Killing poverty

Malnutrition-related deaths in Palghar in Maharashtra are a pointer to the lack of employment and welfare measures for tribal people to keep the wolf from the door.

Doing a weight check of children at Bhospada in Palghar district. This remote village has virtually no primary health care facility and it is in one of the worst-affected regions in terms of malnourishment.

Two-year-old Sagar Wagh died of pneumonia on August 28. He is among the 255 children from Palghar district of Maharashtra who have succumbed to acute malnutrition-related illnesses since April this year. State government figures record 82 deaths in August and 47 in September in the district.

The Palghar deaths are symptomatic of a larger problem in the tribal belt in the State. Every year after the monsoon, the tribal regions see a spate of deaths, particularly among children, because of hunger and malnutrition which increase the risk of diarrhoea, tuberculosis and pneumonia.

Some 17,000 malnutrition deaths, including that of adults, occurred in 2015 across the State, points out a petition filed in the Bombay High Court. Recent figures from the Integrated Child Development Services (ICDS) scheme say there has been a 5.8 per cent increase in the number of underweight children in the State. According to State government figures, 7,000 children in Palghar suffer from various forms of malnutrition.

Activists say it is only a conservative estimate of the numbers. They say the problem is massive, but it is only when deaths begin to make news that the government rushes in with quick-fix remedies like a few additional meals. This too fizzles out owing to lack of funds.

Palghar and other affected districts are just a few hours from urban centres such as Mumbai, Thane City and Nashik. “It is baffling how hunger can exist when the region is so easily accessible,” says a local social worker. “The obvious reasons lie in the bureaucracy, corruption, unemployment, the neglect of the marginalised, and sheer lack of sensitivity,” he says.

Says Vivek Pandit, a social worker from the Shramjeevi Sanghatana, which has been working closely on employment issues in the district: “What is causing this gap and why has it not been addressed? This is Maharashtra, a significantly more developed State than others. It is 2016 where technology and modernity are meant to help in progress. Starvation and malnutrition deaths should not exist in these times.”

Pandit asks how the same machinery that records the deaths is unable to visit the families and check if they are getting ration or other support. “The establishment knows that the problem exists. Yet no one does anything about it,” he says. “The main issue here is that we are not able to address the root cause of the problem which is unemployment. Every tribal belt is struggling with unemployment issues leading to bigger problems of health, and eventually hunger.”

Treating the symptom and not the problem is what the government does, says Pandit. In a typical example of official reaction in such situations, Ministers and bureaucrats rushed to the villages in Palghar and announced a few relief measures. This included a compensation package, a district-wise survey of children via anganwadis, and provision of eggs for four days a week to children (two bananas each for vegetarians). “This will give relief but it is definitely not a solution,” Pandit says.

Most families this correspondent spoke to said their diet consisted of rice and vegetables they had grown. Besides, they get some milk from the cattle, which they consume. Meat, chicken and fish are occasional treats. Social workers say the obvious lack of protein and carbohydrates causes severe dietary imbalance and leads to different levels of malnutrition.

Meanwhile, following a petition by the non-governmental organisation Swaraj Abhiyan, the Supreme Court criticised the Maharashtra government for its insensitivity and lack of interest on the issue. “You don’t bother when children die. Your State is not taking any interest and advocates are also not taking any instructions from the government. Do you think we are wasting our time here?” asked the bench headed by Justice Madan B. Lokur.

“We have seen news reports that talk about children having died of malnutrition in Maharashtra. You don’t bother when people die because you think it is a small figure in a country with such a large population,” the bench observed.

The Bombay High Court too came down heavily on the State government for its lack of “sensitivity” on the death of tribal children and about being “not concerned at all”. It said judicial orders were almost an “exercise in futility”. Hearing a public interest litigation (PIL) petition on malnutrition deaths, the High Court gave the State time until October 26 to file an affidavit on the budgetary allocation for the welfare of tribal people and on the actual spending.

The real picture

The courts will hopefully be able to shake up the government to do something far-reaching, says Mariam Dhawale of the All India Democratic Women’s Association (AIDWA). “The fundamental problem is that there has been no economic development in these regions, and therefore unemployment is a huge issue,” she says.

Mariam Dhawale, who is involved in tribal rights and welfare, paints a grim picture of the situation in Palghar and similar tribal regions. To begin with, she says, the government stopped the “khavt system” in the tribal region. This is a type of loan in the form of grain and money given to Adivasis before the rains. They would pay it back after the harvest. And with the public distribution system practically non-existent, rations are hard to come by. Grains have become expensive and they can ill afford to buy them for food. They live off what they grow and collect from the forests. Mariam says the low protein intake adds to the dietary imbalance.

According to Mariam, the government gives out via the anganwadis a Take Home Remedy (THR) kit for children between seven months and two years. This is meant to be a balanced supplement. “It is essentially pre-cooked rava , which you need to mix with hot water and eat, like instant food. But it is so awful that the tribal people end up giving it to their cattle.”

In a face-saving measure, the government has now begun to distribute eggs and bananas. “One of our workers say that at the last meeting in Vada [another taluk in Palghar], the local egg seller raised the price of an egg by Re.1. The anganwadi worker gets only Rs.5 for an egg. Now the poor woman has to pay from her own pocket. As it is, her salary is delayed by at least two months,” says Mariam.

