Healthy Line Shops Help To Reduce Malnutrition Among India’s Tea Communities

Sanju Joshi’s retail shop sits on a dusty road, overlooking a line of fairy-tale-like little cottages. Stick fences, meandering trees, perfect heaps of firewood and colorful flowers, each to their own little plot— maybe one hundred of them— adorn the circumference of a small forest in the heart of the Kodomoni Division of the Nahortoli tea garden in India’s north-eastern state of Assam.

Family-operated retail shops or “line shops,” feed the surrounding community of more than a thousand tea workers and their families and, thanks to people like the Joshis, are helping to eradicate malnutrition and non-communicable diseases that have plagued these populations for generations.

Assam’s “tea tribes” as they are formally called by the local government, are the descendants of three to five generations of tea working families with roots in the eastern states of Odisha, Jharkhand, West Bengal, Chhattisgarh and Bihar.

In the organized sector, there are about 400,000 tea workers, employed across about 400 large estates in upper Assam— more than half of whom are women. Their work has been vital to the economy of the Indian sub-continent. After all, more than half of all tea is grown here— and India is the second largest tea producer in the world.

Most of the families who live here, averaging in size from five to eight people, have a historical link to these tea gardens. The living, the schooling, the working— everything happens here. There are health facilities, shops, a school…

While tea estate life has created historical and cultural continuity, it has also perpetuated risky diet-related behaviors, leading to inter-generational malnutrition and non-communicable diseases.

But an NGO intervention that began just prior to the pandemic has provided great hope for change.

I visited the Nahortoli tea estate one afternoon, a month before the end of plucking season. As the day wound down, I watched sacks of green tea leaves being loaded to massive, caged trucks, women tea pluckers making their way home in groups, and men— many involved in estate maintenance and supervision—beginning to trickle in.

I observed some of the women leaving their groups and heading straight to the Joshi’s shop to pick up items before it got dark— probably for their family’s dinner. During the winter months, darkness envelopes the area as early as 4:30pm.

Children, having returned from school, gathered around to observe the spectacle of foreigners visiting their neighborhood.

A group of little ones watched me curiously from a distance, laughing in unison when I greeted them with a jovial, “nômôskar!”

I walked over, and with the aid of my Assamese translator, asked them to tell me their names and ages. They were between 10 and 12 years… not the 6-to-8-year-old age group that I had assumed when I greeted them so animatedly.

No wonder they laughed at my childish antics.

Saroj Kumar Mohanta, a Director at Ecociate, a consulting firm that is supporting Swiss NGO, Global Alliance for Improved Nutrition (GAIN) to bring healthier food to the tea communities through the Joshis’ and other line shops, tells me that 36% of children under the age of five in rural Assam exhibits low height-for-age while even more are underweight.

Malnutrition has been an ongoing issue among these populations. According to the last National Family Health Survey conducted by the Indian government, more than 68% of children in rural Assam, between the ages of 6-months and 5 years, and more than 66% of women between the ages of 15 and 49 years is anemic. One eighth of women between the ages of 15 and 19 have been pregnant at least once, yet less than one fifth report taking iron folic acid for 180 days or more during pregnancy.

The unpainted cement and red brick exterior of the Joshis’ line shop nestles into the rustic terrain, as three women make their way to the outdoor service counter, the vivid colors of their saris popping against the grays and browns of their surroundings. Signage carrying nutritional messages, using mascot ‘Kaki Maa’ (or Aunty) branded by GAIN and affixed to walls and beams, reminds consumers of the necessary foods to maintain good health.

Sanju’s infant daughter squeals in delight as customers make their way to the counter.

“What kinds of vegetables do you have for sale today?” One of the women questions Sanju with a smile, her gold nose ring glistening in the afternoon sun.

“I’d like a bottle of oil… You know— the new one with the F+ symbol.”

Healthy dietary practices and increasing demand for nutritious foods that were popping up on the shelves of the new “healthy line shops” were the fruits of an educational campaign, consisting of cultural activities, such as street plays and cooking competitions, designed by Ethical Tea Partnership, a membership organization working to improve the lives and environment of tea communities, and GAIN’s Workforce Nutrition Programme.

This nutritional literacy has continued to help to improve diet-related health outcomes within the community.

