Invitation to a village

After quite some time, I got another opportunity to visit a nearby village. This visit was quite different from most of my previous visits. I went after the Village Headman invited me to visit the village and advise them on how to develop the place. This village, Patna in Manika block of Latehar block was a village where the Project on Community Based Rehabilitation for the Disabled was working. 

The Village Headman was disabled himself. It was quite a sad story on how he got a bad limp. He slipped and fell from a bund when he was studying in the third standard. From his description, it looked as if he had a posterior dislocation of the hip which was never managed properly. 

A meeting was arranged where the villagers could discuss issues with me. However, there was a small hitch. Most of the villagers thought that I would be late like most of the other guys who get invited to the village. 

So, I had time to walk around and see the village. Below are few of the snaps from the walk . . .

The violet colored plants are wild tulsi.

The water body on one end of the village

Recently, there was a government program promoting organic farming using compost. These are compost pits made using government grants. Unfortunately, nobody was sure about how to make the compost.

The dried looking fields. The farmers were trying to plant wheat

The lunch we got in the village. Rice with pigeon pea curry (dhal). Side dishes included mashed pigeon pea leaves made in two different ways.

My jottings after the visit to Patna village –

1. The segregation on the basis of caste within the small village of about 180 families affected the progress of the village.

2. Similar to most of the villages in our region, they had abandoned traditional cropping which included millets. That had spelt doom for them. Members from about 80 families had already migrated to other places in search of work.

3. There were 4 graduates in the villages. They were running pillar to post in search of a job. None of them was even exploring the option of self-employment/enterpreneuing.

4. There was a medium sized lake on one side of the village. The villagers were not able to use it for commercial gains.

5. The villagers had heard about the intervention we were doing in the neighbouring villages of Ghutwa and Ekta under the Climate Change Project. They wanted us to help them out too. There are challenges. Patna village is in Latehar district whereas the Climate Change Project is being implemented in 30 villages of the Satbarwa block, which is in Palamu district. Considering the enthusiasm the village had to see change, I would have to oblige them.

Finger Millet (Ragi)

That is the snap of a plate of Ragi (finger millet) idli with chicken curry. 

The item is part of a effort from our CH team to re-introduce and popularize finger millet (ragi) cropping in our part of the country. 

Finger millet is known by the following names in different parts of the country. 

We had found out that millets had been the backbone of the food security of quite a large part of this region of the country for ages. Till the green revolution forced rice and wheat cultivation onto the population. It was furthered pushed on by construction of dams to ensure sustained irrigation.

However, with the reality of climate change, people have slowly started to realize the significance of alternate cropping in which millets play a vital part. 

There are quite a lot of websites which glory the use of millets in our regular diet, but I found quite a good blog which describes things in detail. It is very well recognized as on of the best food items that can be given to babies during weaning.

More than all these are the facts about the cultivation of millets . . . I had mentioned about them in my previous post . . .

- These crops are hardy and require less water. 

- They can be grown in low fertile soils.

- Millets grow better with biofertilizers.

- Most of the millets are pest-free. In traditional societies, they used to be used as used as anti-pest agents to store pulses etc. 

- Nutrient to nutrient, most of the millets are much superior to rice and wheat.  

Well, for all the food pundits, here is the nutritive value of finger millets when we compare to rice and wheat.

	Protein (gm)	Fibres (gm)	Minerals (gms)	Iron (mg)	Calcium (mg)
Rice	6.8	0.2	0.6	0.7	10
Wheat	11.8	1.2	1.5	5.3	41
Finger millet	7.3	3.6	2.7	3.9	344

I'm sure this will impress you. And one can very well conclude that one cannot address malnutrition without seriously looking into issue of popularizing millets. 

More on what our Community Health department is doing with regard to popularising Ragi cultivation and usage in my next post . . . 

By the way, I'm yet to find someone to help out with getting Kodo seeds . . .

Kodo . . . Need information

95% of you who would be reading this post would google, 'kodo' and find out that it is a Japanese professional taiko drumming troupe.

However, the 'kodo' I refer to is a type of millet cereal (Paspalum Scrobicalatum) which was a staple diet of many a tribal communities primarily in the Chottanagpur region along with other parts of the country.   

The following is the name in various other Indian languages . . .

English: Kodo millet

Tamil: Varagu

Marathi: Kodra

Bengali: Kodo 

Oriya: Kodua

Telugu: Arikelu, Arika

Punjabi: Kodra

Hindi: Kodon

Below is how it looks like (all snaps from wikipedia). I've never seen this cereal.  

