The state's migrant women and children face hunger and malnutrition despite a plethora of government schemes on paper.
When Sheila leaves home for her seven-hour-long shift at a boiler factory on the outskirts of Ahmedabad city in India’s western state of Gujarat, she packs two dabbas or lunch boxes—one for herself and the other for her three- and six-year-old sons. She gives her six-year-old son 20 rupees for extra expenses before heading out. The four rotis and aloo palak sabzi remain untouched when she returns home in the evening. The 20-rupee note, however, is more often than not gone; her son spends it on snacks at the local store.
“He will not eat on his own. If I bring my younger son to work, he buys some snacks from the site store. I have no time to feed them. I will lose time from work,” said Sheila, who makes 350 rupees a day.
The private clinic in the city that she takes her undernourished sons to consistently sends her away with one answer:”Feed them well.”
“Arhar dal (lentils) is 150 rupees per kilo. We buy milk packets for eleven rupees every day to make tea. It is not an item that we can buy [in adequate quantity] for our children to drink,” said Sheila. “If we manage to work, we will have food to eat, else not.”
Like thousands of labourers from disadvantaged communities in India, Sheila is a migrant worker. Hailing from Bihar’s Manjhi village in Chhapra (or Saran) district, Sheila migrated to Ahmedabad with her husband nearly three years ago to pay off mounting debts. She had to leave her two daughters, aged ten and fifteen, back in Chhapra. But her young sons refuse to stay without her.
“Majboori se zindagi barbaad hoti hain (Helplessness has ruined my life),” she said.
Childhood malnutrition typically contributes to childhood diseases and is a major cause of child mortality in India. Some of these diseases include poor IQ levels and reduced cognitive function and physical development as well as behavioural problems like attention deficit hyperactivity disorder, socialisation issues and poor emotional regulation. In severe cases of malnutrition, children suffer from protein deficiency, resulting in Kwashiorkor, a disease in which excessive fluid retention leads to a swollen abdomen. Research has established the link between poor hygiene level and malnutrition.
Out of 125 countries, India ranked 111 in the 2023 Global Hunger Index. India’s level of hunger was described as ‘serious’ with a score of 28.7. Gujarat's multidimensional index in 2023, as per the public policy think tank NITI Aayog, revealed a poor headcount ratio of 18.47 percent. Over twenty-three per cent of people in the state are deprived, and over nine per cent deprived of nutrition.
According to the 2011 census, Uttar Pradesh, Bihar, Rajasthan and Madhya Pradesh—states with a high incidence of poverty—accounted for half the inter-state migrant workers around the country. Gujarat had over 30 lakh seasonal migrant workers. The World Bank describes migrant workers as vulnerable due to the lack of “social capital and networks, language barriers, low bargaining power, and difficulty in social integration”.
Gujarat’s Socio-Economic Review for 2023-24 shows that 1.45 lakh or 4.81 per cent of the 30.28 lakh children screened were identified with severe acute malnutrition (SAM). Of these, nearly 16,000 were admitted in Nutrition Rehabilitation Centres (NRC) or to Child Malnutrition Treatment Centres (CMTC).
With no beginning date in sight for an updated census, malnutrition and other healthcare issues in migrant workers’ children in Prime Minister Narendra Modi’s home state of Gujarat continue to be invisibilised.
Migrant workers' children between the ages 0 and 14 struggle to get basic nutrients. The Integrated Child Development Services (ICDS) programme – a central scheme executed by state governments – aims to provide nutrition and health services for children under the age of six years and pregnant or breastfeeding women. This is executed through community-based anganwadis (community-based centres in India that provide integrated child development services, nutrition, healthcare, and education for young children and mothers).
One such ICDS scheme that several migrant women do not have access to is Mamta cards. The Mamta card, issued to pregnant and nursing mothers, is an ID for accessing maternal and child welfare services like nutrition, health check-ups, immunisation, and counselling. The card aids in tracking service usage, ensuring that eligible beneficiaries receive vital support for maternal and child health, including that of malnourished children.
According to the migrant worker parents I interviewed, they were unable to receive entitlements—in the form of lentils, wheat and rice—in cities through their ration cards. “We’ve been refused rations here since the address on our cards is linked to our villages,” said one of the women migrant workers. For the few months that they spend in cities, lack of access to rations prevents them from providing nutritious food to their children.
Ghosh observed that several state governments that the centres had not been receiving the minimum funds they required to keep the nutrition programme running. “As a result, they are even less able to ensure that last-mile delivery occurs, especially for marginalised and more vulnerable groups,” she said.
