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 born in Kaanathur and had lived there for most of his life. He told me about changes in childbirth practices which he had witnessed during his lifetime.
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When Murugesan himself was born, a maruttuvacci (midwife) from the nearby village of Navallur assisted with his mother’s delivery and continued to come to their house to help his mother for fifteen days following the delivery. Murugesan explained that the maruttuvaccis in those days were very knowledgeable about children’s diseases like māntam (infant indigestion) and i
Murugesan himself had had nine children, of which only three had survived. His first wife had had two children but only one survived, and that wife died in childbirth. The second wife, who was his first wife’s younger sister, had had seven children and only two of those children survived. All of the children had died before they reached the age of three, and most died within one year. The first child of the first wife was born at home with a maruttuvacci and died after 28 days. The second baby was also born at home and six days later his wife got janni (fits with a fever; in childbirth this often refers to tetanus). The people in the community thought that she was possessed by some spirits and they called the maruttuvacci to provide a cure. The maruttuvacci gave his wife a janni tablet along with cukku (dried ginger). But this did not cure his wife and her condition was deteriorating rapidly. It was decided that since the situation was so dire it was necessary to take his wife to Kasthurba Gandhi Hospital in Madras.
There was no main road to Madras in those days and therefore no buses. The journey was long and arduous so people did not consider going to the Madras hospitals when a woman’s labor began. Only if an emergency arose would they make the voyage as they did with Murugesan’s wife. It was 9 P.M. when they strapped her onto a board and transported her by bullock-cart to the canal. It was December and the night was cold. At the canal they boarded a small sailboat and sailed to Thiruvanmiyur. It took seven hours to reach Thiruvanmiyur from Kaanathur. From Thiruvanmiyur they went by horse-cart to Adyar. And from Adyar they could take a bus to Kasthurba Gandhi Hospital. They reached the hospital at 7:30 A.M. There was a doctor there who attended to them. The baby survived but his wife died in the hospital two days later. That was in 1952. It had taken them ten and a half hours to reach Kasthurba Gandhi Hospital from Kaanathur. In 1995 they could travel that distance within an hour.
His second wife’s first child was born in the Andhra Sabha Hospital near the Adyar bridge in Madras. They had gone to the hospital in advance to avoid the complications which his first wife faced. That baby died from diarrhea after ten days at home where they were treating him with nā
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Murugesan and others of his generation all told me that before the bus route had been established in the 1960s almost all deliveries in the area took place in the home and were assisted by a maruttuvacci. Only in extreme emergencies were women, like Murugesan’s first wife, transported to Madras for hospital attention. It was because of the death of his first wife and the deaths of so many of his children born by his second wife that they had taken the trouble to have three of her deliveries in the hospital in Madras. Murugesan came from one of the wealthier families in Reddikuppam and had received more education than others in the community at the time. He said that his wives’ visits to the hospitals in Madras were unusual within the community, where most could not afford the time and money required for these trips.
Everyone told me that since the road had been laid and the buses had begun to ply this route, women were all “running to the hospital for deliveries.” In fact this was not quite true. What was no doubt true was that there had been a marked increase in the number of women traveling to hospitals for deliveries. But many women I met in 1995 had had their deliveries at home. I decided to gather some statistics on the delivery sites for women in this area during the time of my research.
Based on the records of the Kaanathur Voluntary Health Services mini-health-center
