Khargone and Khandwa - the difference institutions make

Driving from Khandwa to neighboring Khargone its hard to tell where one district stops and another begins. We drove through Pandhana block of Khandwa, another rural and malnourished district, where on our field visits, locals had just enough contact with the government medical system not to trust it. Pandhana's population, a mix between scheduled tribes and schedules castes, are the same people as those across the boarder in Zhirnya block of Khargone, the block with reportedly the highest malnutrition in the district.

We saw a more subtle, yet the most crucial difference between the two districts however, at a town on the border. At the first town in Zhirnya we stopped to ask two woman at a bus stop where the anganwadi center was. One woman turned out to be the anganwadi herself and another the block supervisor. The anganwadi supervisor actually out on a field visit! This is something for the books! While we still found 2 SAM children in a hamlet of the village during a rapid assessment with the staff, the fact that they were at least active was encouraging.

In Khargone we were met by both the Chief Medical Officer and the District Program Officer for Women and Child Development, the two senior officers in charge of malnourished children, who in many districts are cordial at best. Here is Khargone these would-be mortal enemies were friendly and courteous. I attended a coordination meeting, called by the Health Department, but attended by block officers from both departments, where they walked through programs one by one, debating problems, highlighting concerns, and working towards mutually agreed upon solutions. Again, does not sound revolutionary, but this is the first time I've seen cooperation amongst the two departments to this degree at any level of government.

The level of cooperation we received was so great that we became a bit suspicious. The District medical coordinator actually prepared us a clustered list of the villages we should work in in the two blocks with the highest malnutrition, Zhirnya and Berhampura blocks. This was too good to be true. In Khandwa WCD prepared a similar list for us, and when we went to check it out, it turned out the villages on this list are those by the road, with access to health facilities, good farming, low rates of malnutrition and some of them even non-existent. We went out by ourselves to check a random selection of Khargone Health Department's "malnutrition list" and were pleasantly surprised that they are sending us to the right locations (not pleasantly surprised that there is tons of malnutrition in this area, but pleasantly surprised they're making our job easier to get to these places). We also consulted with the only NGOs in the area, Lepra Society and Khandwa Diocean Service Society, and they concurred that these were the villages neglected by government and NGO services and in dire need of a malnutrition intervention.

Not only did the Health Department provide us with a list of villages, but they also helped us line up interviews with some great staff members. Khargone has a University offering a Masters in Social Work program so there are many local men and women with a high degree of education who are also interested in social work in their home district. While in other districts we cannot afford MSWs as staff members, in Khargone we found them willing to work for us in order to gain experience with an NGO in their home district (here being one of the only NGOs has its benefits).

Khargone still has a large malnutrition problem, but the difference here as opposed to other districts, is that the district administration is willing to recognize the problem and address it head on, bringing in partners to help them in this process.