In villages from where workers frequently migrate (mostly Madhya Pradesh, Bihar and Rajasthan), many families expressed difficulties accessing ICDS schemes due to documentation requirements or the long distances they needed to cover to walk to anganwadis.
According to Jayeshbhai Gamit Shantilal, coordinator at the non-profit Centre for Labour Research and Action which works with sugarcane factory migrant workers in Gujarat, migrant workers faced significant challenges navigating online procedures and Aadhar linkages for scheme enrolment. “While urban rations are accessible under the One Nation One Ration Card scheme with written approval from villages, seasonal migrants find this process problematic as they eventually have to return to their villages,” he pointed out.
Shantilal said the other challenge was that there was no inter-governmental coordination between source and destination. “When seasonal migrants come to the city and we try to link them to anganwadis, the anganwadis say they do not have a budget and their quota is exhausted,” he said. “A budget must be allocated so that children can be enrolled in anganwadi centres closer to the work sites.”
According to the 2019-21 National Family Health Survey (NFHS), - 5 data, twenty-five per cent of children are wasted (a condition where, according to the World Health Organisation, a child is excessively thin in relation to their height, posing a heightened risk of mortality). This condition may result from inadequate recent food intake or a recent illness causing weight loss. The NFHS data states that eleven per cent of children in Gujarat are severely wasted.
The NFHS report’s statistics on children are as follows: forty percent are underweight. In the first six months when most babies are breastfed, twenty-seven per cent of children were listed as stunted, and thirty-two per cent wasted and underweight.
But data sets like these don’t include migrant workers and their children, so the percentage of actual damage to migrant workers' children is severely underreported.
A 2020 study on social security and health rights of migrant workers in India funded by the National Human Rights Commission showed that the social security entitlements of interstate migrant workers were weak. The human rights violations include an absence of proper accommodation, poor-quality accommodation, and poor access to available schemes and services due to lack of access to information and language barriers, among others.
Of the 395 million migrant workers in India, 62 million are estimated to be Dalits and 31 million Adivasis. Adivasi communities are disproportionately represented among migrant workers alongside Dalits. Adivasis migrating from southern Rajasthan to Gujarat turn to hazardous casual work. In Gujarat, Adivasis constitute around fifteen per cent of the total population.
The twenty migrant workers’ families I spoke to in Ahmedabad, Surat and Mahisagar districts in Gujarat mostly belonged to Adivasi communities like Bheel.
With the Lok Sabha polls for 2024 in full swing, a crucial critique of the Bharatiya Janata Party-led government is its delay in conducting the decennial census which was scheduled for 2021. The census provides crucial data for strategic analyses of existing marginalised communities in India. It determines who benefits from welfare schemes and the percentage of these benefits. The delay—the first in about a century in India—exacerbates existing social issues faced by at-risk communities.
According to a report, the government, by continuing to use outdated 2011 census data, denies many low-income citizens ration cards under the National Food Security Act (NFSA). Developmental economist Jayati Ghosh seconds this. “Migrant worker families are the worst affected, also because public services continue to be residence-based,” she told me. “At least 100 million people are excluded from the NFSA because the access was based on the socio-economic census of 2011-12, more than a decade ago. There has been a growth in population since then.”
I interviewed six grassroots workers from Aajeevika Bureau, a non-profit established in 2005 that extensively works with migrant workers in Rajasthan and Gujarat, and Prayas, a field social work project spearheaded by the Tata Institute of Social Sciences. They informed me that government schemes, including ICDS, had not reached industrial areas where migrant workers often worked.
Deepti Makwana, senior associate at Aajeevika, advocates that the government focus on reaching industrial areas where work sites also serve as living spaces for migrant workers in addition to the open settlements on the outskirts where they usually reside. “Currently, there is no database of migrant workers’ children,” she said. “This needs to be prepared after due identification and the policies need to be tailored to address their nutritional challenges.”
The onus of caring for children disproportionately falls on the shoulders of women. Researcher and writer Mitali Nikore’s 2022 paper in ORF states that data shows how “childcare is the third biggest consumer of women’s time spent in unpaid work”.
Many women that I spoke to, including grandmothers of children who were often the sole caregivers, pointed out that it was difficult for them to balance household chores and agricultural work while making time to take their children and grandchildren to the anganwadis.
Beyond the crisis of documentation, time management emerges as a formidable challenge confronting migrant women trying to access welfare schemes.
