On migration

Last night as I got off the Rajkot Express train from Bhopal to Meghnagar, Jhabua I stepped onto a full platform – at 3am.

Families lay strewn across the platform, huddled together with a few possessions, using thin sheets as a blankets or laying bare across the dirty train platform. Children, many babies too young for a journey like this, most too undernourished, slept peacefully on their backs. A few men and women were sitting up and stared at me with a weariness in their eyes so heavy, they couldn’t even muster up surprise to see a blonde tiptoeing around them. Maybe they were unable to sleep because they were anxious about the road ahead or maybe they were aching from the concrete on which they were trying to rest between their long journey from the village to the train station and the train coming in at 5am to take them to their worksites the next state over. Even though I’m usually not one to be shy with a camera, I’ve never mustered up the courage to take a picture of these migrants – I feel like I am intruding on the most vulnerable part of their life cycle.

These wretched masses and ghostly figures have been a fixture of my late night travels between Jhabua and Bhopal (the Meghnagar Bhopal train leaves at 12:30am; the Bhopal Meghnagar train arrives at 2:30am; the train to Gujarat leaves at 5am). Their nightly migration vigil highlights the challenges I’ve faced during the day. Migration is a monumental challenge for public health, education, and development, one that colleagues and I wrestle with everyday.

An average of 64% of Jhabua and Alirajpur’s population migrates seasonally to neighboring states Gujarat, Maharashtra, or Rajasthan or to Indore (see map xx). There are two types of migration patterns in Jhabua and Alirajpur, the seasonal migration of the poorest of the poor out of necessity and the migration of the moderate poor who leave for better economic opportunities. The better off of the migrants are predominantly men who leave their families behind and may come back home at more regular intervals. The poorest of the poor bring their entire families, malnourished children and all.

Migrants leave Jhabua and Alirajpur every year around the end of the harvest time in late September – November and come back around planting time in May/June. Some migrants may come back for festivals such as Diwali or Holi, but many do not come back for another 6 months.

Migration is one of the, if on the, greatest challenges for any malnutrition work. Any progress we’ve made in a child’s weight gain is often lost while the family is migrating. Training migrants have received on the use of local foods to prevent malnutrition doesn’t often apply in their new locations. Functioning self-help groups break down. Its hell for our follow up and monitoring and evaluation systems.

A family may know how to use locally available foods to make nutritious meals and may have home remedies for diarrhea and other illnesses from locally available materials, but this knowledge often is useless in the places they migrate too. Anyone who has traveled through India can see that landscape, people, food, culture, and language can differ vastly from state to state, region to region, and even district to district. What is known to be nutritious in one location may not be available or may be prohibitively costly in another location. Migrants do not mix in with the inhabitants of their adopted communities. They often live in small camps or on construction sites together, quite separate from the larger community. There is discrimination towards migrant laborer from local residents (this is a worldwide phenomenon isn’t it?). With this separateness, cultural and sometimes legal, most migrants do not reach any of the social and health services in the states where they migrate.

When our migrants leave Jhabua, they may make double the wages (many make from 150-200 inr a day in Gujarat), but food costs more and health facilities are inaccessible. Bhils who often only speak a little Hindi, find themselves in a foreign land in Gujarat, Maharashtra, and Rajasthan, with different people, different languages, different foods. In countless conversations I’ve had with migrants in Jhabua and Alirajpur, I’ve only heard from a handful of migrants who received any type of medical care while in Gujarat. No preventative care. Our HIV/AIDS program faces a constant uphill battle to try and get HIV+ migrants transferred to ART centers in neighboring states during migration so they can continue receiving their medications every month (I’ll write another post on the challenges of HIV and migration).

Migrants often are employed in agriculture or construction, which means long days, backbreaking labor, and children left to themselves. Mothers can’t take time off of carrying bricks on their heads to breastfeed every two hours, let alone cook a nutritious meal for the children. During construction, children often subsist on white bread and biscuits during the day, with one home cooked meal at night. Biscuits and breads fill the stomach, but offer no nutritional value and cost more than a nutritious dal and roti.

With this year's drought (the worst in 37 years), our contacts throughout the field in Jhabua, Alirajpur, and Gujarat estimate that migration is about 10-20% more from Jhabua this year (sources include railway station masters and labor contractors). However in the Bundelkund region of Northeast Madhya Pradesh, where the drought has been even more harsh this year, we are getting reports from colleagues that this year’s migration is the highest they’ve ever seen, with each bus leaving the region packed to the brim with people leaving with all their belongings – this year many have no plans of coming back. From Bundelkund they’re all headed to Delhi – where they are likely to find no welcome reception with the Delhi City Planning Commission actively clearing migrants’ slums in preparation for the Commonwealth Games next year.

There are many challenges we face in migration, but with those challenges, interesting opportunities for cross-state collaboration with partners and government, interdisciplinary problem solving, and flexible approaches. Mobile crèches for the children of road construction workers, teachers who travel with migrating labor, HIV target interventions for migrants – there are numerous groups doing exciting things to reach out to one of the most vulnerable groups in the country. Throughout the next few months, I’ll try to bring out some of these various approaches to the problem in this blog as I explore how to tackle migration and malnutrition for our program.