Piecemeal initiatives

Print edition : November 11, 2016

In Ahmedabad, children of a poor family have a quick bite at the roadside in between selling the national flag ahead of Republic Day this year. Photo: Vijay Soneji

Malnutrition exists on a large scale across the “developed” State of Gujarat.

GUJARAT never loses an opportunity to boast about its high rate of development. But beyond the massive expressways, big industries and economic zones is another facet of the State. Socioeconomic indices of the State have repeatedly pointed out that one of the biggest challenges Gujarat faces is the staggering number of malnutrition cases and the poor health of its women and children. Unlike other States where these issues are largely restricted to the tribal zones, in Gujarat it is spread across districts and even in Ahmedabad.

The latest Socio Economic Review of Gujarat (2014-2015), which was released in February this year, showed that there were 1.97 lakh malnourished and 24,762 severe acute malnourished children in 46 taluks in Banaskantha, Patan, Navsari, Junagadh and Kheda districts. Additionally, 1.47 lakh of the 43 lakh children at anganwadis in the State were found to be suffering from severe acute malnutrition.

The report of the Comptroller and Auditor General (CAG) in October 2013 on Gujarat emphasises the poor level of health in the State. According to it, Gujarat’s figure of “severely malnourished” children (4.56 per cent) exceeded the national average (3.33 per cent). Additionally, every third child was underweight and close to 1.87 crore people had been deprived of the benefits of the Integrated Child Development Services (ICDS) because the government had not sanctioned the required number of anganwadis. Ahmedabad alone had a staggering number of 85,000 children who were malnourished.

The CAG report sent shock waves at a time Gujarat was riding high on its development policies. But the government went into denial. It said: “In June 2013, [the] percentage of severely underweight children has come down to 1.61 per cent. As a result of various nutrition interventions undertaken by the government of Gujarat, the percentage of underweight children decreased from 73.04 per cent in March 2007 to 25.09 per cent in March 2013.”

Officials countered the CAG’s opinion that 66 per cent of the children in the State were underweight and claimed that this figure had declined to below 26 per cent in 2013 because of the various steps taken by the government. In fact, the State announced that in 2012-13 about four lakh children were “freed from undernutrition”.

“The Gujarat government is in complete denial about this issue. But how long can they hide it? These are bare facts. This cannot be manipulated. Because they stay in denial, they do not address the problem,” said Rohit Prajapati, a human rights activist who works among Adivasis in the State.

According to him, the Gujarat government has ignored the poor and the marginalised. “This problem stems from the larger issue of development policies in this State. The development is only for the creamy layer. Ordinary people are completely neglected. But the marginalisation will have its effects and come to surface in ways like this. Malnutrition is a result of poor development and neglect. We have been combating malnutrition across the State for decades. They just hide the truth,” he says.

There is little government data on malnutrition in the State. A few independent agencies which undertook a review of the health of children in the tribal belts of the State had alarming details. A study conducted by the non-governmental organisation Child Rights and You (CRY) in 2014 identified one of the broad reasons for the high level of malnutrition, particularly among the tribal people, as the terrible condition of anganwadis that take care of children between the ages of seven months and two years.

The anganwadi workers would show up sporadically or not at all. Another significant reason identified by the study was children’s lack of access to midday meal schemes. Yet another factor was the virtual non-existence of the public health system.

CRY’s study covered 249 anganwadis in 17 districts across the tribal regions in Gujarat. Its data disclose bleak facts. As many as 30 per cent of the anganwadis do not have utensils to cook in and about 65 per cent have no toilet facilities.

Rights activists and social workers point out a strong link between the state of anganwadis and the extent of malnutrition. The CAG report stated that as against the required 75,480 anganwadi centres in the State, only 52,137 had been sanctioned and of that only 50,225 were functional.

Feeling the heat of criticism, the Gujarat government at some stage announced a slew of measures to “fight malnutrition, particularly in the Dangs, and other tribal belts”. In May 2016, the then Chief Minister, Anandiben Patel, announced programmes that would provide iron-rich supplementary food to children and also health camps on a regular basis. The government also promised to serve milk five days in a week at anganwadis.

These are but piecemeal initiatives. Unless the government addresses issues such as employment and land rights, streamlines the public distribution system and improves rural health, we will not see any improvement, said Prajapati.