At Sheikh Bhirkiyo, Sindh, women are at the forefront of tackling malnutrition by working together for a better future. You! takes a look…

Shabana Khatoon and Amir Bux running their farm
Shabana Khatoon and Amir Bux running their farm

Shahida stands proudly in front of her presentation, rounding up her work with the European Union-funded Programme for Improved Nutrition in Sindh (PINS). The women in Local Support Organisation (LSO) Sheikh Bhirkiyo are anything but ordinary. Even as they welcome guests, they make sure to leave quite the impression. Asking everyone to bring in their ajraks and dupattas, they’ve transformed General Secretary Shahida’s modest veranda into a burst of colour and embroidery, with people looking around in quiet awe as they take it all in. Her pride is justified.

12 villages that are a part of the LSO Sheikh Bhirkiyo had resolved to work together towards better nutrition. That’s 2,945 households, most of who lived below the poverty line with obvious implications on their health. Now they are united in overcoming the challenges of malnutrition that was impacting the future they wanted for their children.
PINS aims to improve the nutritional status of children under 5 and of pregnant and nursing women across 10 districts in Sindh. The multi-component programme is supporting the Government of Sindh’s multi-sectoral Accelerated Action Plan (AAP) for the reduction of malnutrition in Sindh. The programme worked with LSO, Sheikh Bhirkiyo, to mobilise and train individuals. This will in turn improve food intake as well as reduce water-borne diseases through disaster-resilient infrastructures. It will also promote sustainable food production systems through the network of the above community institutions.
Women are on the frontline of it – after all they are ones who stand to lose the most with malnutrition. Many struggle through their pregnancies, plagued with micronutrient deficiencies and poor nutrition. The babies born are mostly underweight who struggle to gain weight as they are growing, often becoming stunted which is irreversible beyond the age of two. As a result, they are destined to a life with struggles.
When PINS started working with LSO, Sheikh Bhirkiyo, women were teamed up with men to become Community Resource Persons (CRPs) to raise awareness on better dietary and hygiene behaviours. Nearly 3000 women were sensitised on ways to achieve better nutrition. In a similar vein, 12 of the 24 Agriculture Entrepreneurs are women, trained to impart knowledge on cultivating organic and seasonal produce. Together, they trained over 1,200 households, with the programme providing seeds to kick-start their kitchen gardening journey.
“Earlier, we were mostly restricted by the male members in our family, who wouldn’t allow us to participate as much. But with programmes like PINS, we took charge using it as a platform to bring the change which is a proof that we too were drivers of change. This allowed them to see our abilities in a different light, making them more amenable to listening to us. Now, we are often the ones giving advice to our husbands,” says one of the women, as she smiles and gives her husband a knowing glance.
Shabana, a CRP, highlighted the condition of water, sanitation and hygiene in the community. “1,803 households were encouraged to build latrines, largely through awareness sessions and visits for further counselling. This allowed the community to achieve open defecation free (ODF) status with all 12 village organisations certified by the district ODF committees.”
There was a mutual agreement when the women were asked if they felt any kind of impact from PINS in their lives. The responses came in multiple forms, from a realisation to being able to become a business owner. “I was always under the notion that my needs would always be second. Even as we were pregnant, when we should be getting extra care and attention, we would still be eating leftover food. Now, this has changed when I started sitting through the sessions. In my latest pregnancy, I was more aware of all the things I should be doing, including prioritising my health. To make things easier, I was given a grant of PKR 30,000 to purchase two goats,” elucidates Soomri.
Women like Soomri now own goats which is often the first asset they have to their names. It makes them more likely to drink their milk which they wouldn’t be doing otherwise. That milk is often bartered for some fruit or meat which means a more balanced diet. There is also behavioural change aimed at helping them recover as they become new mothers.
Azeema Khatoon, one of the residents of the village talked about the different changes that had come into the lives of the women and their children. “Women were often forced to start working on the second day after giving birth. Now, mothers-in-law understand the importance of proper rest in the post-partum period, when a woman’s body begins to heal, thanks to the community awareness session”.
