FACILITATOR’S GUIDE CHILDREN AND MOTHERS HEALTH AND NUTRITION TOWARDS BUILDING RESILIENCE OF URBAN COMMUNITIES Save the Children works in 120 countries globally and across 19 states in India for children’s rights Save the Children works in 120 countries globally and across 19 states in India for children’s rights - to inspire breakthroughs in the way the world treats children, and to achieve immediate and lasting change in their lives. It is determined to build a world in which every child attains the right to survival, protection, development and participation. We deliver immediate and lasting improvement to children’s lives worldwide. Save the Children works for : • A world which respects and values each child. • A world which listens to children and learns. • A world where all children have hope and opportunity. Copyright © 2016 by Save the Children All rights reserved. This flip book is developed and designed by Save the Children. No part of this doc- ument may be reproduced, distributed, or transmitted in any form or by any means, including photo- copying, recording, or other electronic or mechanical methods, except in the case of brief quotations embodied in critical reviews and certain other non-commercial uses permitted by copyright law. 3 This publication is protected by copyright. It may be reproduced by any method without fee or prior permission for teaching purposes, but not for resale. For use in other circumstances, prior written per- mission must be obtained from the publisher. © 2016 Save the Children Concept & Guidance: Mr Abhay Narayan Tripathi, Honourable Secretary, Maharashtra State Commission for Protection of Child Rights Contributors: Sandhya Krishnan, General Manager State Programme, Maharashtra Save the Children Sheikh Khairul Rahaman, Programme Coordinator- Urban DRR, Save the Children Dr. Ninad Salunkhe, Program Head, Apnalaya Rupali Goswami, Advocacy, Campaign & Communications Coordinator, Save the Children Technical Support: Ray Kancharla, National Humanitarian & DRR Manager, Save the Children Reviewed By: Sangeeta Srivastava, Administrative Officer (I/c), Maharashtra State Commission for Protection of Child Rights Content writing and Designing: Zivanta Analytics Production In-charge: Rupali Goswami, ACC Coordinator, Save the Children he invisible parts of our cities are kept in Twraps by the glitz and glamour of the city PREFACE lights, sparkling glass towers and serenading neighbourhoods. The invisible parts are the urban slums, where the losing battle to make a decent living is business as usual. These slums are characterized by inadequate sanitation facility, improper housing, lack of safe drinking water, drainage system, proper disposal of waste and facilities which make them vulnerable to health hazards. In Mumbai it is estimated that nearly 55% of Mumbai’s population lives in Slum areas, which translates to 6.5 million individuals. These urban slums given inadequate civic infrastructure and economic wherewithal are highly vulnerable to disasters - may that be an epidemic, a natural or man made calamity or urban strife. It is said that it is better to give seeds than food, which translates into being better prepared than to provide relief when the worst strikes. Save the Children along with its partners is working in the slums of Mumbai to make them more resilient to disasters. In a step towards the aforesaid goal, Save the Children has designed this Facilitator’s Manual for use by front line health workers, including ICDS workers and volunteers during their sessions, home visits and counselling in the communities. To ease learning and retention, the manual has been designed with illustrations and is expected to be a handy reference guide. This document lists out the hazards identified through participatory vulnerability capacity analysis and use the findings as the basis of intervention in reducing health risks of pregnant women and young children. Sandhya Krishnan General Manager State Programmes, Maharashtra State Programme Office, Save the Children (Bal Raksha Bharat) INTRODUCTION I am Ammu, I stay in Shivaji Na- I am Aman, Ammu’s best friend. I stay gar Slum Pocket of the M-East Ward. My in Baiganwadi slum pocket of the M-East Ward. father has a tailoring shop and my moth- My father died when I was six. Me, my mother er is a home-maker. I have three younger and my younger brother stay in our one room siblings. We have limited means but are a tenement. My mother works as domestic help. happy family. My mother though illiterate We have difficulty in making our ends meet. I has always pushed me to study. I study in and Ammu are classmates. Class X at the Shivaji Nagar Government High School. 