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India: Newsline
In rural India, improved sanitation and iron supplements help girls stay in school

Rina lives in Jharkhand state in eastern India, where access to schooling is frequently hard to come by – especially for young women. Like many adolescent girls, Rina was forced to drop out of school at just 13 years old.
Girls at risk
The village school that Rina used to attend is located about 22 km outside of Ranchi, the capital of Jharkhand state and home to one of the country’s largest tribal populations. Although the school has separate toilets for boys and girls, there is often no water.
“During my period, there was a lot of blood,” explained Rina. “I used to face a lot of problems to keep clean.”
Now Rina spends her days doing household chores, washing clothes and dishes and helping her mother cook and care for her four siblings.

“I’ve given up studies, so I don’t know what I can do in future,” she added.
Adequate sanitation has a huge impact on girls’ school attendance. Providing private and separate sanitary latrines in school can increase girls’ enrolment and help keep them in school as they enter adolescence, said UNICEF Chief of Child Environment in India Lizette Burgers.
Widespead anaemia
In India overall, an estimated 6 out of 10 schools have common toilets. However, this number is only one out of four in Jharkhand and the adjacent impoverished states. About half of schools across the country lack separate toilets for boys and girls.
“When she had her first periods, Rina was having dizziness and weakness and would take to her bed,” said Rina’s mother, Chari Kachhap. “We consulted the doctor, who said it was a vitamin deficiency. But even after taking vitamin tablets, there was no improvement.”
Then Sheila Tirkey, an ‘anganwadi,’ or community health worker, visited their home and explained the symptoms of anaemia – as well as the need for adolescent girls to take iron tablets and eat a healthy, balanced diet to prevent the disease.

“Now we plan it out,” she said. “We have the best meal we can with the money we have to spend on food.”
Changing behaviour
In 2005, Ms. Tirkey started an adolescent girls’ group where every Saturday girls can get iron tablets and learn about health, menstrual hygiene and cultural arts and crafts. But at first she faced resistance from some families.
“Many parents asked, ‘why are you leaving work and going to sit and chat?’” Ms. Tirkey said. “I went to their homes and explained to their mothers why it is important to control anaemia. Parents became convinced.”
The group has now swelled to 28 members. Volunteers map the homes in the village, visiting girls to make sure they take their iron supplements, as well as promoting breastfeeding and immunization to new mothers and their families.
Anaemia affects a large percentage of adolescent girls in India. According to Dr. Victor Aguayo, UNICEF Chief Child Development and Nutrition in India, while adolescence is a period of rapid growth, anaemia limits girls’ growth and their ability to learn – reducing their productivity and earnings later in life.
Legal protection
Supervised Iron Folic Acid (IFA) supplementation is essential to preventing anaemia, added Dr. Prakash Gurnani, Chief of UNICEF’s field office in Jharkhand. UNICEF is working to administer weekly tablets to both school-going and out-of-school adolescent girls in five districts of the state. As of March 2010, about 90 per cent of girls were consuming IFA tablets in these five districts.
“We’re reaching out to 2.8 million girls,” said Dr. Gurnani. “In just a few years, this programme has changed the face of anaemia in the state.”
But despite improvements in their health, many young women remain out of school for other reasons, including traditions and social pressure. In Jharkhand, as in many parts of rural India, a girl is considered ‘paraya dhan,’ or property that belongs to her future husband’s family. Investing in girls, including sending them to school, can be viewed as money wasted.
However, experts hope that a 2009 law known as the ‘Right of Children to Free and Compulsory Education Act’ will help to guarantee all Indian children quality elementary education.
For her part, Rina hopes to one day take advantage of the new law to achieve her dream job in paramilitary service.
“Education is very important,” she said. “If I had a chance, I would go back to school. I would be happy to go back and sit with the little ones, just so that I can learn.”
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