Plight of Assam’s tea tribe women

A baby girl born in the tea gardens of Assam has fewer chances of survival than her male counterpart before reaching the age of five. Most of the tea tribe girls in Assam are victims of child marriage and human trafficking. Many of them are deserted by their husbands after bearing children. Lack of awareness is one of the reasons why teenagers elope, often resulting in early pregnancy and the abandonment of the young girl once her partner realises the additional responsibility  – Prof. (Dr) Dharmakanta Kumbhakar (drkdharmakanta1@gmail.com)

Cane baskets on piggybacks, plucking leaves in a lush tea garden with radiant smiles – this is the picture-perfect image of Assam’s tea tribe women, painted mostly for cover shots. But in reality, they are far from happy. And they have countless stories of irony.

Most of them suffer from illiteracy, poverty, poor health, and a lack of awareness. Their basic amenities, such as healthcare, education, housing, childcare facilities, maternal care, and accident cover, are not adequately provided. Nothing has ever changed as far as the lifestyle of these women is concerned.  Ignorance among tea tribe women and the lack of management support are to blame for this situation. The top tea estate management does not want too much development for these women.

A baby girl born in the tea gardens of Assam has fewer chances of survival than her male counterpart before reaching the age of five. Most of the tea tribe girls in Assam are victims of child marriage and human trafficking. Many of them are deserted by their husbands after bearing children. Lack of awareness is one of the reasons why teenagers elope, often resulting in early pregnancy and the abandonment of the young girl once her partner realises the additional responsibility. Though tea tribe women in Assam earn the same as their male co-workers, that does not mean they have a say in the way they lead their lives. They often face domestic violence. Alcoholism, mostly among men, is a major cause of domestic violence. Both the government and NGOs need to spread awareness against alcoholism, child marriage, and domestic violence in the community.

Most of the tea tribe girls of Assam are deprived of education. Often, they drop out of school to work and supplement the family income. The management does not want them to be educated. If they become educated, ultimately, they can fight their own battle, and this is what the estates do not want. One hopes that the primary and high schools established by the Assam government in the tea garden areas will help the tea community girls become highly educated and lead a better lifestyle.

Most of the tea tribe women of Assam are unaware of proper menstrual hygiene-related practices. Only a few use sanitary napkins. The rest use unsanitary old cloth pieces, papers, dried leaves, grass, etc. These unhygienic and unsanitary practices lead to urinary tract infections, reproductive tract infections, and even death among them. A major publicity campaign should be launched to encourage them to use sanitary napkins. The need of the hour is to improve the quality of life of these poor women by providing them with free, highly subsidised, and easily accessible sanitary napkins.

Health-wise, malnutrition is common among the tea tribe women of Assam; nearly 95 percent of them are anaemic and malnourished. A study by UNICEF and the Assam Medical College found that out of 14 meals in a week, only two are nutritious in a tea tribe family. Women and children from tea tribe families suffer from malnutrition from an early age. Anaemia and malnutrition continue to cripple these women, making them among the most vulnerable to diseases like tuberculosis. Smoking, consumption of alcohol, poor quality of life, and poor housing, which debilitate the immune system, make them more vulnerable to developing tuberculosis. Tuberculosis kills more women in the reproductive age group than all causes of maternal mortality combined in the tea garden population of Assam. One expects that the Assam government’s scheme of providing free rice to the tea garden community under the National Food Security Act will definitely improve the nutritional status of Assam’s tea tribe women and thus their overall health.

The major tea-growing areas of Assam have a much higher maternal mortality rate (MMR) than the state average. Anaemia, hypertension, and malnutrition are some of the major causes of the high MMR among tea tribe women in Assam. Almost 90 per cent of the tea tribe women of reproductive age are anaemic. In most anaemic pregnancy cases, maternal mortality is an inevitable reality. Hiding pregnancy is very common among tea women workers, as they fear losing their jobs. They do heavy work throughout the nine months of their pregnancy with poor nutrition. Thus, they become weak, anaemic, and vulnerable to high maternal mortality. Of course, the Assam government’s welfare scheme of providing Rs 15,000 under the Wage Compensation Scheme for pregnant women in the tea gardens is helping pregnant women of the tea tribe take care of themselves and their unborn babies better without compromising the livelihood of their families, thereby helping to reduce maternal and infant mortality in the community.

Tea tribe women usually drink alcohol and high-salt tea that is served to them as an energy drink to combat dehydration and extreme fatigue due to heat build-up. A recent study found that they consume around four times more salt than others. Alcohol and high salt intake lead to complications in pregnancy, often characterised by high blood pressure and organ damage; in medical terms, it is referred to as eclampsia, one of the main reasons for the high maternal mortality rate among tea tribe women in Assam.

Moreover, due to the unavailability of any nearby hospitals and healthcare facilities in the tea gardens of Assam, tea tribe women often bleed to death during delivery, a risk known as postpartum haemorrhage (PPH). The proper role to be played by ASHA workers is the need of the hour, as they have the means to reach out to this population. Workplace intervention is another way to address maternal health problems. Active participation by tea tribe women is required in the Village Health Nutrition Day (VHND) programme and the Tea Garden Mobile Medical Unit (MMU), where issues of general healthcare, nutrition, and reproductive health are discussed.

The Assam government and a few NGOs are trying to promote good health practices among Assam’s tea tribe women, with some success. But a lot more needs to be done. The Employees’ State Insurance Act, 1948 (ESI), should be implemented properly. The issue of poverty and the unavailability of good healthcare infrastructure for maternity care can be sorted out through proper implementation of the ESI. Women in these tea gardens must use the Mother and Child Protection (MCP) cards properly so that they can monitor their health and that of their children. One hopes that effective implementation of the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana and the Ayushman Asom Mukhya Mantri Jan Arogya Yojana in the tea gardens of Assam will improve the health status of Assam’s tea tribe women.