And you may be surprised by how many girls tested by two NGOs in southern India were anemic

4 min readJan 25, 2016

Of all the women around the world who die in childbirth each day from preventable causes, 20 percent are in India. Of these, 60% die directly or indirectly from a single condition that a lot of us consider easily treatable: anemia.

Nutritious meals or common supplements cure common anemia, a deficit in red blood cells that carry oxygen to tissue. The symptoms of anemia — dizziness, fatigue, more frequent infections, difficulty focusing or learning — are often mistaken for something else. But there’s no mistaking it once a woman is pregnant.

Pregnancy and delivery require strength and endurance; severely anemic women have neither. When their luck runs out in labor, anemic women hemorrhage, their hearts fail, or later, they die from infection. Babies born of anemic mothers are more likely to be born too soon or with birth defects.

Poverty, disease and lack of access to healthcare mean that for poor young women of childbearing age, anemia can be fatal. It is also sexist.

Despite the stunning transformation of India over the last few decades, a paternalistic culture persists in many places that regards girls as second-class citizens. Within families, women feed their husbands and sons first and the best of what’s available. In poor homes, there isn’t much and girls are often the last to be fed. Researchers are used to seeing low body mass index (BMI) and malnutrition more often in girls than in their brothers.

While it is easy to see the impact of anemia, the victims are not always easy to find. The girls most likely to be sick are also the girls most likely to be hidden from view, kept at home by their families.

So it is all the more remarkable that an innovative foundation in India has been successful in finding, organizing, screening and treating thousands of adolescent girls and pregnant women in a very short time.

WomenStrong International and Dhan Foundation reached and tested thousands of young girls in just 20 weeks.

The Dhan Foundation was founded 30 years ago on the Gandhian principles of justice and satyagraha, or leadership. Cultivating self-help within communities, Dhan works with under-resourced urban and rural populations across India, partnering with government, health systems, the private sector and other non-governmental organizations (NGOs) whenever doing so holds promise for improving the lives of India’s poor.

In Madurai, a city of about a million people in the southern state of Tamil Nadu, Dhan partnered with WomenStrong International to survey 13,000 families in an effort to find and screen girls at risk for anemic. Over about 20 weeks, more than 4,000 girls were tested, revealing that 87.5% were anemic, and a quarter of those tested were severely so. Not surprisingly, about 80% were underweight or severely underweight suffering from malnutrition.

Finding, screening and treating thousands of young girls reduce maternal mortality and birth defects

All the girls with anemia were treated. The sickest were sent to the local community hospital while the rest were given iron and folic acid tablets to take at home. Equally important, Dhan and WomenStrong offered education about anemia and nutrition to girls, women and their families, stressing the importance of nutrition and the need to feed girls the same as boys.

The screening program has succeeded because of Dhan’s remarkable network of grassroots women’s Self-Help Groups (SHGs) that are formed around a program of community microfinance banking. The microfinance program kick starts Dahn’s broader efforts in community organizing and, once established, the small cells of organized women become the conduit for a wide variety of programs that address other needs, like shelter and education.

Over the years, Dhan has created nearly 41,000 Self-Help Groups in villages and urban slums, supporting more than 600,000 families across 12 Indian states in their efforts to climb out of the deepest poverty. More than 200,000 women and girls have been screened for anemia nationwide as part of the Eradicate Anemia project. The project with WomenStrong, part of a larger multi-year effort, is just getting underway.

Anemia screening is the first step toware treatment, education and changing attitudes.

The girls of Madurai will be tested and weighed again next year to assure that the treatment is working — and that sexist attitudes are changing. Helping women in southern India to lift themselves out of poverty means helping them rise above long-standing injustice to realize their potential, make real economic progress and, in the case of anemia, save young lives.




Sydney Rubin is Deputy Director of WomenStrong International, an award-winning communications consultant and writer, and former foreign correspondent..