[Reader-list] RTF (Right to Food) Articles - 13

[Rakesh Iyer]

Source : Frontline

Link: *http://www.flonnet.com/fl2317/stories/20060908001705200.htm*
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*Vol:23 Iss:17*

Article:

*DEPRIVATION*

* Starving childhoods *

ANNIE ZAIDI & PHOTOGRAPHS
A.M. FARUQUI
* Hunger-related deaths among children continue to afflict the tribal
population of Sheopur.

*

"THE tribals need to change their attitude and lifestyle," said R.K. Dixit,
the Chief Medical Health Officer (CMHO) of Sheopur district in Madhya
Pradesh, in response to a query about continuing reports of children
starving to death in the region. The Sahariyas, one of the poorest tribal
communities in Madhya Pradesh, live mostly in remote villages with little
access to health care. Undoubtedly, they would like to change their
lifestyle - to begin with, they would like to eat two square meals a day.

Since *Frontline* reported 13 hunger-related deaths in Patalgarh village in
February 2005, there have been similar deaths in at least two of the four
villages this correspondent visited this year in the same district. But,
just like last year, local officials continue to seek refuge in denial. They
deny that acute hunger is a problem. They insist that existing government
schemes are being implemented properly. They deny that anything more could
have been done.
Hunger deaths are a sore spot with officials in Sheopur. Bring up the
subject and official responses range from "it is their culture" to "they
don't care about children dying; they have so many that they don't even
remember" to "they're accustomed to hunger now" or "it wasn't really
starvation... maybe some underlying malnutrition". When he was asked for the
total number of malnourished children in the district, Dixit told this
correspondent to consult the civil surgeon. The civil surgeon's office was
found locked.

Not so remote, but starving

Karrai village in Karahal block was in the news recently after five children
died. When *Frontline* visited the village, its residents spoke of seven
deaths in July. Kishen's three-year-old daughter, Karan's four-year-old son,
Heera's three-year-old son, Ramhit's one-year-old son, Laddoo's infant
daughter, Jagram's seven-year-old daughter, Harvilas' one-year-old son. All
of them appeared to have succumbed to fevers, coughs, measles, or something
else that they did not know the name of. But looking at the surviving
children's distended bellies, protruding eyes and wasted limbs, there can be
little doubt as to what, at root, is wrong with their health.

Two other children were dangerously sick and were hospitalised at Sheopur.
Hari Sahariya's son Gajraj and daughter Ramdhara are both very fragile, but
at least they are alive. Hari told *Frontline*: "I stayed for 10 days at the
big district hospital. But there was no money. The children were fed, but
not us. How could we have stayed on longer?"

Hari does not know what is wrong with his children, but the medicines
prescribed offer a clue - they are all vitamin or mineral supplements. It
seems that all the children needed was better food.

Karrai is not particularly remote. The village is barely two minutes from
the main highway. It even has a health centre, an anganwadi and a school.
When asked if the school gives mid-day meals regularly, a student, Chatru,
nodded uncertainly. "Sometimes, yes. When the master comes, there is food.
The master comes after every two days."

The smallest children get a fistful of *panjeeri* (a roasted mixture of
corn, soya, sugar and oil) at the anganwadi centre every day. But infants
who are too small to eat are particularly vulnerable. Draupadi, a mother
with a baby in her arms, said, "What can these little ones eat? If we eat,
they'll drink some milk."

Several newborns go hungry since the mothers have not eaten, and mothers are
forced to keep the babies alive by making them lick a little jaggery.

The other problem with the way the anganwadis handle malnutrition is that
the registers are not maintained properly. The worker does not seem to know
precisely how old the child is and therefore cannot judge how severe its
condition is. Usually, malnutrition is measured against a chart balancing
height and weight parameters; but because malnourished children are often
stunted, it becomes impossible to assess whether they weigh enough unless
age is taken into account. However, there are few birth registrations and
the people, being illiterate, do not keep personal records. It is very
important, under the circumstances, that the anganwadis keep a record of
birth along with that of height and weight gain.

