Sumo Nayak, India
Here and there in Irukpal, a village in the eastern Indian state of Chhatisgarh, you may notice an odd drawing of a stubby tree on the side of some of the low-roofed houses. On some, the tree is unfinished, the branches and roots still bare. On others, each branch and root is cross-hatched at regular intervals, with nine X's up the trunk.
These drawings are not decoration; they are low-tech but powerful databases, and for the mothers of Irukpal they can mean the difference between a healthy baby and disaster. The records stored in these diagrams are one facet of a comprehensive strategy designed by CARE to keep mothers and newborn children in Irukpal healthy and strong.
Sumo Nayak, 22, is one of these mothers, and one of the trees is hers. The six X's on the trunk represent her six months of pregnancy. The twigs on each branch show the iron folic acid tablets she has taken to prevent anemia. The marks on the roots indicate each time she has received supplemental rations of high-protein meal.
Besides being a proud expectant mother, Sumo is a mitanin, or volunteer maternal health worker. (Mitanin means "friend" in Chhatisgarhi). Trained by CARE, she and the other mitanins visit new and expecting mothers in the village regularly, using the tree diagrams to ensure each woman follows best practices for her new or unborn child. They also encourage visits to the village anganwadi, where health workers come each month to immunize children and distribute supplemental rations, vitamins, and iron folic acid tablets.
Sumo and her colleagues have been strikingly successful. Thanks to their outreach, over 80 percent of the mothers in the village came to the anganwadi last year, up from 20 percent in 2002. Their success contributed to striking gains in children's health: over the last five years: infant mortality in Chhatisgarh dropped 13 percent and malnutrition in children under 5 fell 20 percent – the greatest reduction of any state in India.
The mitanins are bringing other changes to the village. Some, like Sumo and her colleague Asmati, now hold elected positions in village government. "Before, women would never go to the village assembly," Asmati said. "They didn't know what to say, and they were hesitant. There were too many men there. Now they raise issues in the assembly."
Across Chhatisgarh, over 6,000 CARE-trained maternal health workers have been elected to the village assemblies, where they are discussing health and nutrition issues. The result has been a sea-change in attitudes – a change that shines in the faces of mothers and children in Irukpal.
Asmati smiled as she thought back on her success. "Like everyone here, I grew up on gruel and water. Never in my life did I think I'd be elected to the village assembly or the regional government"—or, she might add, make such a positive difference, in concert with CARE and other mitanins like her, in the lives of the women and children in her village and beyond.