1 Will You Help Us Do Our Assignment? ur class teacher has given us an assignment on documenting the Health and Nu- Otrition Hazard prevalent in the M-East Ward. This is what she has asked us to do : 1. Walk through M-East Ward- Health Hazard Perspective 2. Demographic view of M-East Ward 3. Seasonal and Hazard Risk mapping calendar 4. What are the Health Hazards and precautions to take? 5. Collect Emergency Contacts We invite you to our journey through the M-East Ward as we go about finding the answers. 2 Evolution of the M-East Ward Slum t is still early in the morning, but the narrow fruit seller is out, some children walk towards Ialleyways of slums of M-East Ward is already their school. M-East Ward is a busy place, but the bustling with activity. The women are lining up at worn out sandals and the weary faces tells you the stand-post to collect water, children sit besides that very few people earn much money. the winding lane for their morning ablution, a lazy dog jostles in a muddy puddle of water dispers- ing thousands of newly hatched mosquitoes. The How did M-East Ward Evolve into a Slum? 1927: Deonar 1971: Abattoir 1972-73: Re- Garbage Dump set shifted from Bandra to location of poorer up. India’s oldest and Deonar to make way residents from Inner Asia’s largest dump- for a bus depot city areas to Shivaji ing ground (132 ha) Nagar, Baiganwadi and Lotus colony. 1976: 2nd wave of 1986-93: 3rd wave 2003-06: World relocation to accom- of relocation in order Bank funded MUTP modate city’s indus- to ‘clean’ Mumbai of its & MUIP infrastruc- tries. Residents of slums brought a large ture projects added a Janata colony, BARC, number of people to large number of hhs resettled at Cheetah M-East ward to M-East Ward slums camp 3 The Best and the Worst Wards in Mumbai Tale of Two Cities based on Health, Education and Livelihood Indicators The Best Ward in Mumbai The Nana Chowk Haves HDM Score 0.96 The Worst Ward in Mumbai The Ward M-E Have Nots HDM Score 0.05 Tale of Two Cities Source: HDM Report, Municipal Corporation of Greater Mumbai, 2009 In 2009, Municipal Corporation of Greater Mumbai com- missioned a study to ascertain the inequity of development across the municipal wards in Mumbai. Shivaji Nagar ME Ward is the worst in Mumbai in terms of health, educa- tion and employment. The attendant infrastructure leaves Baiganwadi much to be desired. Mumbai City ME Ward Mankhurd Literacy Rate 89.22% 66% Govandi Unemployment 17.8% 51.87% Vashi Naka Cheeta camp Median Income 20000 8000 Infant Mortality 34.57 66.47 Slum Population 52.06 lakh 5.85 lakh Total Population 124.42 lakh 8.07 lakh % Slum Popn 41.81% 72.49% Source: TISS M-East Ward Survey 2011 Map not to scale 4 In Some Pockets at M-East Slums Things Are Alarmingly Worse No JOB A B C D E F G H I J K LOW LITERACY: Illiteracy in M-East ward HIGH UNEMPLOYMENT: In the working is estimated at 21 percent. Baiganwadi, has the age group of 20-55, less than 50 percent men worst scenario as regards illiteracy (above 25 and less than 10 percent women reported to percent). Mankhurd and Govandi too report il- be in some form of income generating activ- literacy above 20 percent. At aggregate level ity. Muslim women report the highest rate of the gender differential in levels of illiteracy is a unemployment (close to 90 percent) among significant 20 percent. Nearly 30 percent women religious categories. reported being illiterate, which is twice the aver- age for the city. -------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- POOR HEALTH & NUTRITIONAL STA- TUS: 50% of the population suffers from life- style-oriented illnesses such as heart disease, diabetes, respiratory ailments, high blood pres- sure, Tuberculosis. Nutrition related problems plague most children with 45% of them suffer- ing from stunted growth and almost 35% being underweight. The mean number of pregnancies recorded is high, at 2.88. The ward also records a high number of abortions compared to the city average. The proximity to dumping grounds make things worse for general health and well being. -------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- Underweight Illiter- Slum Locality No. of Slums Slum Popn Sex Ratio Regular Emp Children (0-6) acy Shivaji Nagar 5 slum pockets 118255 933 45% 12% 19% Baiganwadi 12 slum pockets 95481 891 47% 16% 26% Mankhurd 28 slum pockets 209642 819 53% 16% 24% Cheeta Camp 4 slum pockets 78674 946 43% 7% 18% Govandi 16 slum pockets 85815 910 44% 19% 22% Vashi Naka 19 slum pockets 90251