Uma Chaturvedi, a fellow with the Right to Food campaign who has been
working in Sheopur for two years, says this is a significant problem: "The
anganwadi registers are ill-kept. The weight and grade [of malnutrition,
which is judged in grades of severity from 1 to 4] columns are often left
blank; many column entries are completely bizarre. For instance, there was
one entry in the name of Priti, daughter of Ghamandi. Between February 2003
and December 2004, the child was given seven different dates of birth.
Between December 2004 and June 2005, no entries were made at all. How can
one child be born seven times and how can she grow younger as time passes?
How will you judge her level of malnourishment correctly then?" Uma
Chaturvedi found at least 20 such cases of bungled age entries in the
anganwadi centre of one tiny hamlet, Kishanpura.

According to officials, the anganwadi centres alone cannot be blamed for
they are not equipped to deal with hunger on such a large scale. Sheopur's
ICDS (Integrated Child Development Services) officer O.P. Pande told *
Frontline*: "We are supposed to provide supplementary nutrition. For
example, we can give about 300 calories worth, of the total requirement of
1,200. But if the child is entirely dependent on this small supplementary
meal, it is bound to be malnourished."

Nevertheless, one cannot ignore the fact that in some villages, anganwadi
services are either absent or only partially functional. In Patalgarh,
despite assurances and visits from officials, the villagers say that at
least eight children have died since the 13 deaths reported in February
2005. It was only in May that the village got a functional anganwadi centre.
The village still has no midwife, no medicines and no nurse; the anganwadi
worker does not have the skill or resources to help with deliveries or
provide pre-natal care to women. There is one male "multi-purpose" health
worker in the area, but he is responsible for three panchayats and would not
be able to assist in childbirths anyway.

The result is that many children die as soon as they are born, while mothers
frequently die during childbirth. Gokul's wife Bhagwati died on the road
while he was trying to get her to a hospital 70 kilometres away on his
bicycle. The newborn baby died as well. Gokul is now left to care for three
other young children and his aged mother.

In another such case, a woman called Kalli was saved with great difficulty.
Right to Food activists happened to be in the village when she was in labour
and managed to take her to the district hospital in a car.

Recently, residents of the village signed an affidavit complaining of
misbehaviour by district officials. When Kalli's newborn died and her life
seemed to be in danger, they called up the CMHO, the District Collector and
the Deputy Collector of the block, asking for a car or an ambulance to be
sent urgently. The then CMHO allegedly told them that if they could not make
it to the hospital, they could not hope to get medical assistance. The
(former) Collector allegedly hung up on them. The SDM claimed to have sent a
vehicle but it never arrived; later, when they confronted him with this
fact, he allegedly told them not to talk back.

Patalgarh has other problems to contend with. Under the National Rural
Employment Guarantee Scheme (NREGS), the villagers were given the work of
digging and building roads. Almost all families have job cards. According to
the entries on the cards, many families have already got more than 100 days
of work over the last three months, though most of them have worked for
between three and seven days only. But with mechanical regularity, the cards
proclaim that the card-holders worked for six days a week, week after week.

Santosh Sahariya, who is literate, says that he worked for only six days but
his card mentions 36 days. Besides, he was engaged in digging a pond, while
his card entries claim that he worked on road construction. Residents say
their cards were taken away by the `contractor', sometimes without their
permission, and the entries were made without their knowledge. Most of them
are illiterate and do not know what the cards say.

When questioned about these fake entries, the district panchayat chief,
Shyam Singh, told *Frontline* that he had visited the village along with the
Collector and no such problem had been mentioned. He added that a lot of
people worked on both projects, the pond and the road, working through the
day. When it was pointed out that the villagers denied having worked more
than a few days, he said, "Come back with an appointment." When asked if it
would be possible to obtain a list of all NREGS projects currently under way
in the district, he said, "Ask the Collector."

The Collector, M.S. Bhilala, was not available for comment.

The problem of hunger is, of course, directly linked to the problem of acute
poverty, ration distribution and employment guarantee. Madhya Pradesh has a
dubious record there. Food and Civil Supplies Minister Gopal Bhargava
recently went on record as saying that at least 54 per cent of the BPL
(below poverty line) ration cards in the State had been found to be
fraudulent and fresh cards would have to be issued.

The new list that was drawn up and implemented this year (based on a 1998
survey) seems completely irrational. Many poor families have been struck off
the list. In Rohni village, for instance, only four families have been given
yellow ration cards, which certify them as being BPL. Gaya Khushwah, for
instance, is a landless widow. She is not certain how old she is, but looks
older than 80. Her ration card, however, mentions her age as 40. She gets
neither the old-age pension nor the widow's pension and now her name has
been struck off the BPL list. Radha, another landless widow who must also be
at least 80 years old, has been struck off the list too. Some old people did
not have ration cards at all, and most of the families did not have job
cards or health cards either.

