‘I get to share my worries here’

It’s a hot, sunny March afternoon and adults from Aurapani village are gathered inside a small white church. But it’s not moral pressure that has brought them here.

The group sitting in a circle on the floor have one important thing in common – they have been diagnosed with chronic blood pressure issues, either high or low. So, they meet once a month to get their blood pressure checked and use the time to chit chat on a variety of things while they wait to get their medicines.

“I like coming to meetings because I get to share my worries here,” says Rupi Baghel, known fondly as Rupi bai. The 53-year-old has been coming here for the last five years. A Baiga tribal, she is a subsistence farmer and relies on non-timber forest produce (NTFP) like fuelwood and mahua from the forest to supplement her income. Baigas are listed as a Particularly Vulnerable Tribal Groups (PVTG). Aurapani (also spelt as Ourapani) village is largely populated by the Baiga community. 

Located in the Kota block of Bilaspur district, the village lies close to the Achanakmar-Amarkantak Biosphere Reserve (AABR) in Chhattisgarh. “I used to go into the jungle to collect bamboo to make jhadoos [brooms] which I would sell. But I can no longer walk long distances so I stay home,” says Phulsori Lakda explaining how high blood pressure-induced exhaustion has impacted her life. In the sixties, she now stays home and takes care of her goats and collects cow dung during the day. Most Baigas depend on the forests for their livelihoods. 

In Chhattisgarh, 14 per cent of the rural population have hypertension, says the National Family Health Survey-5 (NFHS-5), 2019-2021. “An individual is classified as having hypertension if that individual has a systolic blood pressure level greater than or equal to 140 mmHg, or a diastolic blood pressure level greater than or equal to 90 mmHg” it says. 

Early detection of hypertension is critical to stem the rise in non-communicable diseases, says the National Health Mission. Information on lifestyle changes to lower BP is done through the support group. “Mai meeting mai aati hu, toh alag cheez seekne ke liya milta hai, jaise, yoga, jo mere sharir ko majbut rak tha hai [At the meetings, I learn good habits, like yoga that helps me keep my body a little strong],” adds Phulsori.

She is referring to the information given out by Suraj Baiga, a 31-year-old senior health worker at Jan Swasthya Sahyog (JSS), a medical non-profit which has been working in the area for almost three decades. Suraj explains to the group the impact of too high or too low blood pressure, and breaks it down by likening blood pressure to switches in the brain: “if we don’t want BP to make the switches in our brain weak, we need to take medicines regularly, do our exercises.”

Manohar Uranv, affectionately known as Manohar kaka is 87 and has been coming to support group meetings for 10 years. “My BP is under control now, but it took me time to control my anger.” He then adds, “I have learned not to take tension!”

JSS also organises other support groups for not just hypertension but other chronic diseases too – 84 such groups operate in 50 villages, drawing over a thousand people. Younger working people do come but it’s the senior citizens who flock in large numbers.

“The elderly are being abandoned because they have stopped being productive. Mental and physical health take a toll, they are lonely and, in many cases, they don’t have much dignity at the end of their lives,” says Minal Madankar, program coordinator at JSS.

It is largely this age group that seeks medical attention and support. As well as advice on food. “We get to learn things that will help me take care of myself, like how eating millets is better for me than eating rice, and of course, I get my medicines here,” says Rupi Baghel. 

After the session participants are treated to kodo millet kheer. JSS staff hope the taste of millets will induce them to switch, and also serve to bring them back next month. The rural communities JSS covers in Bilaspur and Mungeli districts mostly have lean diabetes and they put it down to changing diets, as well as the addition of refined carbohydrates like white rice provided by the public distribution system (PDS).

“There has been a shift in agriculture and dietary practices. The communities here used to grow and eat different varieties of millet, which are far more nutritious and healthier, but now it's been shifted to only polished white rice, says Minal. Many of the participants said they ate more rice and wheat, dropping millets almost completely.

There has been a change in cultivation patterns practiced earlier. They used to cultivate different dals and tilhan (pulses, legumes and oilseeds), ensured protein and essential vitamin intake, but not anymore. Even different seeds that would contain nutritious oils, like mustard, groundnut, linseed and sesame are almost gone from their diet.  

After the discussion and blood pressure checks, the fun begins — stretching sessions and yoga is met with many groans and grumbles followed by giggles.

“When we oil a machine, it keeps it going. Like that we need to oil our muscles. Like a motorbike, we must continue to oil our engines,” says Suraj, eliciting more laughs before the group breaks up and they return home.