In Tharparkar: Treating Cancer with Disprin

By: Shabbir Ahmad Wahgra

The women of Tharparkar dress in vibrant colours. The more barren and colourless their lives, the more they have a need to dress in brightly coloured clothes. Perhaps this is a defense mechanism – hunger and poverty can suck the colour out of peoples’ lives. Yet, the colour of hope lives on in their faces – the most beautiful colour. Perhaps, this is what helps them survive.

Travelling to Tharparkar for the first time, I experience excitement and nervousness in anticipation. As the scenery whizzes past on our six-hour journey by Jeep from Karachi to Mithi, The landscape soon begins to change as we approach district Tharparkar in Sindh. The spectacular fields full of banana plants we saw in Thatta and Sajawal are replaced by white sand dunes, dry shrubs, Neem trees, cacti of different varieties, sand, sand and more sand. Out of nowhere, a peacock suddenly appears and a myriad of blue and green splashes its feathers – against the barren desert backdrop, it is definitely a treat. Camels lazily trudge along the way. Men pass by in brightly coloured shalwar kameezes. Few villagers were fetching water from a deep well with the help of their camel, the water which they as well as their animals will drink from the storage tank which every household locked on the brink of the well.
I can hardly spot public transport except few “keekdaas”, a British era transport trucks which are still used in Tharparkar. I peer for an oasis or a pond on the way. I was hardly able to spot a couple.
This desert district in Sindh might be the most impoverished in Pakistan, but at the same time it’s perhaps the most peaceful place in the entire country. Tharis keep their doors unlocked. Their only wealth, their cattle are seen grazing in the fields without herdsmen. There are hardly any police pickets and no concept of police patrolling with crime rate at only two percent.

During a visit to main hospital in Mitti, the misery was written on the faces of Thari mothers as all the mothers present at the Mithi Civil Hospital tell tales of malnutrition. “A healthy mother means a healthy child. Thari mothers are underweight.

But the situation inside villages is even worse. Kumari is a Lady Health Worker (LHW) in the village Borli Bheel in union council Chelhar some 20 kilometers from Mithi, working on a project funded by World Food Program. Her house is exceptionally clean and this is typical of the houses of the Meghwar Hindu community in Tharparkar. The district, incidentally, has a majority of Hindus as its population. Muslims and Hindus co-exist peacefully in this region.

In this small hundred household village Kumari welcomes us, some thirty women have already gathered at her house to meet us. “Community living” is the word that comes to my mind instantaneously – something that is on its way out in the cities.
While the world is trying to understand string of deaths and malnutrition emergency in Tharparkar, which everyone thinks is all due to drought, poverty, lack of food and health facilities. I, myself, have the same assumption before this visit but the ground realities are bit different. No one can deny the existence of above-mentioned problems but few other reasons, which are complicating the health of infants, are very less focused.

One of the core reasons of the malnourished children are a result of mothers continuously giving birth to many children without spacing. “The minimum gap is usually nine to fifteen months. A child doesn’t get breastfed enough in case of another hasty pregnancy”.

Sunil, a male villager told me in funny way, “Our women quite commonly give birth to up to twelve children,” he said and laughed, saying there was a woman in Khurbiyoon village who has borne eighteen children.

The food of a pregnant woman is normally just one to two rotis and a glass of milk if she is lucky. The average Thari woman doesn’t visit a doctor even in case of a problem but calls the Daai who can only advise the woman some native remedy.

A usually untrained midwife who is locally called a Daai is the all-in-one caretaker for a pregnant woman, whose wisdom and experience is never questioned. The woman expecting a baby has to follow whatever the Daai advises. The Daai, a Guru of sorts, commands a certain respect and authority in the communities, and often predicts, without an ultrasound, what the gender of the newborn will be.

The total fee of a Daai is between five hundred to one thousand rupees depending upon experience and reputation. If the newborn is a son, an extra Chunni (dupatta) and dry dates are given as a gift in gratitude.

“The family and relatives find out if a son is born by the Daai beating a plate,” said Kumari, explaining the traditions. “If she comes out without a sign, people turn back and understand the new guest is a daughter.”

There are few very strange traditions, which are also contributing in malnutrition and retarded growth of children in Tharparkar. The midwives of the desert use centuries-old remedies for newborns, which are often detrimental to mother and child’s health.
Traditionally, a Thari baby is not breastfed for at least 48 hours after birth. Many mothers, who follow instructions of Daais religiously, believe the first milk is toxic for their children. Thus, the newborns lose out on the proven benefits of the first milk called Colostrum, which contains important antibodies to protect the newborn against disease, and is lower in fat and higher in protein compared to ordinary milk.

“A mother is advised not to feed the baby immediately after birth. It could be injurious,” Junta, a fifty years old Daai with more than thirty years of experience said. “It is better to give milk [of goat] and gurr to the newborn,” she stressed. She shared that newborns are also immediately given desi ghee. “The mother dips her finger in ghee and puts it in child’s mouth.” The newborns are also given drops of hot water till their mothers are allowed to feed them.

Another tradition which effects the health of new born is the local custom of feeding a baby born anytime during the day after watching the first star on the sky after sunset and if a baby born at night he or she has to wait till next night so this 12 to 24 hours wait becomes fatal for the infants.
Usually, pediatricians advise that a newborn should be breastfed for 24 months but this practice doesn’t exist in the desert. “Six months are enough; mothers start giving pieces of roti to babies within two months,” said Noor, mother of a newborn, while she was waiting for a doctor outside the Civil Hospital, Mithi.

“Only two children died due to malnutrition while all other deaths are due multiple factors” said Lola Castro, country director of world food program who was also on the visit of this drought affected area. She said WFP, government and other agencies are doing lot of efforts but this multifactorial problem can only be solved through multifactorial strategy including massive mobilization campaign using local people.

Each year hundreds of social development programmes are initiated in Tharparkar with donations from international development groups, but no programme is properly addressing the main issue of awareness and busy in treating cancer with disprin.

The government and other aid agencies intervention through wheat and food supplements distribution need to be supported by massive awareness campaign to break the taboos only then these precious lives can be saved in this calamity hit area.

(The writer is a Journalist with more than 13 years of experience in print and electronic media)