[Reader-list] RTF (Right to Food) Articles - 10

[Rakesh Iyer]

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*Volume 25 - Issue 22 :: Oct. 25-Nov. 07, 2008*
INDIA'S NATIONAL MAGAZINE
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*DEPRIVATION*

* Dying of hunger *

 AJOY ASHIRWAD MAHAPRASHASTA
*in Satna*

 * Malnourished tribal children die because ICDS schemes are all but
non-existent, and the government is in denial. *

   PRAMOD PRADHAN

* At Hardua village in Ucchera block of Satna district, a child with Grade 3
malnourishment and suffering from skin infection. *

THE final five kilometres to Ramnagar (Khokla), as the village is officially
called, in Satna district of Madhya Pradesh has to be done on foot down a
hill thick with shrubs and bushes. As we enter the village, eager eyes scan
us for food or some other kind of livelihood support only to droop in
disappointment once they learn that the wait has been in vain. The people of
the Kol and Mawasi tribes who inhabit this village are a desperate lot: they
have neither employment nor food, and their malnourished children are dying.
In the past four months at least four children have died and those standing
by the side of their elders had protruding stomachs, sunken eyes, wrinkled
legs and slightly deformed heads, all symptoms of malnutrition.

Ramnagar has one small *pucca *house where the school, the anganwadi
(government-run creche) and the panchayat sub-office function from. The
people overcame their timidity despite the presence of the village patwari
and the gram panchayat secretary to tell *Frontline *that the anganwadi and
the ration shop had been closed for almost the whole of last year.

Sukhlal, one of the village elders, said: “Only a month back the preparation
of the midday meal in the school and the anganwadi’s supplementary nutrition
programme and the work through the National Rural Employment Guarantee
Programme [NREGP] were given to us. We didn’t get even six days of
employment by the government last year and the ration shop opened only once
in six months.”

But the district records claim that one person from each of the 100 families
in the village was given 60 to 94 days of employment and each family got 35
kg of grain (wheat or rice) every month.

The story is no different in Hardua and Nakgheer villages, a 60-km drive
from Satna town cutting through difficult rocky terrain and streams. Neither
village has electricity but it is not a priority for the residents. “All we
want is food and employment,” said Jagannath, an elder in Hardua. Here, too,
children have died of malnutrition-related causes.

Pappu, a resident of Hardua, lost two of his children in August on
consecutive days. “We don’t know what happened to them. They had fever for
many days and none of the medicines we gave seemed to have any effect,” he
said. “And because we have very little money and a very low income, we could
not feed them well,” he added.

Most of the people living in such difficult conditions blamed destiny for
the deaths, and in the extreme called it God’s will. They have been looking
forward in vain to the government support they had been promised by
political parties during elections. The issue came to the fore when people
from 150 villages of Satna district at a meeting on August 24 decided to
boycott elections if their women and children continued to suffer for want
of food.

An investigation by the Right to Food campaign claimed that at least 163
children died of severe malnutrition in the past four months in four
districts of Madhya Pradesh – Satna (69), Khandwa (47), Shivpuri (32) and
Sheopur (15). All the children belonged to tribal/indigenous communities –
Kol, Mawasi, Saheriya and Korku.

These are some of the most deprived communities in the State; most of their
members are landless and have no permanent source of income. Their food
insecurity and deprivation have been worsened because of schemes that do not
function and corruption in the NREGP and the public distribution system
(PDS).

In Bhopal, a senior official of the Department of Women and Child
Development, who did not want to be named, said: “Why is the government
blamed for everything negative that happens in the State? Shouldn’t the
tribal community be blamed for malnutrition in the villages, for neglecting
their children and for lack of hygiene in their houses?”

Such bureaucratic insouciance is up against a court directive. On September
26, the Madhya Pradesh High Court ordered Chief Secretary Rakesh Sahni to
file a report on the malnutrition deaths in the State by October 13. It also
asked the Collectors of the four districts to file affidavits regarding the
deaths. The court was hearing a public interest petition filed in May 2007
by the Madhya Pradesh Right to Food campaign. The court also stated that
malnutrition could be a possible reason for the recent deaths. This was in
contrast to the State government’s position.

