Birth on the Threshold. Cecilia Van Hollen
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in cash, such as fish sales or other work in the informal sector or in factories, they often stopped this work after marriage and during their reproductive years. They would then resume such work once their last child was weaned. During their reproductive years, however, women did continue to do non-cash-earning work, such as cleaning fish and prawns and repairing nets, in addition to their heavy workload looking after the household. And some had no choice but to continue to sell fish in the markets even during their reproductive years.
Semirural Landscape: Kaanathur-Reddikuppam
I was first introduced to the Kaanathur-Reddikuppam area by Dr. Vijaya Srinivasan,59 who had set up a small outpatient clinic in a new retirement community in Muttukaadu, just south of Kaanathur-Reddikuppam. A couple of the health workers at this clinic also worked for the Voluntary Health Services (VHS) in Kaanathur-Reddikuppam, so they became my first contacts in this small town.
The area referred to as “Kaanathur-Reddikuppam” consisted of a cluster of three communities which were adjacent to one another: Kaanathur, Reddikuppam, and Bilal Nagar. In 1995 a main road separated Kaanathur on the west side of the road from Reddikuppam and Bilal Nagar on the east side. Kaanathur and Reddikuppam were the two original communities in this area. Kaanathur was a community made up primarily of “scheduled caste” Hindus and some Christians, many of whom worked as agricultural laborers in the fields away from the coast or as wage laborers on construction projects. According to the Integrated Child Development Services’ (ICDS) balwadi workers who kept census-type records for the area, agricultural laborers here earned approximately Rs. 4,000 (US $111) per year, and other wage laborers earned approximately Rs. 3,000 (US $83) per year. Generally, men earned more than women engaged in the same kind of work. For example, female agricultural laborers sometimes earned Rs. 15 per day, whereas male agricultural laborers often earned Rs. 30 or more per day.60
Reddikuppam was primarily a Hindu Pattinavar fishing community settled close to the beach. As did their counterparts in Nochikuppam, these fishermen earned an average of approximately Rs. 6,000 (US $167) per year, but their income varied greatly depending on equipment and the vagaries of nature. Prior to the 1980s all the residents of Reddikuppam were living in thatched huts. Over the years, these huts were repeatedly destroyed in fires and then rebuilt over and over again. Finally, during the 1980s, the Tamil Nadu government began building individual cement-block houses for the residents of Reddikuppam. The government requested payment for these houses, but most residents moved into the houses without paying for them. All the utilities and facilities, such as electricity and the water pumps connected to bore wells, had to be installed and paid for by the residents themselves.
All the land occupied by residents of these two communities was owned by one Telegu landowner whose last name was Reddi. Much of the land that was not cultivated and that was not right on the coast was covered with casurina trees, which were sold in Madras as firewood. When Mr. Reddi decided to sell off his land, the people from Kaanathur and Reddikuppam joined together and asked for twenty acres. Ten acres went to Kaanathur and ten acres to Reddikuppam. An adjacent ten acres were sold to a Muslim man named Ahmet Khan. Bilal Nagar was a newer Muslim community which was established in the early 1980s when Ahmet Khan practically gave away plots of land at a very low price (Rs. 25/plot) to poor Muslim families. In 1995 these plots were selling for Rs. 10,000–60,000 and being bought by more wealthy Muslim merchant families who were relocating from but maintaining business connections in Madras.
There was a general consensus that the most significant change in this area in people’s memory was the laying of the main road from Madras. This project began in the mid-1960s, and originally the road only went as far as Uthandhi, a small town about 1 km. north of Kaanathur-Reddikuppam. Residents of Kaanathur-Reddikuppam then had to walk to Uthandhi to catch the bus. This distance was difficult not only for women carrying basketloads of fish to sell in distant markets or bringing back vegetables newly available from Madras, but also for women in labor who wished to deliver their babies in Madras. The road was extended through Kaanathur-Reddikuppam south to Kovalam a few years later. The bridge which crosses the lagoon in Kovalam, south of Kaanathur-Reddikuppam, was finally built in 1987, enabling the road to stretch beyond Kovalam all the way to Mamallapuram,61 home of the famous seventh-century shore temples from the Tamil Pallava dynasty. Mamallapuram has long been a pilgrimage destination for Hindu worshipers; with the completion of this road it also became a popular tourist destination and a weekend outing spot for Madrasis. Buses passed through Kaanathur-Reddikuppam regularly on their way between Mamallapuram and Madras.
There was a bus stop in the middle of Kaanathur right at the point where the dirt road led down to Reddikuppam and to the sea. In the mid-1960s there was only one tea stall in this zone between Kaanathur and the road leading out to the sea. In 1995, however, passengers getting down from the bus faced a long row of small shops which ran along the side of Kaanathur parallel to the new road, giving Kaanathur the air of a very small town.
The new road not only enabled people from Kaanathur-Reddikuppam to travel farther for such things as trade and medical care but also provided a direct conduit for the flow of people, goods, and ideas from the metropolis into Kaanathur-Reddikuppam and its surroundings. In fact, ever since the road was built to connect Madras with Mamallapuram, the entire stretch of land between these two destinations had been changing rapidly, transforming from a rural agricultural and fishing area into a major resort area. Amusement parks, health spas, an upscale drive-in theater, new homes for the elderly, hotels, and numerous privately owned vacation homes, also known as “farms” (many of which are owned by nonresident Indians), now dotted the landscape on both sides of this road. One major effect which this development had on residents of Kaanathur-Reddikuppam was that landowners were selling off their plots to these new enterprises, so agricultural laborers from Kaanathur were increasingly turning to employment as construction workers and servants for these resorts and vacation homes. And laborers who previously also owned and cultivated small plots of their own land were selling these off as well, leaving them increasingly dependent on wages from the new developments. Some people commented that this loss of ownership had created a sense of helplessness and depression within the community and that alcoholism was on the rise as a result. Some turned from agricultural work to working in an illicit liquor trade.
The emergence of these new resorts did not have the same kind of immediate impact on the work of the fishing community in Reddikuppam. The fishing industry was, however, significantly affected by the increasing use of new technologies, especially new motors. As in Nochikuppam, some residents of Reddikuppam joined the fisherman’s cooperative and could purchase motors at discount rates. People in Reddikuppam were somewhat ambivalent about the merits of these new motors. Although a motor could indeed bring in a much more profitable catch, the investments required to purchase the motor, the diesel, and repairs to the motors were very substantial, so that anyone who made these investments and yet still did not have a good catch could suffer extreme financial losses. Another significant change in Reddikuppam was the recent arrival of private companies that used aquaculture technology to farm prawns. These companies created competition in the prawn trade and perpetuated the loss of land in Reddikuppam by buying land from poor fishing families who resorted to selling it. These companies, however, did not employ Reddikuppam residents in their operations.
The new road not only ushered in the leisure establishments which catered to the whims of middle- and upper-class Madrasis and other outsiders, but it also brought new institutions (such as schools and medical facilities) and new forms of media (particularly via televisions and VCRs) which were used by the local population. In addition, the road linking local residents more directly to institutions and markets in Madras resulted in dramatic changes in the provision of maternal and child health services in the Kaanathur-Reddikuppam area. The changes in childbirth practices which will be discussed in the remainder of this book need to be seen in the context of these more general changes brought in by the construction of the main road. The following story of Murugesan provides an example of the availability and accessibility of MCH services for birth prior to the building of this road.
When I met him, Murugesan was sixty-five years old and the president of the Kaanathur-Reddikuppam panchayat. He lived in one of the largest houses in Kaanathur, a light blue, cement house in a walled-in compound at the far end of the main road. Murugesan was