Since anganwadi centres run at fixed times, women were unable to drop or pick up their children at those fixed timings, said Makwana. “We have been pressing for mobile anganwadis (a portable unit that delivers integrated child development services, nutrition, healthcare, and education, particularly to vulnerable communities in remote or underserved areas) to be popularised,” she said. “Mothers working long hours do not have enough time to cook and feed their children, who then typically rely on junk snacks.”
Mothers I interviewed at the Vatva boiler factory site in March this year said they could only manage to feed their children roti and saag on most days. They would make dal and chana (lentils) on some days. Even though their children looked visibly undernourished, they had not been weighed. In the absence of access, awareness, and time, the notion of assessing their children's weight has largely eluded them.
Migrant workers who typically work in construction, garbage collection and at boiler factories either take children along with them to their work space or leave them behind at their makeshift homes. At work, these children are not inside the boiler rooms but in the factory's outdoor areas. These areas, though not inherently hazardous, have hard living conditions: uncleanliness on account of coal or woodblocks, lack of sanitation, and uninhabitable tents.
At the boiler where Sheila works, many families have migrated from the tribal districts of Madhya Pradesh and Gujarat. They stay at the allotted site, which is not conducive to habitation. Sheila considers herself relatively lucky to be able to rent a space away from the site for 1,500 rupees a month. “We cannot sleep here, Didi,” she said. “The dirt… the mosquitoes… I have to spend 20 rupees every day to commute to my rental accommodation but I can’t stay here.”
Lack of access doesn’t just impact women and children at the factories. The sinister hand of deprivation and its impact permeates into the natal health of migrant workers in Gujarat.
According to at least twelve women I interviewed from the boiler and sugarcane sectors,pregnant migrant workers work till the last few days of their pregnancy, putting tremendous stress on their health. They go back to the villages for their deliveries due to being unable to access healthcare facilities in cities, and typically hand over their wages to their husbands.
The women often return to cities shortly after their child's vaccination within 14 weeks. Some women resume work within two months of giving birth, breastfeeding between breaks. Additionally, because they cannot prioritise their own nutrition during pregnancy and post-childbirth, this put their babies at risk.
At a textile boiler factory in Narol on the outskirts of Ahmedabad, an NGO representative gathers a group of women workers finishing their shifts to raise awareness about their rights. She finds it difficult to capture their attention—the contractor interrupts a few times, children plead with their mothers to buy them ice-cream from local carts and a few women mumble that they’re running late. “We have to cook dinner,” one woman muttered anxiously.
The social worker assures a quick end to the meeting. She asks, “Have you ever been to Lal Darwaza, Gandhi Ashram or the riverfront (popular tourist spots in Ahmedabad)? Have you ever eaten pani puri by yourself?”
The group of women breaks into laughter. “I do not have even five minutes to myself,” one woman laughed.
The social worker emphasises this as evidence of the female workers’ stark lack of rights in the city, being confined solely to their workplaces. She proceeds to address healthcare, vaccinations, and rations. When she addresses their children’s health, the women listen more closely. “Take them to anganwadis,” she said. “They will serve roti and saag or roti and peas sabzi to your children.”
But anganwadis in Gujarat are facing their own cataclysms.
Dr Abhay Bang, who worked in the tribal belts of Chhattisgarh for years, said that a meal of roti and saag, while good, was inadequate to meet children’s nutritional needs. He said, “We need to add pulses, peanuts, milk and dairy, eggs, fish, fruits and vegetables and oil. Undernutrition under the age of two hampers [both physical and mental] development.”
Alarming statistics show that over twenty-five percent of the 42,421 independent anganwadi centres in Gujarat and fifteen percent of the 7,097 rented ones are unsuitable for children. Moreover, thirty percent of the 3,511 government-owned centres suffer from issues like leakage and dilapidation, making them extremely unsafe for children. The department acknowledged that 4,622 centres urgently needed repair, with 1,792 awaiting decisions.
None of the children I met at the two boiler factories were enrolled in schools. The relatively older children (as young as seven to as old as fifteen) often held the responsibility of caring for their younger siblings. “I used to go to school here. But we could not afford the fees anymore when it increased,” said Babli, 10, whose parents migrated to Gujarat from Jobat village in Madhya Pradesh’s Jhabua district.
Babli’s mother Hathri runs a small store at the boiler site in addition to working shifts there. “We will not be able to get by if we stay back in the village,” said Hathri.
