India: improving livelihoods and medical care in violence-hit areas

22-09-2011 Feature

Since late 2009, the ICRC and the Indian Red Cross Society have been running projects to help improve people’s livelihoods and health care in the densely forested areas of eastern Maharashtra, where sporadic violence has had serious repercussions on people’s lives.

The district of Gadchiroli, like many similar remotely located rural communities, faces problems defined by an inherent lack of access to basic needs. Gadchiroli district is also located in a region with a strong presence of government security forces as well as Maoist rebels, locally known as Naxalites. Sporadic violence in the region has increased even further the humanitarian needs of the local population.

Against this background, Gadchiroli's tribal population is grappling with abject poverty, malnutrition and lack of basic health care. The ICRC-supported Indian Red Cross Society's health-care and livelihood projects seek to improve living conditions for local communities affected by the violence.

Seeds of hope

Emerging from the crowd in the evening gloom at Asavandi village, local farmer Mahadeo Vadde is tired yet excited. Working for 16 hours in 45°C heat has not prevented him from attending a village meeting. He knows it is worth it. Mahadeo used to walk long distances to buy vegetables and seeds from the nearest market. "When you have to walk 25 kilometres, you buy whatever you can get, good or bad. No one will come and give it to you," he says.

When violence struck Gadchiroli district, preventing him from moving far from the village, he had to seek alternative means of livelihood, like selling tendu leaves (used for rolling cheap cigarettes) and cutting bamboo to supplement his meagre earnings. Producing little food and with a family of four to feed, life for Mahadeo, his family and his fellow villagers has been extremely difficult, with basic irrigation facilities virtually non-existent and good-quality seeds hard to come by in the dense forest.

Nutritional support

Help arrived in September 2010 when the ICRC and the Maharashtra branch of the Indian Red Cross Society (IRCS) launched a livelihood project, aimed at providing high-quality seeds for nutritional support. At this evening’s assessment meeting, an elated Mahadeo ecstatically rattles off numbers:

"In two months, 65 kilos produced, 41 kilos sold and the rest saved for consumption. I am able to provide healthier food for my son and I have just bought a new school bag and clothes for him. My wife has told me to ask you for double the number of seeds!" Mahadeo exclaims.

Suresh Wadde, another farmer at Asavandi, lost half his crop the previous year due to lack of irrigation and poor seeds. "The Red Cross gave us aubergine, okra, tomato and chilli seeds. Now we also need rice and corn seeds," Wadde insists. "If the Red Cross doesn’t give them, we won’t get any good seeds. I don’t want to lose my crop again."

Many like Mahadeo and Suresh are beneficiaries of Red Cross activities aimed at ensuring economic security and adequate health care. Alongside the livelihood project, the ICRC/IRCS Mobile Health Unit (MHU) programme, launched in June 2008, provides communities with access to both preventive and curative health care – extending and reinforcing the scope of the ICRC/IRCS-supported Primary Health Centre started earlier.

Health care on the move

About an hour's drive from Gadchiroli town is the violence-affected Kasansur taluk (administrative area). We are heading for the Red Cross base camp at Kotmi village. Men and women carrying baskets of tendu leaves are soon left behind and a deserted terrain begins. Forty-five minutes further on we see a hand waving at us. It is Raju, son of the first beneficiary of the MHU programme, from Kotmi.

When we arrive in Kotmi, Mangesh Subhash Patar, 18, is being treated for fever at the MHU – or Dawakhana (pharmacy) as the locals call it. For this potter-cum-farmer the health unit is not just about treatment, it’s also about prevention. "I abide by all the health awareness practices taught to me by the doctor – except for giving up smoking," he confesses with a bashful grin. Previously all that he and his fellow villagers had in the way of health care was a Pujari (traditional healer).

"There was a health centre but no doctor or nurse from outside wanted to come here because this is an area affected by violence. In a village where people were once afraid of approaching vehicles," Mangesh adds, “they now come running to the Red Cross vehicle because this is the only source of medical care."

Preventive care

Today the MHU serves 23 communities of various castes, tribal and religious affiliations across 29 villages and has treated more than 4,000 patients in the past three years. With some 20-30 deaths from malaria and diarrhoea in the area every year during monsoons, the health unit aims to provide preventive care through vaccinations as well as health and hygiene awareness sessions given by Red Cross doctors and volunteers.

Spearheading Red Cross voluntary activities in Kotmi village is Mangaldas Pungatti, 45, a former Naxalite commander. He once controlled 70 villages before being captured and spending three years in prison. Working as a volunteer, guide, translator and communicator in Gadchiroli's violence-affected areas, Mangaldas now coordinates humanitarian activities in seven villages.

"I prefer these seven villages to those seventy," he smiles. "For me, the Red Cross is about give and take. I wanted to save myself by saving others.” Referring philosophically to his transition from alcohol dependency to his humanitarian work now, he says, “I have moved from Kranti to Shanti (from revolution to peace)."



Gadchiroli, India. Gadchiroli is one of the poorest districts in India. Poor irrigation keeps crop yields down, forcing Mahadeo and most other farmers in the region to seek alternative sources of income every summer.
© ICRC / A. Abbhi


Indian Red Cross volunteer and former Naxalite commander Mangaldas Pungatti goes through questionnaires from the previous night's meeting.
© ICRC / A. Abbhi


The ICRC and the Indian Red Cross Society work in close cooperation, travelling to the villages to meet those most in need, sometimes at night.
© ICRC / A. Abbhi


Mangesh Pattar receives treatment at the Mobile Health Unit. The lack of proper health care has meant that many in his village have died of malaria.
© ICRC / A. Abbhi / v-p-in-e-00193