Ruksar, with the baby planted firmly on her hip, pointed to the pot sitting on the floor. I glanced down at the thick, brown liquid sticking to the sides of the pot and noticed bits of fish floating on the oily surface and then my eyes moved slowly around the room. There is no window and the only natural light creeps in from the long hallway connecting two other homes to the laneway. The kids in the room stopped their chatter and knitted themselves into a tight circle, five sets of deep brown eyes looking at Ashley and then at me and back to Ruksar. The smell in this small room is so sour and dank I can taste the air. It occupies the room and smells of kerosene, coconut oiled hair, baby urine, cooking oil and musty, damp clothing..
I looked at Noorsaba, a tiny dumpling of a girl who is about three years old. Her eyes shone like polished granite in the dim light while her tiny mouth stayed pursed into a straight line. Noorsaba was the reason for this house visit because I had noticed her sitting outside her home on the tracks day after day, never smiling or playing, just sitting as if she had been tethered there, her tiny face covered in small bumps.
Ashley asked Ruksar what they eat, if they have enough food and where her parents are. Wiping the baby’s nose with the hem of her stained blue kurta while jostling him to keep him quiet, her wide weary face already burdened by life’s most menial chores, she told us her parents work 12 hour days, the mother as a house cleaner for three other families and the father as a driver. We found out Ruksar is the sole caregiver for her siblings during the day. Her brother, Estakhar, the oldest at 12, is employed making buttonholes for a shirt maker.
The children spend the day sitting in their hut, tousling with each other, playing hide and seek in a pile of dirty floor mats and tangled sleeping sheets or watching Hindi cartoons on a tiny television. Sometimes they wander outside to sit on the train tracks or they busy themselves making cooking fires out of scrap wood. They have been told by their worried mother to stay in or near the house while she works. None of the kids attend regular school and the parents are illiterate.
We are concerned about the health of these kids and asked permission of the parents to take them to a doctor. The next day the six kids, Kane and I walked through the bustling Mumbai traffic in single file to the nearest small clinic. We are turned away and try another small hospital where the doctor quickly examines the kids, mutters about ‘tribals’ (a derogatory term for people from villages particularly from Uttar Pradesh and Bihar) and then generously gives us some multivitamin supplements and suggests they need more protein in their diet. “Eggs will do. They should each eat one a day.” We marched back through the traffic, busses whooshing within inches of us, trucks with large loads churning dust in the air, trying to keep everyone in line, the two little ones on our hips.
Eager to start the kids on the road to renewed health, I arrived the next morning to help them dole out the liquid supplements. Ashley informed the mother that the kids need exercise and that she must let them run and play in the garden areas while she is at work. She agreed and we are excited to get them out of their dank hut into the bright sunshine and into the garden for some fun. After the supplements have been sucked through clenched teeth and water has been drunk to wash the residue down, we all filed out of the house and headed for the swings in the garden. Shy, their eyes cast downward, the kids needed prompting to join the other kids already playing. Within a few hours we had smiles, bare feet kicking up dirt, some tumbles and the good kind of exhaustion that comes from play. The kids headed back to their home happily jumping up and down on the tracks, spinning and twirling until they were out of site. I decided to check on them about 45 minutes later. Sitting in the strange dusky light of their home, Roshni, who is about 8 years old, suddenly lay on the floor and started whimpering while she rolled herself in a dusty blanket laying nearby. Uncovering her, I cupped her small face in my hand. Her face was hot, so hot that I was startled. I flipped the blanket back and grabbed her arm. Her whole body was hot. My hand remained warm after I touched her body, now curled up in the fetal position. I ran to get Kane, imploring him to hurry and along with Estakhar, his hand barely to his mouth with his first bite of food after his shift sewing buttonholes, Kane carried Roshni’s very limp body out of the house, through the slum and into traffic, back to the small hospital we had been to the day before. Emotions were running high; we were worried. Estakhar was very quiet but beautifully attentive to his sister, running behind Kane, staying close so he could use his hand to shield Roshni’s face from the searing sun.