 One little step, not enough

 It is not as if the government is not making any attempts to tackle hunger
and poverty. It introduced the Bal Shakti Yojana in August 2005. Under this
scheme, if a severely malnourished child is brought to hospital, he/she can
be admitted for up to 14 days and provided food worth Rs.15 every day,
including high-protein soya biscuits and milk. In addition, the mother is
also entitled to Rs.35 a day, to enable her to eat and stay with the child.
She also gets Rs.100 as mobility (transport) allowance. The wards or centres
for malnourished children are called Poshan Punarvas Kendras (Nutrition
Rehabilitation Centres) and local officials have the freedom to take the
help of local non-governmental organisations (NGOs) or community
organisations to establish bigger centres with better facilities.

In Sheopur, the first Nutrition Rehabilitation Centre has been set up in the
district hospital, as a separate ward. Dixit said that it was launched on
July 30 but so far no one to cook and so the children were being given soya
biscuits and milk. He added that the mothers had been given Rs.100 on
admission.

Meanwhile, the department is talking to a local organisation but appears to
be waiting for it to get formally registered as an NGO, before a kitchen can
be made functional.

However, it seems that rules are being violated at the very outset. Gulbai
Bheel brought her sick one-year-old daughter Leela from Madanpur village.
She did not get any money upon arrival, nor was she told that she was
entitled to Rs.35 a day as food allowance. Gulbai had not eaten all day, nor
had any of the three other women who had arrived at the hospital the day
before. The fathers who brought their children had not eaten either, and
nobody seemed to know whether they were entitled to a food allowance.

Sheopur might take a leaf out of neighbouring Shivpuri district's book.
Shivpuri, which also has a large tribal population with a serious
malnourishment problem, was the first district in the State to start
implementing the Bal Shakti Yojana and has already got four Nutrition
Rehabilitation Centres in place.

The Collector, Dr. Manohar Agnani, told *Frontline*: "It has only been seven
months and we cannot say that the effort is either complete or foolproof.
Our capacity is 76 beds and by the most conservative estimate, there are
about 3,137 severe cases in this district. We have catered to about 1,000
children already and are taking care to follow them up when they leave the
hospital. We have surveys to monitor progress and we admit there are
failures. For instance, despite our efforts, some of the Grade 4 children go
back to their villages, and they cannot be brought down to grade 1 or 2; a
few have even died. But slowly, we are building capacity and will have more
centres in each block. The Gwalior Medical College is helping, UNICEF
[United Nations Fund for Children] is helping and we get clothes or toys as
donations for the children. We have also written to the State government
recommending 70 recipes that can be tried at anganwadi centres, using
ingredients that are available locally and are nutritious."

The results of the eighth Bal Sanjivani campaign survey (2006) are
disturbing. In Madhya Pradesh, 49.21 per cent of the children were found
malnourished, 0.91 per cent seriously so. That is well within the limit of 1
per cent set to be reached by 2007, but the figures are much worse for
districts with large tribal populations. In Sheopur, which has the worst
record, 57.68 per cent of the children are malnourished, of whom 2.59 per
cent are severe cases.

Madhya Pradesh also has the dubious distinction of being number one on the
list as far as infant (less than a year old) mortality rates are concerned.

There are 79 deaths for every thousand live births. In effect, this means
that at least one lakh children die each year in this State alone. Child
mortality rates (for children between ages one and five) are even higher, at
137 for every thousand. While disease and infection are among the reasons,
malnutrition is an equally important factor.

Every year, reports of starvation deaths trickle in from different parts of
the State. Three cases were reported from Chhatarpur in the past fortnight.
Earlier, one child died in Piprani and at least four died in Gadla village.
None of these villages was particularly remote. There is no way of knowing
how many might have died in villages to which there are no proper roads and
where there are no telecommunication facilities.

At present, the State of Madhya Pradesh sets aside only Rs.150 crores for
feeding children at anganwadi centres, at the rate of Rs.2 daily for every
child. Going by the 2001 Census, Madhya Pradesh has at least 1.06 crore
children under the age of six. At least Rs.600 crores will be required to
feed them all one small meal a day. Surely the situation calls for a bigger
budget for the State's underfed children.

    * *