“Not too long ago, people took what they could get; whatever was stocked in the shop, without requesting a healthier option” says Sunita Joshi, Sanju’s mother. “If they wanted oil, they just asked for oil. Now they specifically ask for fortified oil, with the F+ symbol.”

Biju Mushahary, Senior Project Manager for Workforce Nutrition at GAIN, describes the shift in preference from regular to fortified oil as one of the more significant project outcomes— oil that has been fortified with fat-soluble vitamins A and D provides 25-30% of the recommended dietary allowance.

The replacement of milk substitutes with dairy has also improved dietary access to important micro-nutrients such as vitamin A, vitamin B12, and calcium, essential fatty acids, and minerals such as potassium, magnesium, and phosphorus, which can play an important role in stimulating growth.

Prior to the healthy line shops project, the inventory of Sanju’s shop and others like it was lacking in nutritional value, consisting mainly of spices, biscuits, oil, potatoes, rice and other staples– limited options of basic food items that the tea workers would purchase using cash or credit. Other than onions, access to vegetables was rare and red lentils were typically the only pulses on offer. Fruits were not stocked at all.

Limited economies of scale also made sourcing practices cumbersome and tedious, resulting in added expenses for shop owners.

But since the educational groundwork was put into place and with the launch of the new, market-based solution, store owners have been sourcing healthier options at better costs and with more logistically efficient processes, and members of the community— and women in particular— have become more informed consumers, demanding better nutrition for themselves.

“We wanted to create a win-win scenario for all of the supply chain actors so that the model could continue beyond the project period,” Mushahary explains of the many benefits to the variety of stakeholders.

During the pandemic, Unilever which is the largest buyer of leaves from the Nahortoli estate in the Assam area, recognized the necessity of the Healthy Line Shop project to improve health, livelihoods and productivity, and created the enabling environment to ensure its success.

Other tea companies that took a similar interest in supporting the project were Taylors of Harrogate, Republic of Tea, Jacob Douwe Egberts, Ringtons Foundation, Wollenhaupt, Reginald Ames and Bigelow. This made it possible for GAIN, Ethical Tea Partnership (ETP) and Ecociate, to work together to make nutritious food more accessible to tens of thousands of tea workers.

“This is a promising model which can have a sustained impact on the health of tea estate workers and their families,” says Unilever Chief Sustainability Officer, Rebecca Marmot.

“Unilever is proud to support these innovative, market-based solutions together with GAIN, the Ethical Tea Partnership and Ecociate, to create access to nutritious food through Healthy Line Shops, alongside a behavior change campaign.”

The Joshis’ retail shop was one of the first to benefit from the model and since then, 32 Healthy Line Shops on 8 Assam tea estates— with more than 120 additional shops in the pipeline have made nutritious foods more accessible to Assam tea workers and their families.

The Joshis say that the one-time free supply of nutritious food products originally offered to get the project started was appreciated but not necessary, to convince them of its benefits.

Public health has been a priority to the Joshi family for multiple generations.

Sanju’s grandfather was a pharmacist and his father worked in the community hospital. His mother, Sunita, has been a Community Health Volunteer (CHV) for almost thirty years.

“I see a lot of night blindness, diabetes, and high blood pressure in this community, and I know first-hand the connection between a healthy diet and a healthier life,” she says.

The Joshis currently invest more than 25,000 rupees per month on a growing basket of nutritious food products including fortified mustard oil, milk, eggs, pulses, vegetables and fruits, among other items.

Other line shops in the area have also embraced the approach, and the added dietary diversity has had major implications for future nutritional outcomes.

“I talk to my customers about eating better,” Sanju says. “When you give people better health, they are better producers and consumers. I’ve seen my sales increase as a result. This is great for me because I want to give the best to my daughter and make sure that she has a bright future.”

The model has also helped to reduce the cost of doing business for the Healthy Line Shops. With the new distribution network, designed by Ecociate, dedicated aggregators have been able to source food for the Healthy Line Shops at fair prices and provide doorstep delivery at reduced rates. The project team provides business support to Healthy Line Shop owners, to help support their growing businesses, enabling them to become more profitable.

By working through the existing shop network in the local community, the project has improved the livelihoods of line shop owners, provided multiple options for nutritious food, and is helping to improve the nutrition of Assam tea communities for generations to come.

“When they were growing up, I would tell my three children about the importance of eating healthy,” shares Sunita. “With my Healthy Line Shop, I now have the power to make long lasting change.”