establishment of nuclear families played a contributory role in the subdivision and fragmentation of the existing land, leading to new problems like producing enough food, water and housing facilities. In view of this fragmentation, effective farming was not possible and the uncertainties of the land holder of his economic future became more pronounced. As it is evident from our survey, the quality of the land is also not good. The presence of red laterite soil mixed with pebbles and stones makes cultivation hard and tiring, and unsuitable for the cultivation of any other crops apart from ragi. Ragi can be grown in poor quality soil and not much water is required for its steady growth. The accessibility to water resources is reduced to nil in almost all the places and farming is very much dependent on the vagaries of monsoons. The success or failure of monsoons means food or scarcity. Failure of monsoons is one of the most important factors leading to food scarcity and malnutrition. The lack of continuous and steady availability of water not only affects the yield per acre but also the quality of the crop. All the above three factors. viz., i) the small size of holding, ii) poor quality of land and iii) the inadequate supply of water reduces the chances c£ application of modern agricultural practices. Of course in the first in stance the infrastructure available is inadequate»

With the existing land holdings, variation in the cultivation of crops is not possible. Since agriculture in most of the cases, is followed as a means of feeding the family, no other crops are grown apart from ragi and cultivation of crops must. be considered in relation to the needs of the family. More often the grains produced are not sufficient till the next harvesting season which is why both men and women are forced to take up coolie work. There is also a lack of adequate warehouse and storage facilities in most of the villages- Crops are damaged by insects and rodents and other pests. In many situations like this the farmers are not only helpless but also do not pause to calculate

the consequences and take sufficient measures.

Lack of easy mobility of labour also affects the state of nutrition in many ways. There are many people in the villages who for various reasons are not easily mobile; attachment to their land and family, religious beliefs regarding poverty and economic status, and difficulties in adjusting to new environment and general conditions. We found that there are many men in the villages who go to nearby towns to earn their income and in this process they not only change their eating habits but also try to inculcate their newly acquired habits among the family members. Women are usually less mobile than men although women go to quite far off places to do coolie work.

Villages situated nearer the road sides have access to tap water whereas villages situated inland lack this facility and in such cases the Government has dug bore wells. But even this facility is denied to many other villages, situated inland, and people there depend on well water. In any event if the well goes dry they have to walk a long distance to fetch water and in most of the places a lot of women's time is spent on fetching water. This has an adverse effect on the hygiene of the people and ultimately affects the nutrition. The limited supply of water does not allow them to use water carelessly and therefore most of the people in such villages take baths very rarely, once in a month or so. People depending on well water have a big problem during the rainy season. Whenever there is a heavy rainfall, the ground water seeps into the well and becomes muddy making it unsuitable for drinking.

Most of the people live in poorly built, poorly ventilated, and poorly tiled or thatched houses. Protection is also poor during the times of heavy rain, since there will be leakages in many places making the house chilly and cold, affecting the health of the people living there.

It is abundantly clear from the above that nutritional status is closely correlated with a number of factors needing micro study. However, while considering or studying the level of nutrition attained one should not be blind to certain minute factors which do exert pressure on nutrition. Availability of parent's time towards the care of children, understanding the problems and the needs of children, etc., are some of the small factors affecting nutrition and child care. If all things

are available except parental care the nutrition level may not develop appreciably. Regarding this, we often found that the blame for malnutrition is put on women and not on the men. Sharing of domes tic responsibility between the partners is strikingly absent. In the balance, the major portion of the problems weighs dangerously on the women's side. In this process of confronting some of these problems she herself becomes a victim to malnutrition and many diseases and due to society's fault not only the women but also all the children in the family pay a heavy price. She enters world of in-laws with well-defined roles, and should faithfully play the defined role to gain the appreciation of the people immediately around her. In this conflicting situation she is baffled as she is at a loss whether to fulfill her choice or compromise with the existing social reality. If she ignores the social reality she will be labelled and socially ostracised. Being all the time under various obligations she finds it labourious to distribute her limited time in various work. She has to squeeze in all her many assigned roles within her limited sphere of time. The fulfillment of all the work calls for united will, strength and sacrifice on the part of women. Men being the 'wage-earner' is freed from all these troubles, of course ignoring the fact that women are also wage earners. Any new move on the women's part is a challenge and threat to men's superiority. A change in the role of women is urgently required, although the prospect is very low, until they are taken into account in the present socio-economic system, thus alleviating the problems of women. This has an immense significance on child care and nutrition, and such a change would affect the patterns of social relationships and the existing stratification of society.

When men spend money on the consumption of alcohols, more than their earnings, it does not mean that they don't know the problem of under nutrition and malnutrition in the family. They do it fully aware of these facts. Their community gives more protection to men and the public opinion here is sym pathetic to the problems of men and less so to a woman's, and hence this irresponsible habit. Quite frequently in many families the sorry state of affairs can be attributed to the heavy drinking of men.

Since ninety-nine percent of the people in all these villages are farmers, their income and nutritional level depends on the produce they get from the land. All the grains produced are consumed by

their families and hence there is less chance for a variation in the nutritional state, since they don't have any monetary holdings to buy extra things. The existence or non-existence of a market does not affect their food intake.

People here do not understand the value of vegetables and kitchen gardens are a very rare thing to see. Since all the existing lands are occupied for the cultivation of food grains, the growing of vegetable gardens is a must. After a day's hard work they find it difficult to maintain kitchen gardens. There is a necessity for women to be taught about vitamin-rich foods, ways to cook, variety in cooking to improve the daily diet of the family.

The use of the hospital and clinic has considerably lowered the death rate. This led to the increase in population which resulted in malnutrition and under-nutrition. The increase in the number of children in families is not without adequate reasons. Most of the parents in these villages expect at least 2 or 3 to die. In view of this they have as many children as possible and general preference is given to boys, for they are considered to be economic assets and social security in old age.

All the above factors become irrelevant if importance is not given to the economic status, which plays a deciding role in nutrition and child care. Unless the economy of each individual family is improved, there is no way out of this nutritional and child care deficiency.