The public interest petition sought District Collectors and the Chief
Secretary to be made accountable for the lack of implementation of the
Integrated Child Development Services (ICDS) Scheme. Earlier, the Supreme
Court, while passing an interim order on May 8, 2002, in *PUCL vs. Union of
India and others, *stated that District Collectors, Chief Executive Officers
and the Chief Secretary should be held responsible for the lack of
implementation of the ICDS.

Meanwhile, in Satna, the district administration’s response to the deaths
has been one of denial. District Collector Vijay Anand Kuril said: “There
are malnourished children in Satna and we have already submitted our report
to the Health Department. However, the recent deaths of children in the
district were not because of malnutrition but because of various diseases
like jaundice, diarrhoea and fever, heat stroke, and so on.”

A joint team of State and Central government officials visited the district
in the last week of September and, according to the Collector, found no
Grade 3 and Grade 4 malnourished children in its villages. The district
officer of the Women and Child Development Department, M.L. Mehra, also
denied any malnutrition-related deaths.

The United Nations Children’s Fund (UNICEF) has graded malnutrition cases
into four, and of these Grade 3 and Grade 4 represent severe malnourishment
and children detected to be in these categories require immediate care.
 Damning statistics

 AJOY ASHIRWAD MAHAPRASHASTA

* A typical example of a Grade 3 malnourished child at Ramnagar(Khokla)
village in Majhgawan block of Satna district. *

 Madhya Pradesh tops the list of States in infant mortality rate (IMR), with
72 deaths per 1,000 live births, according to the Sample Registration Survey
2007-08. Even the State government website shows that 97,223 children in the
age group of 0-1 year died of malnutrition between April 2005 and July 2008.

Madhya Pradesh also tops the list of States in undernourishment in the
latest National Family Health Survey (NFHS-3), with 60.3 per cent of the
children suffering from malnutrition. The NFHS-3 shows a 6 per cent increase
over NFHS-2 in malnutrition-related deaths in the State. The total number of
malnourished children in the State has risen to more than six million,
according to the report. Of them, 12.6 per cent are severely malnourished as
against the national average of 6.4 per cent.

According to senior officials in the administration, the State has, with the
assistance of UNICEF and the World Food Programme, unveiled special schemes
such as the Bal Shakti Yojana, Shaktimaan and the Bal Sanjeevani Abhiyan to
treat severely malnourished children. Besides, it has advocated
community-based programmes to tackle the problem.

All these schemes come under the ICDS, a major scheme for children under six
years of age, who comprise 16 per cent of the total population in the State
according to Census 2001. If allocation of funds is any indication, the ICDS
is not a priority for the State government.

It spends only 0.86 per cent of its total budget through the ICDS for
children under six. Incidentally, only 1.51 per cent of the State’s budget
is allocated for the Department of Women and Child Development. In money
terms, the allocation is Rs.590 crore, up from Rs.190 crore last year. But
only Rs.222 crore has been allocated for the implementation of the ICDS in
2008-09 against the need of Rs.799 crore.

All the 1.078 crore children under six years of age in the State should be
covered through universalisation of the ICDS, the Supreme Court had ruled in
*PUCL vs. Union of India and others*. For this purpose, only 67,000
anganwadi centres are functional, whereas, according to informed sources,
the actual need is for 1.26 lakh centres.

The Seventh Report of the Commissioners of the Supreme Court states that as
per Census 2001 as many as 6.6 million children are enrolled in anganwadis
run under the ICDS in Madhya Pradesh, but only 3.89 million, or 35.9 per
cent, get supplementary nutrition from the State through anganwadis.

Satna district, where the deaths of children were first reported, presents a
bleaker picture. Even the Women and Child Development Department’s figure
for Grade 3 and Grade 4 malnourished children in 28 villages in the district
is more than 4,000, but between January and August 2008 only 435 children
were brought to nutrition rehabilitation centres (NRCs).

Of the eight blocks in Satna, there are only two functional NRCs, with a
total of 26 beds. The one in Satna has 20 beds and 36 children are being
treated there, and the one in Nagod block has six beds. An NRC has been
sanctioned in Malhar block but it is not yet functional. The NRCs, which
fall under the Public Health Department, get a list of malnourished children
from the Women and Child Development Department.

However, officials of both the departments deny their responsibility for the
deaths in the district and shift the blame to the other.

