Emma Krijnen-Kemp travelled from Hull to Kolkata in India to investigate a world of contrast
Clearly visible on the small black and white screen is a tiny head, body and arms. For Jin, visiting her well-equipped local hospital in Humberside, this is amazing. The scan gives her the chance to see her baby for the first time and provides reassurance that her pregnancy is going well.
Later that same month, I am introduced to 18-year-old Reshima, also going through pregnancy. Her experience will be somewhat different to Jin’s.
Reshima lives over 5,000 miles away in Kolkata (Calcutta), the former capital of India, and once the second largest city in the British Empire. Kolkata has been described as a decaying city, suffering from over-population and increasingly high levels of pollution. Sanitation is predominantly lacking, living conditions are generally poor, and much of the water is a toxic cocktail. The very thought of bringing up a child in such poverty causes anxiety.
“The main problem is that of nutrition,” explains Dr Nimai Dey, a paediatric consultant in child health with Child in Need India (CINI).
There is clear evidence of this as I look around the clinic. Underneath the swathes of their colourful saris, the young women are painfully thin and their children lack the animate spirit of infancy. Healthcare workers at CINI confirm that it is quite common for women and young girls to go hungry, while the men of the family are fed. The men joke that women are probably eating their share while they prepare and cook the food.
This is how the cycle begins. Mothers are underfed and malnourished and then give birth to low-weight babies. These babies experience health complications and poor growth. If the girls survive to become mothers themselves, they will perpetuate a legacy of inferior health and high infant mortality.
Dr Dey explains: “The parents need counselling regarding appropriate feeding and hygiene. We can admit them to the nutrition rehabilitation unit if they are very sick to help them get well. We then teach them about cleanliness and nutrition, and this is sustainable.”
Breaking the poverty of ill healthCINI knows the best way to tackle things is to provide a service that breaks the cycle of poverty, malnutrition and ill health. This is the same approach that has been adopted in Britain. Jin, for example, has started accessing Sure Start, a government-run programme that aims to ensure that all families get the best start in life. By offering pre- and post-natal care, guidance, advice and basic family support, Sure Start helps families to effectively manage early childhood.
Jin feels that she is being well cared for. She has ample advice on nutrition for both herself and her child, she knows about the developmental stages of her pregnancy and when she should stop working. She has regular contact with her midwife.
Jin explains that she will soon start birthing classes. “I’ve also been given all the options on childbirth and whether I want a waterbirth, a hospital birth or a home birth,” she says.
In India, Reshima is expecting her first baby in the same month as Jin. She has many concerns and really wants a hospital birth. Although she will not get the reassurance of a scan, with the support of CINI she is now registered with the hospital and has received iron tablets, folic acid, and immunisation for tetanus.
Reshima’s choices about childbirth are restricted. Her husband will not be allowed into the delivery room to support her. If she comes from her husband’s house, rather than her own family’s home, it will be her mother-in-law and not her own mother who attends the birth. As traditional home births present many complications, CINI is promoting safer hospital births. There are reports that some women are having to share beds during labour, therefore improving conditions has become a key priority for the charity.
Jin has few worries now. She says: “Everyone bends over backwards to help you. People see the bump and just want to take care of you and make sure you are eating well. That’s how our society is.” CINI is trying to create a similar status for poor women in India so that pre- and post-natal care becomes everyone’s concern.
Sponsor a MotherThe Sponsor a Mother programme helps ensure that women have the access to good nutrition and healthcare support they need during pregnancy. They also get advice and support about breastfeeding, and help with preventative healthcare – so that their children have a strong foundation on which to build healthy lives.
CINI’s Sponsor a Mother programme is beginning to have an impact. In India, six out of 10 births are not attended by a trained person, but in CINI’s project areas, this has been cut to just over one in 10. Rates of child malnutrition and mortality have also been halved in areas where the charity has long-standing projects. The idea is that mothers are supported by sponsors: £10 a month ensures that the mother and child receive all the necessary care they need to see them through the critical time to the child’s second birthday.
Having mobilised the community, CINI has also engaged the local Indian government. It wants things to be sustainable for the future and has secured local government funding to match the donor’s sponsorship.
The results are amazing. Kashmira, who like Reshima is 18, is one of 650 mothers who are currently being sponsored. Her son Rafika was born at home with the assistance of a trained birth attendant. He weighed a healthy six-and-a-half pounds and has continued to steadily gain weight. He has been immunised and both he and Kashmira are regularly monitored by CINI’s health care professionals.
As CINI’s programme of support grows and takes effect, Reshima and the other young mothers of India can also look forward to a more promising and healthier future.
For more details about CINI and the charity’s sponsor a mother programme see
www.cini.org.uk or call 020 7582 1400.