She identifies the main issue as unemployment. Budgetary cuts by the State government have eliminated some schemes that were helpful. One of it was with wages in the form of food and cash. “When you give only cash it is invariably and unfortunately spent on alcohol,” says Mariam.

Currently, only work under the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) exists. But the work is erratic and the payments are slow. If the authorities have the will, they can create jobs under the MGNREGA such as the construction of bunds, roads, canals and related work like breaking of stones, she says. However, the constant complaint that activists like her have to listen to is about villagers having to walk long distances to receive payments. When they do eventually reach the bank, they are told the computer is not working, or that there is no power, and are asked to come the next day. “The poor woman would have spent Rs.100 already just getting there and is told to come back! What kind of sensitivity is this?” asks Mariam.

The authorities say the Adivasis have a closed mind and refuse to allow change, which is why they remain backward. However, the authorities need to make a concerted effort to understand their culture and work on areas which help in their uplift, says Mariam.

“Most tribal people are landless in these regions. Whatever landholding some of them have is marginal. Therefore, employment is critical in solving issues here. When you raise the issue of malnutrition it also raises many fundamental questions regarding the tribal belt. The marginalisation of tribal people has led to a very pathetic situation,” she says.

A crucial factor that should have worked for the tribal people but has let them down is the Forest Rights Act, 2006. Access to forest resources was meant to ensure livelihood and food security. But the failure in its implementation has been detrimental to the community. For instance, in Palghar district, only 30 villages in Jawhar taluk and six in Mokhada taluk have been granted these rights. The total area covered is just about 1,743 hectares. Activists say it should be much more to make a difference for the Adivasis.

Desperate lives

Set deep in the hills of Palghar district, Kalamwadi is an Adivasi hamlet that comprises 16 homes. About 150 people live here in huts made of mud, sticks and thatch. Other than the electric connections in some homes that are few and far between and the approach road that was probably tarred once, the hamlet shows no signs of modernity.

It is mid day and so most adults are in the fields. A few women appear to be tending to the many children who are milling around. Among them is Sita Shiva Wagh, a young woman whose two-year-old son, Sagar Wagh, died in August because of illnesses caused by severe malnutrition. Holding another child in her arms, Sita, who looks more like a teenager, says Sagar had been losing weight for a few months. When he became very weak they decided to take him to hospital. He died of pneumonia within a few days. At the time of his death, he weighed 4.5 kg. “He ate once a day at the anganwadi. We do not know what happened,” she says.

Sita and her husband leave for work in the fields or road construction at 8 a.m. and return by 5 p.m. The children are left in the care of a few older women. A plate of food, usually just rice and vegetables, is left in the house. The children, who are in the age of two to five years, are taught to eat that when they are hungry. “We earn Rs.100 or Rs.150 a day. But we don’t have work every day. Nowadays only my husband goes for work.”

In another hamlet, Koch, near Kalamwadi, Namdev and Sundar Savra are both home as they have been told some officials would come visiting. The vines that grow on the roof of their hut make it very picturesque. To an outsider, the village, located in a valley overlooked by an imposing hill, would seem idyllic. However, the village is a den of poverty; there is no electricity, water is scarce and there are fewer options for employment. The vines on the roof are of the gourds and cucumbers they grow for sustenance.

“We still have not got the Rs.51,000 the Minister promised us,” says Namdev Savra, the father of two-year-old Ishwar Savra, who died in September. “We took our son to the hospital in Mokhada. They said they could not do anything. We could not afford to go to Nashik and so we came home. He passed away here. Many Ministers, officers and media people have come, but we have not received anything,” Savra told Frontline . “Give us work,” he tells this correspondent. “Take me back to Mumbai and give me a watchman’s job, I will do it well.” There is desperation for any work and an income in his voice.

Vulnerable community

Sub Divisional Officer Swapnil Kapadnis says Palghar is a newly carved tribal district, which houses the Katkari tribe, which is among the most vulnerable and backward communities in the State. He says they migrate for construction work during the months when there is no rain. Most return for sowing just before the monsoon.

According to Kapadnis, it is during this time that deaths start occurring. “The homes are damp, it is humid and there is little access to food. Moreover, Adivasis also come to hospital when the illness is at an advanced stage. So the mortality rate tends to be high,” he says.

“The system of leaving a plate of food for the entire day is terribly sad. How does a small child know what to do? But there are no options. Both parents need to work,” says Rahul Sarang, the tehsildar of Mokhada. “Most tribal people here are landless; those who have land have just about five acres [two hectares]. And the land is mainly located on slopes and does not hold water, which makes cultivation difficult. Therefore they migrate elsewhere or rely on jobs under the MGNREGA.”

Sarang says the basic health of women is also poor. Most marry extremely young and bear many children. Stunted growth and physical disabilities add to the problem of children’s health. He says the authorities have begun a survey of children in the district to get a clear picture of the problem. They are also monitoring anganwadis and ashram schools (residential). He is hopeful that the Village Child Development Centre programme, which was shut, might restart.

Samarthan, an NGO working in the area, has collated government information which states that there are 5,864 children in Palghar who fall under the Moderate Acute Malnutrition category (as defined by the World Health Organisation). Another 1,456 children come under the Severe Acute Malnutrition category.

However, ICDS figures on Maharashtra indicate the problem is across the board. The Marathwada belt, which had to grapple with severe drought from 2014 to 2016, recorded the highest rise in the number of severely underweight children. Activists say the budgetary cuts in ICDS and lack of attention to this area have only compounded the problem in Maharashtra.