Doctors in the Departments of Preventive and Social Medicine at the B J Medical College and the N H L Municipal Medical College say they have not noticed much improvement at least in the last decade. A check-up of some 12,000 children in last January revealed that about 70 per cent had anaemia and 15 per cent severe anaemia, says Dr Vasudevbhai Raval, head of the Department of Preventive and Social Medicine at the B J Medical College.

Dr D G Dholakia, gynaecologist and obstetrician at V S Hospital, says, ``Seven out of the 10 women have anaemia, at least 10 out of 100 have to be admitted for severe anaemia and five require blood transfusion.'' The condition can be especially dangerous for pregnant women and that brings to the fore the lack of ante-natal care.

Besides women, children are the main victims of anaemia. The discoloration of the tongue or nails is a sure sign of the condition. Malaria, tuberculosis, worm infestation and dietary habits have been identified as its major causes. The standard treatment is administration of iron and folic acid tablets.

The anaemia control programme is being run through the 950 primary health centres. While the rural PHCs are run by the State Government, the urban centres are the responsibility of municipal corporations. Field workers are supposed to visit houses and distribute iron doses. ``This is not being done, simply because we do not have enough people,'' said a doctor at Ahmedabad Municipal Corporation. On an average, there is only one health worker for a population of 12,000.

The school health programme, too, hasn't been successful. ``There has been some improvement, but the problem requires community education and involvement, which is missing,'' says Dr S N Vani, head of the Department of Paediatrics at the civil hospital in Ahmedabad. ``The programme is being implemented patchily many workers in the field are not even aware of what they are actually doing,'' he adds.

Doctors say children are supposed to get iron doses for three months, but there is no check to ensure that they keep getting it. The field workers only fill up target numbers. ``It is a numbers game, without concrete results,'' says a doctor.

In any case, administration of doses of iron-folic acid tablets alone isn't sufficient, according to Dr Vani. Equally important is educating students about the causes of anaemia. Bhatt says a beginning is being made and more than 70,00,000 letters have been sent to educate parents.

Education Minister Anandiben Patel had also written to teachers to include them as health workers in the programme, said Bhatt.

Doctors working in the field say sustained action is lacking. ``We keep jumping from one programme to another,'' was Dr Vani's complaint. The programme will not work just by writing letters ``which not one of my friends has received,'' said a doctor in Ahmedabad. ``What is required is a sustained campaign to educate the people, but politicians want glossy literature to get international and national grants,'' he observed.