While more than 60 percent of Indian women are anemic as they eat last and the least, rising hunger levels hit the marginalised most.

Kalahandi, October 14 (RHC)-- On September 3, Ranjita Majhi, a 33-year-old Kui speaking Khond woman in the eastern Indian state of Odisha, gave birth to a baby boy.  She was elated as she had taken a 30,000 rupees ($400) loan for the delivery. Since she was severely anaemic, her health complications prevented a normal delivery.

As a result, Majhi had to travel 60km (37 miles) to a government hospital in Bhawanipatna district, where she had a caesarean section.  All was well in the Majhi household for four days.  But then the child died.  “I don’t know how to repay my loans, now the child for whom I took the loan is also not with me. They said they do not even know how he died,” she told Al Jazeera, wiping her tears.

Bhawanipatna’s district hospital doctors claim they also do not know how the child died.  But activist Roshnara Mohanty from Ekta Parishad NGO hints at malnutrition. She says access to forest is prime for tribal women and prevents them from being intergenerationally malnourished.

In 2009, Majhi left her Rampur village in Kalahandi to move to Madanpur Rampur town. She and her husband belong to the Kui-speaking Khond tribe, but were landless.  With decreasing access to forest, they migrated to the town in search of livelihood opportunities and started working as casual labourers. Her husband started working in a small eatery while she became a domestic worker.

In 2020, India’s COVID-19 lockdown resulted in a tremendous collapse of livelihoods, causing an epidemic that India has been trying to fight off for decades: hunger.   Majhi’s husband, like countless other marginalised folks, lost his job in May this year while a devastating second COVID wave was at its peak.

While 50 percent of the households in rural India were forced to reduce the number of meals ever since the lockdown was imposed as part of an immediate adjustment for food security, about 68 percent of the households reduced the number of items in their meals, according to a study by the People’s Archive of Rural India.

Nisha, 30, who goes by her first name only, tells a similar story as her anaemia worsened in the last two years.  “I could not go to a doctor in the last few months even though I have an unbearable pain in my ribs – because I have no money. Only social workers have gotten us some help, we did not get any other ration,” she told Al Jazeera.

Nisha is a Dalit, a marginalised community that falls at the bottom of India’s complex caste hierarchy. She lives in a slum in New Delhi’s Shahdara area and works as a rag-picker.  She recounts picking up at least one bag of biomedical waste every day during the peak of the COVID second wave.

On most days, she has crushing headaches, rib pain and fatigue that do not allow her to work. Yet she must work to support her children’s education.  Having to go back to unsafe work environments is a story many Dalit and Adivasi (tribal) women share.

The State of Working in India 2021 report (PDF) shows that 83 percent of women lost their jobs during the coronavirus pandemic, with 47 percent women and just 7 percent men unlikely to recover from the job loss.

Beena Pallical from the National Campaign on Dalit Human Rights says most marginalised women were pushed back into work that put them in unsafe spaces and made them susceptible to catch the virus.  But they had to do the work because the system works against them, she said.

“Dalit and Adivasi women die younger than dominant-caste women, and nutrition and health have always been a struggle for Dalit-Adivasi women. You throw in the livelihood crisis and the hunger crisis during the pandemic, and the effects suffered by marginalised women would be manifold,” she told Al Jazeera.

Studies show 56 percent Dalit and 59 percent tribal women are anaemic, while the national average is 53 percent. In 2016, India ranked 170 out of 180 countries where women suffer from anaemia. Dalit women die 15 years younger than the dominant-caste women, a United Nations study (PDF) says.