A senior official of the Women and Child Development Department, who did not
want to be named, said children were 10 times more prone to fatal infection
because of malnutrition.

Despite this, the State has only 121 NRCs, according to the official
figures, and only 95 of them are fully functional. These centres have only
1,678 beds to take care of 13 lakh children. A Right to Food campaign
activist, Prashant Kumar, said: “With the present 14-day package for
children at NRCs, it would take 33 years to reach and serve all the
malnourished children in Madhya Pradesh. Alarmingly, 49 NRCs have no trained
staff.”

After the local media carried reports of the malnutrition-related deaths,
the NRCs extended their seven-day supplementary nutrition programme to 14
days. Under this package, the child is brought to the NRC and given adequate
nutrition for 14 days. After that the NRC has to follow up on the condition
of the child every seven days until the child comes out of Grade 3
malnutrition.

Given this state of affairs, it was no surprise that the Satna district
administration was wary of giving the media details of the implementation of
various schemes. In fact, throughout the *Frontline* team’s stay, its
movements were monitored by the police and the civil administration. The
police said the monitoring was being done because free movement in the area
involved risk as it was a “dacoit-infested” area.

However, they seemed more interested in knowing what the team was doing and
what conversations it had with the people. Collector Kuril even said the
reporter should have sought his permission before coming there.

According to informed sources, the district administration has been
suppressing details of severely malnourished children in Satna. According to
Kuril, all the Grade 3 and Grade 4 category children in the district are
being treated in the NRCs.

However, doctors in the blocks, who did not want to be named, said there
were many more severely malnourished children and alleged that there was
pressure from the district administration not to report such cases.

In the 11th edition of the six-monthly report of the Bal Sanjeevani Abhiyan,
published in November 2007, the government committed a *faux pas*. The
report says that 3,18,371 children were weighed and only 2,941 of them were
found to be malnourished. It says that the severely malnourished in Satna
district form 0.92 per cent, which would be 2,557 children.
 PRAMOD PRADHAN

* The meeting on August 24 in Majhgawan block, at which people from 150
villages in Satna district participated and decided to boycott elections if
the government continued to neglect their women and children. *

In the same report, in another table, this figure is given as 0.80 per cent,
which would mean 2,173 children. That is, 384 children were wiped out of the
records. When the local media highlighted the anomaly, the government
removed the second table from the report.

The figures of malnutrition in the NFHS and UNICEF reports are very
different from those in the government’s records. The NFHS-3 says that there
are 12.65 per cent severely malnourished children in the State as opposed to
the State government’s figure of 0.56 per cent.

Officials in the ICDS say they have their own parameters to judge
malnutrition. This is despite the fact that UNICEF was appointed by the
Madhya Pradesh government to oversee the process of women and child
development in the State.

The shoddy implementation of the PDS and the NREGP has compounded the
problem in the villages worst affected by malnutrition. The Supreme Court
has stipulated that the poor, including below poverty line and Antyodaya
Anna Yojana cardholders, should be provided at least 35 kg of grain, but
people in Satna district say they do not get more than 20 kg.

While the district administration claimed that it gives 94 days of
employment in the villages, the people said they did not get even a single
day of work last year and not more than six days this year. The residents of
Hardua village also said that the sarpanch had taken away their job cards
and that he himself filled up the registers.

With the government looking to promote private industrial investment, the
tribal people may have to face a new problem: large-scale displacement. The
government claims to have signed memorandums of understanding (MoUs) worth
Rs.3,00,000 crore with private companies, particularly in the mining sector.


A move to privatise the health sector is also apparent in the setting up of
the Rogi Kalyan Samiti, a public-private venture where the community would
generate funds for treatment of the poor. There are also plans to give
children in anganwadis ready-to-eat food provided by private companies
through the supplementary nutrition programme. This may not go down well
with the tribal people, who have their own unique food habits.

A pilot project to distribute ready-to-use therapeutic food (RUTF) has been
on since September in Khalwa block of Khandwa district under the directive
of the Union Ministry of Women and Child Development. The aim is to treat
severely acute malnourished (SAM) children, but critics of the programme see
in it an avenue to generate a market for ready-to-use foods among the poor.

With almost all their community rights over forests taken away and with
employment opportunities dwindling, the future looks anything but promising
for the tribal people of Madhya Pradesh.

   * *

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