Now, why am I so much excited about this . . . 

From a nutrition point of view, quite a lot of nutritionists believe that millets are going to be the answer for many of issues of malnutrition that the developing world face. In addition, they are rich in fibre and minerals which means that they could be well accepted by the better off populations. 

Some data . . . 

	Protein (gm)	Fibres (gm)	Minerals (gms)	Iron (mg)	Calcium (mg)
Rice	6.8	0.2	0.6	0.7	10
Wheat	11.8	1.2	1.5	5.3	41
Kodo	8.3	9	2.6	0.5	27

You may not be very much excited about the amount of proteins or calcium. But, look at the fibre content.

Then, there are other aspects . . . and this applies to all types of millets. 

- These crops are hardy and require less water. 

- They can be grown in low fertile soils.

- Millets grow better with biofertilizers.

- Most of the millets are pest-free. In traditional societies, they used to be used as used as anti-pest agents to store pulses etc. 

- Nutrient to nutrient, most of the millets are much superior to rice and wheat.  

Again, why all the sudden excitement? 

It was quite long time back, I wrote about the millet cultivation that was much prevalent in our part of the country. 

As part of a project on facilitating community adaptation towards climate change, we've identified farmers who would be encouraged to take up millet cultivation. They have land which are conducive for millet cultivation. 

Quite a lot of them had been quite enquiring about 'kodo'. They  had heard about how good 'kodo' was from their parents. Very few remember seeing it. 

And we've been searching high and low for people who can provide us with the kodo seeds. 

. . . and we would also need people who could help us with the technical know-how of millet cropping. 

The 2 other crops that we would be facilitating to re-introduce would be 'ragi (finger millet)' and 'bajra (pearl millet). More on them in my next posts . . .

If anybody has information about where we can procure kodo seeds, please contact me ASAP. 

Precious lives . . .

The next week, I've received an invitation to be part of a meeting where we are going to discuss about malnutrition in Jharkhand. I shall put in more about it after I attend it and receive permission from the organisers to write about it. I'm quite interested in this as from the agenda it seems that there is some survey findings that this group wants to share with us. 

As per the State Hunger Index in India, Jharkhand has the dubious distinction on being second last in the list of 17 states which were studied. In addition, it was terrifying to know that 57% of the children in the state are underweight. I don't know the details. 

Well, these are numbers. However, for people like me who dab in clinical care as well as public health, it is not uncommon to keep a very watchful eye on children who come to us for clinical care. And it does not need much experience to put forth the fact that almost 60% of under five children whom we see are underweight. More so if they belong to the tribal population or lower socio-economic status. . 

Last week, we had this boy whom we shall call MK. MK was all bloated up. I was on my way to the Palamu Fort fair when the outpatient nurse called me to take a look at this boy. NK was past 5 years,  but was all bloated up. My instant diagnosis was Nephrotic Syndrome. I wrote off the necessary investigations. 

Later, as I was at the fair, Titus called me up saying that the investigations have all turned up normal for renal function. No nephrotic or nephritis. I told him to admit the patient. 

The next day, I had a re-look at little MK. I could only shudder at what could be a possible diagnosis. Severe Protein Energy Malnutrition. Off went investigations to look at Serum Albumin and Protein. Serum Albumin was 1 gm% and Serum Protein was 3 gm%. His liver parameters and renal parameters were all fine. 

We started him on 'food'. Eggs, high energy biscuits, soya bean chunks . . .  The results were amazing. I found it difficult to identify him during rounds. The swelling of his limbs came down. His abdomen which was distended tense became more flabby. His breathing became more relaxed. He had started to walk when we thought of sending him home and to review him weekly. 

Well, before I wind up this story of MK, I would also like to mention that MK had already been seen by 2 paediatricians and both of them had made a diagnosis of glomerulonephritis . . . put him on antibiotics. The family has been on the run for the last 6 months to treat their child who was all swollen up. 

Malnutrition is the bane of rural India. Unhealthy food habits, non-availability of nutritious food, ignorance about nutritional qualities of different food materials, disappearance of traditional food stuff like millets . . . all of these has been factors. Poverty has made matters worse. 

And most of the serious disease conditions are many a time because of malnutrition or is made worse and fatal by malnutrition . . . leave alone, the resultant morbidity. 

It is sad when the medical profession fails to recognise malnutrition as a disease. In fact, many a time I feel that in our rush for statistics, we fail to recognise individual cases. Lives does not matter to us. Numbers do. 

I hope children in Jharkhand will benefit from the meeting . . .