Assam’s world-famous tea gardens are deadly for pregnant women

Researchers who investigated 150 maternal deaths discovered that 69 per cent of all deaths were among the tea garden community

“Mothers are now able to reach us even during the monsoon,” said Arundhati Das, 52, pointing at the asphalt road outside a one-room government health sub-centre in Bhojkhowa village. The centre serves a population of 10,000 in Assam’s flood-prone Sonitpur district and Das has been in charge of it since 2001. There is a bed in one corner, and a baby weighing scale on top of it. Hanging on the wall are cloth pouches with immunisation cards to keep track of the vaccinations that children in the area have received.

The sub-centre that provides primary health care—iron tablets, information about government schemes, immunisation and contraceptives—gets flooded every monsoon. “The mothers are then forced to stay home,” said . Das Over 30 of Assam’s 33 districts are inundated by the Brahmaputra annually, washing away crops and crippling the state’s rural economy. Arunshati Das does not remember when the road outside her sub-centre was built, but said it enables access to health care and tetanus injections—which reduces the chances of infection among mothers right after childbirth. “Roads are helping save lives,” Das added.

For every 100,000 live births, 130 women die in India due to pregnancy-related complications, according to Niti Aayog, the think-tank of the government. While Kerala has the lowest maternal mortality rate (MMR) of 46, Assam’s MMR of 237 is double India’s average and is currently higher than Zambia’s (224), according to World Bank data (Poland’s MMR of three is the lowest in the world). Assam’s current MMR status might overshadow the strides the state has made in maternal healthcare. In just over a decade, Assam has reduced its MMR from 480 to 237–that is a greater than 50 per cent reduction.

Maternal mortality is high where access to skilled and emergency care is either unavailable or limited, said Dileep Mavalankar, director, Indian Institute of Public Health (IIPH) in Gandhinagar. “Wherever that situation has improved, either in the government or the private sector, the mortality rate has gone down.”