“We also got to know the importance of colostrum, often called mother’s first milk, which we were asked to waste earlier. This has proven benefits to boost the child’s immunity,” she adds.
Under PINS, pregnant and nursing women are also given multivitamins, specifically iron supplements. Malnourished children are also identified to be treated at local hospitals while given supplements to enhance their diets. Seeing these structured procedures and their impact has helped dispel suspicions and traditions, fondly known as totkay.
When asked about what cure they had earlier for stunting, Azeema informs, “We used to weigh a stunted child with cow dung. After making cakes from this cow dung, we would let it dry in the sun. People believed that as the dung cake will dry up, the child would be saved from stunting. Another way was to bathe a child while keeping a puppy below him. They believed that after this totka the puppy will die and the child will survive. Another way was to leave a child in a graveyard and then another person would bring it. Some people would resort to healing through magic, but stunted children ultimately would die, leaving their families devastated.”
The community also agrees that PINS was a blessing, especially when the coronavirus pandemic hit. “We were already prepared, eating better and taking care of our hygiene. We started making our own cloth masks and washing our hands with soap more,” enthuses Shabana. Because of being involved in immunisation programmes before, convincing people to get vaccinated to protect against COVID-19 was not too difficult. Once the vaccine was available at a nearby hospital, the community went in droves to get vaccinated, encouraging others who were still hesitant about their experience. “Now that I look back, this is similar to what we are doing with our community awareness sessions. It’s amazing to see impact in instances like this!” she highlights.
For Haseena, PINS has also meant becoming an entrepreneur, where she has partnered with her nephew to start selling fodder and other food for the livestock in the area. Their best selling product has jaggery in it which is meant to boost milk supply. She earns between PKR 6,000 to 7,000 a month. “I used to do excruciating labour but now I am earning decently with this new opportunity,” shares Haseena.
Shabana Khatoon, wife of Amir Bux, is another agriculture entrepreneur. She had an impressive record at her farmer field school which formed the basis for her getting the grant. Partnering up with her husband, she now uses that space to grow broccoli and purple cabbage that is in high demand in metropolitans like Karachi which is 3 hours away. They earn up to PKR 500 per kg. “We take the pictures of the produce and send it to buyers or will spread the word during community meetings,” expresses Khatoon.
The money they earn is reinvested into their poultry business, for which she received PKR 50,000 and invested PKR 10,000 on her own. She now has 75 poultry birds and is selling eggs in the community. Together with her husband, she also bought an incubator that they use to foster chicks to expand their brood and sell in the market. Started three months ago, the couple now earns PKR 500 – 600 daily. “Earlier I used to sell vegetables or fried fish or would do odd labour work. Now, by working on our business, our monthly income is between PKR 15000 to 16000,” tells Amir Bux.
As part of PINS collaboration with the Sindh Forest Department, there have also been efforts made from the communities’ for more greenery. They aim to plant 500,000 trees under the Ten Billion Tree Tsunami Programme across the ten districts it works in. Within Sheikh Bhirkiyo itself, as many as 600 moringa trees and 400 fruit trees, including guava, falsa, plum and jujubes have been planted. “To be surrounded with greenery and have fruits too is wonderful!” says Kanwal, a community member who has been an active part of PINS.
All these initiatives are clearly bringing about a change. But most of all, it has fostered an unparalleled community spirit to work collectively towards a healthier future. It is wonderful to witness this transformation, which is as beautiful as the myriad of colours from the ajrak that surround these women who are nothing short of changemakers. The generation ahead are lucky to have role models who have sacrificed so much to get to this point. But working on programmes such as PINS have made them smarter, stronger and more determined to build the future they know they deserve.
The author is the Editor of Supplements. She can be reached at:


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