Among many others who have slipped through the cracks of the city’s health system, 22-year-old Zahida Begam, a migrant worker from Govandi slums, was left with no choice but to deliver at home due to her lack of knowledge about maternal health and poverty.
“After children, it is the women who suffer the effects of slum demolitions the most,” said Leena Joshi, project director of the M Ward Project from the Tata Institute of Social Sciences (TISS), Chembur. This is why slums in M (East) ward, which houses 60,000 families, have a high maternal mortality rate.
In this ward, there are 105 beds in the maternity wards for a population of 12 lakh. With the existing poor overall human development indicators, this section of the population is denied even the basic Integrated Child Development Services (ICDS) because they are “illegal” in the eyes of the government.
ICDS is a centrally sponsored flagship programme; it provides a package of supplementary nutrition, immunisation, health check-ups, referral services, nutrition and health education for mothers, and non-formal pre-school education for children between the ages of 3 and 6. Eligible beneficiaries of the programme are children below six, pregnant women, nursing mothers and adolescent girls.
Joshi explained that these daily wage earners do not have ration cards and, therefore, no access to food security. Also, the high cost of transportation compromises their ability to reach the health centre, so they give birth at home. “Rafiq Nagar and Indira Nagar in Govandi are good examples,” she said.
Simpreet Singh of National Alliance for Peoples Movement, an NGO that has been working for the rights of slum dwellers, said, “When a demolition occurs, the slum dwellers lose their belongings. In a bid to salvage their belongings and rebuild their homes, they miss work, and as they are daily wagers, they eat only if they earn for the day.
Moreover, anganwadis are not performing all the health checks they are supposed to. According to a 2006 national health survey, nearly 97% of women in Mumbai slums received no services from the scheme during pregnancy and 99.2% received no services while breast-feeding.
All these factors compound the situation as women become prone to waterborne diseases due to poor water supply in the slums. “There are sanitation issues. Plus, the women are either too young to give birth or old. All this contributes to a high rate of maternal mortality.”