Nuh, with its sex ratio of 942, belies its backwardness. Since the Meo Muslim population considers the birth of a child “Allah ki den” (blessings of God), whatever be the gender of the newborn, the district has large familes and hence more women than many other districts of the state.
That is not essentially a good statistic to flaunt, because this might also be the one district where women really have the odds stacked against them, even by Haryana’s standards.
Rubina is in the second trimester and expecting her seventh child. The 30-year-old was harvesting bajra in a landlord’s plot in Punhana’s Neemka village, when she felt a sudden dizziness. She took a break and called her husband Nasir working in the adjacent farm. “Khoon bahout kam lag raha hai, sharir toot raha hai,” says Rubina in a very tired voice (I think the blood level has further gone down, my body is aching)”.
Rubina has been anaemic for eight years now. Her haemoglobin count is 5 grams per decilitre, which is less than half of what the normal range is. For a healthy woman, the range lies between 12-15 grams.
Multiple pregnancies, poor nutrition and lack of health facilities have made many women like Rubina vulnerable. According to the National Family Health Survey (2015-16), in Mewat 79.9 per cent pregnant women aged between 15 and 49 are anaemic — this number is 68.6 per cent for other women in this age bracket.
Dr Lokveer Singh, Chief Medical Officer of Mewat’s only general hospital, catering to a population of five lakh, says every second woman in Mewat today is anaemic with haemoglobin levels of just 5-6 grams. “Tackling anaemia in women is still a challenge in Mewat. First, because people here do not subscribe to the concept of family planning due to religious views. Second, even though the maternal morbidity and mortality rate have reduced in recent years, the health facilities in terms of hospitals, medicines and availability of doctors, especially women, are poor,” says Singh.
With Haryana scheduled to vote early next week, women of this district, less than 60 km from the opulence of Gurugram, demand better treatment and health facilities in each village.
Rubina’s only demand is of better health facilities in her village. “I am aware that my HB is 5 grams, but I don’t know how to increase it. The nearest hospital is 8 km away and my husband is mostly out. With six children to take care of, I hardly move out of the house,” she explains her predicament.
Rubina is not alone. Wakila, a 42-year-old in Bichore village, has a hemoglobin count of 8 grams. She wants frequent visits by Asha workers with supply of medicines. “Water is already scarce in this district, but the blood is drying out of us women. Anganwadi workers hardly visit villages and even if they do, they only immunise children under the age of five,” she says.
However, Raziya Khan, the district coordinator of ASHA workers in Nuh, says folic acid tablets are supplied once in four weeks in every village. “We are trying to detect anemia at an early stage itself so that recovery is quicker,” she adds.
The Ministry of Health and Family Welfare’s family survey of 2015-16 concluded that the district has the highest percentage of women and children with anaemia and most number of births without the presence of a health professional.
Rubina’s husband Nasir, a truck driver, says: “We are most of the time away from home. If the hospital is away from our village, how are women supposed to even visit a doctor considering the poor condition of public transport here.”
According to Niti Aayog’s survey in 2015-16, reproductive healthcare is found to be largely in a grim state in Haryana, particularly in Mewat. Only 51 per cent women had an institutional delivery in Mewat, thereby magnifying the risk to the woman and the baby.
The mean age at marriage for girls is the lowest in Mewat and as a result around five per cent of the total births in Mewat were accounted to women aged 15 to 19 years. The large family sizes in Mewat is also an indicator of how family planning is not adopted in the region.
According to health consultant Akshita Singh, for more than 500 villages in Nuh, there are only 90 Primary Health Clinics (PHCs) in the district with only one doctor in each of them and there are only four Community Health Clinics (CHC) in each block.
Shabnam was diagnosed with severe anaemia in 2016 and transferred to Alwar medical college for treatment. Still anaemic, the mother of eight children says women in the region are usually up by 4.30 in the morning and retire for the day late. “Right from providing food to the animals, cooking, taking care of our children, sometimes working for a few hours in a farm and mostly importantly filling water, we are tied up the entire day.”
Shabnam also complained that even today most of the villages don’t have water pipelines and young girls go to fetch water at least twice a day.
Nuh also lags behind in education. As per Niti Aayog’s survey, only 23.3 per cent of the female population in Nuh were literate as of 2015. Mohammad Habib, a social worker, highlighted how this is the only district in Haryana without a Central school. Girls don’t study beyond fifth grade because there’s only one higher secondary school in each block.
Abida from Punhana village is aware that for the first time a woman candidate, Nauksham Chowdhary of BJP, is in fray from her district. Irrespective of the party she belongs to, Abida is hoping for her to win so that the situation of women improves in the district. “I don’t even know her name, but being a woman maybe she could help us.
Chowdhary, meanwhile, said her first concern would be to increase the number of ambulances for the transportation of pregnant women. “I want to focus on improving the health facilities in Punhana, especially for pregnant women. I aim to increase the number of ambulances to 30-40 from the present 3-4, and would bring more women doctors to each PHC.”