Death by hunger

Published : May 06, 2005 00:00 IST

Malnutrition deaths of children in a tribal hamlet point to the general state of welfare programmes in Madhya Pradesh.

ANNIE ZAIDI in Sheopur

TWO-YEAR-OLD Suresh Sahariya of Patalgarh village has just been discharged from the district hospital in Sheopur, Madhya Pradesh. With his distended stomach, hollow eyes, and decaying and falling teeth, it seems a miracle that he has survived, when his brother and 12 other children from the predominantly tribal village died due to post-measles complications compounded by malnutrition, in February. Eighty children had been hospitalised.

However, doctors in the district claim that the deaths were caused by various viral infections. The Chief Medical and Health Officer of Sheopur, Dr. A.K. Dixit, said: "There may have been a couple of cases of measles, which may have been compounded by malnutrition. However, most of them were viral infections of various kinds, including bronchitis and pneumonia."

However, other doctors studying the deaths have stated that malnutrition led to measles, even in those children who had been vaccinated against the disease.

Dr. P.C. Mahajan, head of the Department of Preventive and Social Medicine at the Gwalior Medical College, said: "In cases of severe malnutrition, vaccination is not effective. A second attack of measles cannot be prevented. You need protein to produce antigens and Vitamin A to build immunity. It is a vicious cycle - protein-energy malnutrition leading to opportunistic infections, which again leads to low immunity, which kills appetite further. The impact is almost as in the case of Acquired Immune Deficiency Syndrome (AIDS), except that malnutrition is a curable condition, not a disease. Unless and until malnutrition is treated, nothing can be done."

Even today, many children in Patalgarh suffer from severe dysentery with bleeding, vomiting and persistent cough. Although several medical teams and administrative authorities visited the village in the aftermath of the deaths, nobody seems to be monitoring the situation now.

One of the most backward regions of the State, Patalgarh is home to at least 80 tribal families, most of them Sahariyas.

Dakko Sahariya of Patalgarh village says, "The doctors came two months ago to give the oral polio vaccine. Now there is talk of setting up an anganwadi here. For a while, `daliya' (gruel made using broken wheat, soyabean and jaggery) was being distributed to the children, but now even that has stopped."

In the absence of other sources of nutrition, a mid-day meal provided at the village school would have been a lifesaver for children. However, though there is a school building, there is no schoolmaster.

Says Raja Sahariya, resident of the village: "The teacher lives in Hirapur, which is 15 km away. Initially, he used to send a young local boy as his deputy to distribute dal-roti, and some potatoes. Now there is nothing. No teacher, no food, no education. We told the District Collector what was happening through a panchnama. But nothing has been done."

Other food-security initiatives launched by the government, which could have prevented such tragedies, also appear to have fizzled out.

Kailash Sahariya owns a yellow Antyodaya card, which entitles him to 35 kg of grain every month from the local ration shop, which is 15 km away. But he has not received any rations after January 2005. "The ration shopowner gave me only 30 kg then. Since January, he has been telling us that the grain has not arrived."

Kailash Sahariya points out that the average working year for members of his tribal community lasts only four months in the summer, as they collect forest produce. There are no irrigation facilities. When there is nothing else, they eat sama, seeds of a wild grass which look like very fine rice but have little nutritive quality.

Now, the village is performing a puja to appease Khulko Mata, a tribal deity who they hold responsible for the children's deaths. Despite claims that multi-purpose health workers visit the village regularly, nobody seems to have made the villagers aware that the children need food, most of all.

Eight public health centres, two community health centres and 89 sub-centres cater to no less than 608 villages in Sheopur district. To top it all, the health workers were on election duty when the deaths occurred.

When asked about the malnourishment in the district, Dr. Dixit said: "Naturally, malnutrition will be there as it is a tribal belt and it is remote. What can be done? There are at least 85 posts of nurses vacant in the Gwalior Medical College. If hospitals in Gwalior are understaffed, how do you expect things to be better in the villages?"

A report submitted last year by the Bal Sanjeevani Campaign, a government-sponsored survey conducted in conjunction with the United Nations Children's Fund (UNICEF), stated that 1,300 children in Sheopur district were found to be Grade 3 and Grade 4 malnourished.

Sachin Jain, the State coordinator for the Right to Food campaign, said: "I think this is nothing short of state-sponsored killing. There have been at least 169 malnutrition deaths in Madhya Pradesh over the last year, many of them in the tribal belts."

As per the data provided by the Regional Medical Research Institute of Tribals in Jabalpur, 93 per cent of Sahariya children are victims of severe malnourishment and 15 per cent of them are almost on the verge of death due to malnourishment.

Sheopur District Collector K.S. Maran was not available for comment. However, other officials in the Collector's office were rather dismissive about the starvation deaths. One official said: "There is no such situation here. It is just that the media have created a strange situation." He added that since teachers and development workers had not got their salaries for eight months or more, they could not be expected to work properly.

THIS is not the first time that malnutrition- and hunger-related deaths have occurred in Madhya Pradesh. According to a report filed by State Commissioners appointed by the Supreme Court, there were no fewer than 50 hunger-related deaths in the adjoining Shivpuri district. In Hingua village in Badwani district, five children reportedly died of malnourishment, and eight each died in Khandwa and Chatterpur districts.

Reports appear almost daily in local newspapers of grain allotted through the public distribution system (PDS) being smuggled out to neighbouring States and sold in the black market. At least 200 quintals of grain has been caught in raids in Sheorpur and Shivpuri districts.

Shivpuri District Collector M. Geeta said: "When I took charge nine months ago, there was a severe drought, which had been on for two years. Last year there were reports of malnutrition deaths. I have filed at least six First Information Reports (FIRs) with regard to grain theft and black-marketing after conducting raids in PDS shops. Now, thankfully, the situation is not so pathetic, though I admit it is not good yet."

There are 1,500 villages in Shivpuri, of which 600 are Sahariya tribal villages. But there are only 932 Integrated Child Development Scheme (ICDS) centres, most of which are located far away from tribal hamlets. M. Geeta added: "We do not have a strong PDS. We have filed a writ petition in the Supreme Court to ensure that the food-for-work programme is routed through the PDS, and not through private contractors. We have also written to the Principal Secretary, Health, and the Principal Secretary, Tribal Affairs, to help in this regard."

According to the Planning Commission, at least Rs.211 crores is needed for the Supplementary Nutrition Programme in the State. The State government, however, has allocated only Rs.59 crores. This is a big shame, especially when a State like Andhra Pradesh allocated Rs.85 crores, although the requirement was only Rs.80 crores.

Government data show that more than 55 per cent of the child population in Madhya Pradesh is malnourished. To its discredit, the State has managed to bring only 22 per cent of the 1.06 crore children in the State under the ICDS, despite the Supreme Court's repeated orders to ensure full coverage. As a result, 51 per cent of the children are stunted, 20 per cent are wasted and 75 per cent are anaemic.

On the administrative front, there has been little monitoring of programmes such as the ICDS and the PDS, which could have prevented malnutrition-related deaths. Narendra Vithare, a former Bharatiya Janata Party legislator from Pohri in Shivpuri district, admitted: "It is a failure of the administration. Our (government's) failure lies in the fact that we failed to supervise proper implementation of the schemes. The Opposition, for its part, has been indifferent."

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