In sugarcane fields in Surat, children were working alongside their parents. Extra hands meant getting more work done in the fields I visited in Gujarat— children cut bundles of sugarcane, tied them up and loaded them, all to get paid by the tonne. But when hungry, a good, full meal was nowhere to be found.
A Global March report indicates the prevalence of child labour in the sugarcane industry, citing India as a country with “high incidence”.
Kantiben, who migrates every year from Gujarat’s Tapi zilla, gives her children jowar rotis. The sugar mill she works at supplies her with jowar, which is cheaper than lentils and pulses. On some days, she buys ragi to cook ragi rotis for her three children aged nine, five and one.
As her nine-year-old daughter Sonal chewed on a stick of sugarcane, Kantiben squatted on the floor to take a break from cutting. While talking about her children not being able to afford school, her face fell. “Back in school, my daughter would get a mid-day meal where she would eat dal chawal (lentils and rice),” she cried. “We've never visited doctors here or had any blood tests. The anganwadi worker in our village said all the children were underweight.”
Kantiben stresses that her household would not have survived without migrating to the city. Despite receiving 10,000 rupees from her husband's family during her wedding (a practice customary to her Adivasi community), she had to work hard to repay that as debt.
Bhavnaben from Hadol village in Dang zilla laughs when asked if her children are underweight. “The doctors have told me so,” she said. I was advised to feed them well. But how can I afford that?”
Shantilal said, “Sugarcane workers typically come in September/October from other parts of Gujarat, Madhya Pradesh and Maharashtra and live in the city till May, which is the harvesting season for sugarcane.
According to a 2017 Prayas CLRA study, over 1.25 lakh migrant workers, mainly landless tribals or those owning small patches of lands are engaged in sugarcane harvesting in South Gujarat. They mainly hail from the districts of Dhule and Nandurbar in Maharashtra and Dang and Tapi in Gujarat.
This number varies and also goes up to two lakh in certain years. “We estimate there must be at least five lakh children accompanying their parents every year and being pushed into this cycle of poverty,” added Shantilal.
State governments in India aim to provide premix ratios to children between six and thirty-six months, pregnant women, lactating mothers and adolescent girls. The Bal Shakti premix is for children, Matru Shakti for pregnant women and lactating mothers, and the Purna Shakti premix for adolescent girls.
“But there is a need to train communities to use these premix rations properly to address nutritional challenges,” observed Pallavi Patel, director at CHETNA, an NGO working on addressing nutritional challenges of children in Gujarat. “It is also important to ethnographically contextualise food. For example, many Adivasi communities often do not like sweet-tasting food. So while we give out ration kits, we need to ensure that they meet the dietary preferences of the communities in order to see improvement in the community's health.” The systemic enforcement of vegetarianism and reliance on faulty public distribution systems compounds tribal nutritional poverty.
The 2023 Global Hunger Index referenced earlier in the story documents that climate change is a ‘threat multiplier’ and will only worsen this food crisis. While Gujarat was the first state in Asia to start a department of climate change way back in 2010, a 2017 report from Down To Earth magazine pointed to the scarcity of government initiatives in climate change policies that aimed to reduce vulnerabilities in the agriculture sector. even though the state has a poor record of food security for a while.
The families I interviewed had migrated from areas that were grossly affected by the climate crisis which snowballed into an agrarian crisis. Migrant workers in Gujarat did not use the term ‘climate crisis’ but lamented about changing weather patterns and how untimely rains in their villages damaged their crops. According to an independent analysis by think-tank Council on Energy, Environment and Water (CEEW), as many as twenty-nine districts are exposed to extreme weather events like floods, cyclones and droughts.
But on the rare occasions that migrant workers’ children receive timely intervention, it saves lives. Umesh and his wife, who migrated from Kadmal village in Gujarat’s Dang district, consider themselves lucky. When their now six-year-old son was breastfeeding at five months, a visiting ASHA worker found that he was dangerously underweight. “He was admitted to a centre for fifteen days and his nutritional status improved,” said Umesh, 26, who works in a sugarcane field and also runs a small store at the camping site for migrant workers.
The invisibilisation of migrant workers, exacerbated by the climate crisis and aggravated by policy failures, lays bare a stark reality—all states benefit from the cheap labour of migrant worker populations but leave the nutrition of their children out to dry. As the curtain falls, the intertwined threads of child malnutrition in Gujarat’s migrant worker children reveal a complex tapestry—the burden of saving their children disproportionately falls on women, who struggle against the backdrop of government inaction, unpaid labour and their own collapsing bodies.
