And yet there is hope

“Great beauty often portends impending tragedy”

A few months ago in a small hamlet, set among verdant hills, somewhere in central India, I came across Champa. The air is clear and there is winter chill.

The hut in which Champa lives with her husband, three kids, and in-laws, has two rooms. There are two goats in a pen, and a few hens picking busily. The cow looks up with some disdain as we approach. The bells of the village temple clang distantly

Champa comes out of her hut, pallu covering her face, clutching some papers she can’t read, from some past encounter with the rural health system. She is twenty-two, and a mother of three. Her baby Rani, two, is wasting away from severe acute malnutrition. Rani requires emergency treatment or she will die.

But Champa can’t take Rani for treatment in the district Malnutrition Treatment Centre. It is two hours away, on a bus which comes by twice a day. She and her baby would have to stay at least ten days. Champa leaves her house only to work for a daily wage in the fields nearby.

In any case, her father in law, Ram Babu doesn’t think much of city hospitals. He sports a jaunty turban and the biggest whiskers I have ever seen. Ram Babu sways in the mid-day sun, silly on homemade rot-gut. He needs Champa to stay home to cook for the family. If “God takes one child, he always gives another one” he slurs philosophically.

My women colleagues can’t get Champa to show them her face. She speaks little, in halting whispers. She simply accepts the worst as part of life.

Before we leave, Ram Babu, the perfect host, insists we partake of some of the traditional brew. It must be accepted in the palm, with the fingers intertwined just so. A youth idling nearby, incongruous in faded torn blue jeans, demonstrates the right etiquette.

Champa’s situation is simultaneously so simple and yet so complex to resolve.

Simple: get the baby to a treatment centre, where she will be fed a special khichdi for about ten days. It’s WHO proven, kids love the taste. Rani would begin recovering in days, and be prepared to go home in perhaps two weeks.

Complex: because it means tackling an imponderable series of barriers.

There is Champa’s grinding poverty that dictates that she not miss a day’s work.

There is the barrier of product access, because the imported nutrient that could work at home is not available through government.

There is the barrier of physical access, because it involves a gruelling journey, and being away for days.

There is the cultural norm that dictates that her father in law’s word cannot be questioned.

There is the pervasive alcoholism that clouds right instinct.

There is a lack of support from her community.

There is the community health worker who is not even aware of Rani‘s existence.

There is the fact that Champa herself has lost hope, and with it her voice

Rani’s life was saved because the local NGO intervened immediately. But there are millions of Rani’s in millions of villages across India. They too face a web of barriers. There is no one silver bullet for all of them.

And yet we believe there is hope. It’s a longer story. Stay tuned.