The doctors at the clinic responded quickly, giving Roshni injections in her thighs, their concern evident, their response seemed reasoned and calm. They bathed her in cool water in a small room that doubled as a utility closet, uniforms and rags hanging on the walls to dry. Blood tests were taken and we were allowed to take her back to her hut with a promise to return later that day for the results. We arrived back to the community to find her mother frantic, tearful and afraid. She had been called at work to come home. The blood tests revealed Roshni had malaria and typhoid fever. The mother, who is loving and attentive when she has the luxury of being with her children, spent the next two days caring for Roshni and within a few days, Roshni was able to join her siblings in the freedom of play.
The concern about this family was now heightened. The parents are loving, but illiterate and the six kids are cared for by ten year old Ruksar. A relative who boasted about life in Mumbai lured this family from Uttar Pradesh about 8 months ago. Since their arrival in this ‘city of dreams’, the relative has fallen ill and the family has had to pay his medical bills, leaving the parents of this large family no room to breathe financially.
On a quest to educate the mother about nutrition for her children and to get a better picture of their overall health, Ashley joined me to take the entire family (except the father) to the Foundation of Mother and Child Health, a non-profit run by a dedicated team of health professionals who insist on seeing families on a monthly basis to track their progress once they are diagnosed. After a seemingly endless taxi ride through the thick of Mumbai traffic, with the mother, her six children, Ashley and me stuffed into the small black car, we arrived to the clinic and were hastily welcomed to come in. The children’s heads were measured, they were weighed, blood tests were given to detect iron levels and the mother was interviewed. When asked by Dr. Rupal why she had so many children, the mother replied, “God gives rich people money and he gives us children. They are a gift from God.” The doctor diagnosed the children as being in acute stages of malnutrition, with calcium deficiencies showing up in Noorsaba and the baby, vitamin D deficiency taking the form of small bumps on Noorsaba’s face, stunted growth in Ruksa, Noorsaba and the baby, and the concern that continued poor nutrition would also stunt their IQ. The mother was gently but firmly lectured about the ‘food’ she has been giving herself and the children and we were given a list of supplements and dietary aids, plus a list of foods the children should have in their diet. In many households in the slum, kids are fed small cookies/bisquits, purchased for a few rupees, which are nothing but sugary filler with no nutritional value. The mom was told to never feed these to her children again. I asked the doctor why Noorsaba and the baby both feel abnormally heavy when lifted. She guided my hand over Noorsaba’s tiny arm and told me to press. What I thought of as baby fat was actually water retention, a sign of malnutrition. Noorsaba’s entire body felt squishy to the touch.
We left the clinic with a promise to return in one month. While waiting for a taxi, the mother gave Estakhar a few rupees and sent him to buy bisquits. Ashley and I stopped that transaction and purchased bananas instead.
The battle to get these kids healthy will not be easy. Ashley’s idea of colour coding the medicine using embroidery thread tied to each child’s wrist and then to each bottle of medicine made the job of administering it much easier. We make daily visits to the their home with fruit, vegetables and nuts to eat after the ritual of supplements is done. It now takes no encouragement for them to come out and play, though Ruksar’s play is hampered by the needs of the baby who cries whenever anyone else holds him. We set up credit at the small store in the slum so the mother can buy eggs every morning and feed them to her children before she goes to work.
These children, though not formally educated are bright, inquisitive and love to draw, run and take photos with our cameras. They need attention both physically and emotionally, but will get by on neither because they are resilient and wise in a way most kids aren’t. They are a close knit family who shield each other from the sun, but also know their place in the hierarchy of the family unit. Although they share some duties, it is Ruksar who will always have Babu on her hip, clean the floor of baby urine, and stir the rice in the pot.
We are looking forward to our next visit to the clinic to see if we have made any progress with their overall health. For now we are enjoying watching Noorsaba run with one arm completely straight at her side while the other one punches the air to keep the momentum going, her tiny mouth stretched into a happy grin.