Holding out Hope in Dharavi

‘My son had cow’s milk from birth. He looks healthy. What is so great about mother’s milk?” Sabawn’s voice resounds in a narrow, cramped lane in the heart of Asia’s largest slum, Dharavi. A local priestess, she cuts a dramatic figure in her yellow sari and orange tikka.  Gathered around are a group of women, listening in rapt attention. Many of them are heavily pregnant, some are holding newborns.

Sabawn’s comment is an indication of the challenges that lie ahead for the Maharashtra government, corporates and NGOs who have come together in a first of its kind partnership called the AHAR project. A project that aims to change the face of Dharavi, a densely packed slum, home to over a million people, mostly migrants. A well-known Mumbai landmark, immortalized in the Oscar-winning film Slumdog Millionaire, the slum is a maze of narrow lanes, shanties and overflowing gutters.

Not surprisingly it reports among the highest rates of malnutrition in the city. About 35 % children between the critical 0-3 years are malnourished.  While anganwadis or day-care centers have been set up as part of the government’s Integrated Child Development Scheme (ICDS) to provide nutrition, education and health services, the workers here are overburdened and poorly paid, with the result that many children are left behind.

It is here that the non-profit group SNEHA or the Society for Nutrition, Education and Health Action plays a critical role by training sakhis or community link workers who go door to door and advice women on nutrition, breastfeeding, family planning and maternal health.

“Imagine this is your baby” says sakhi Mangal Shinde pointing to a lifeless doll hanging on one end of a scale used to weigh vegetables.  At the other end hangs an empty bag. “What you put inside this bag decides your baby’s future,” she says adding factsheets with pictures of healthy foods for children. As the bag gets heavier, the doll rises. The women smile and clap. Sabawn still looks sceptical and clearly requires several more sessions!  Convincing her is critical as she wields tremendous influence in the community.

“It’s not easy,” admits Dr Evelet Sequeira, Head of Nutrition with SNEHA. “We tell the mother her milk is for her baby and this milk will help in brain development. So when the baby weighs 3.5 kgs at birth it has already passed Class 10. If she were to breastfeed exclusively until 6 months, the baby has cleared Class 12. For every mother her child’s intelligence is very important and this helps drive home the point.”

Simplistic though the approach may sound, it is showing results. Rates of exclusive breastfeeding have gone up. So has immunization. “More and more women are delivering in institutions,” says Priya Agarwal, Senior Advisor with SNEHA. “ Earlier women would register at the local health center in the last trimester of pregnancy. Now it’s in the first trimester.”

Another critical service SNEHA provides is crèches where working mothers can leave their babies. Now mothers no longer leave their infants with neighbors or older siblings when they go back to work. Instead they drop them off at the crèche where their health is closely monitored and they are given supplementary meals.

SNEHA believes the Dharavi experiment will lead to a sustainable model which can be replicated in urban slums across the country. “We have the government and ICDS on board and we are looking at global protocols that have been tried worldwide to see how we can adapt it to our settings”, says Dr Sequeira.

Words that hold out possibilities to thousands of children like Mehboobi, who at 2 years weighed 8 kilos, the healthy weight of a 6-month-old. When she came to the crèche last year, she would not lie down. Tests showed she had spinal TB and suffered from severe back pain. Today she is nearly 3 and weighs 10 kgs.  She has a long way to go.  Watching her perky, shining face shout out alphabets, there is hope she will get there.

For a vdeo link to the Dharavi project visit


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