Hunger and death

Death stalks Orissa's backward Nawrangpur district, where healthcare and food security systems are virtually absent in the Adivasi-inhabited areas.

in Dongiriguda

THE Dongiriguda Adivasi settlement, located in the reserve forest under Jharigaon block of Orissa's Nawrangpur district, may have remained unknown and out of the government's purview for many more years to come but for the death of 11 malnourished children in the 0-5 age group in the space of a few weeks in June-July. The dance of death in the tribal hamlet began when a few children were afflicted with diarrhoea, fever and acute respiratory infection. More and more children showed similar symptoms, resulting in 10 deaths between June 11 and July 22.

Jolted by media reports, government officials, who had never visited Dongiriguda before, made a beeline to the hamlet, treading the jungle path, to save their political masters much embarrassment. They shifted seven children to the community health centre (CHC) at Jharigaon, a good 28 kilometres from the hamlet. Further, they shifted three children, whose condition deteriorated at the health centre, to the district hospital. One of these children died at Nawrangpur on July 24, taking the toll to 11.

The problem of malnutrition is not confined to Dongiriguda. Children from other hamlets in the Jharigaon block are undergoing treatment at the CHC. Earlier, for the politicians in power Dongiriguda did not exist. However, State Health and Family Welfare Minister Bijayshree Routray, along with two other Ministers, visited the CHC. In order to score a few political brownie points, a team of Congress leaders led by Pradesh Congress Committee president Jayadev Jena visited Dongiriguda. On its return from the hamlet, the Congress raised the issue of malnutrition deaths in the Assembly and blamed the Biju Janata Dal-Bharatiya Janata Party government for its failure to help the 82 Adivasi families of the hamlet.

Dongiriguda has remained outside the purview of numerous government schemes because it is a non-revenue village or one that exists within reserve forest limits. None of the families possesses a below poverty line (BPL) card because their's is not a revenue village. They are not extended any government facility except free medicines once a month.

Consumption of unhealthy food and lack of access to health care facilities are common to the backward districts of the State. Malnutrition among children, which is widely prevalent in these districts, is the underlying cause of the high rate of infant mortality in Orissa - 97 per 1,000 live births. Nawrangpur is one of the districts with the highest infant mortality rates.

The malnutrition deaths could have been prevented had there been a working health care system. This is the case in Nawrangpur and elsewhere in the State. Two months ago, 19 children of a village in Baramba block of Cuttack district died owing to the lack of proper health care facilities. The Nawrangpur district headquarters hospital does not have a single paediatrician. The acute shortage of paramedical staff has the people turning to quacks for medical help. So it is unsurprising that death stalks Dongiriguda. (The hamlet has 37 children in the 0-5 age group.) Moreover, the mothers of these children are also in poor health. "The authorities never gave us anything. They even failed to save my child," says Chuku Jani whose son Gobinda Jani died at the Nawrangpur hospital.

DONGIRIGUDA is not accessible by road. To reach the hamlet from Nawrangpur, one must first undertake an 86-km journey to Jharigaon. From there a narrow 22-km dirt track leads to the edge of the forest. From where one must trek 6 km down the jungle path to reach Dongiriguda.

A female health worker is the sole link between the government and the people of Dongiriguda. She visits the hamlet once a month to distribute medicines for diseases such as diarrhoea and malaria, the two main health concerns in the region.

None of the 335 persons in the hamlet, who eke out a living by cultivating paddy and other cereals on small patches of land and work as daily wage labourers in nearby villages, has had any education. So the importance of health and hygiene has never occurred to these people.

The only sanitary well in the village, dug by the local panchayat, remains dysfunctional for most of part of the year, forcing the people to consume water from a nullah. The well was repaired only after the village became the focus of media attention.

Primary health care in the district is in poor condition. This is reflected in the State of the ill-equipped CHC at Jharigaon, which receives about 40 ailing children a day. Its roofs leaks and filth lies all over the place.

As many as 37 posts of medical officers and 112 posts of paramedical staff are lying vacant in the district.The number of vacancies in the former case was 47 in June. Ten doctors were posted to the district in the wake of the malnutrition deaths. These doctors will remain there only for a year as they have been posted in the backward region as a precondition for admission to post-graduate courses next year.

District Collector Arabinda Kumar Padhee is trying his best to cope with the situation with the available manpower and facilities. "We are taking all possible measures to prevent further deaths of children," he said.

He blamed the parents for the deaths. "The parents go to work leaving the children with their siblings, who are not able to handle children," he said.

"The government has no right to rule if it cannot feed its poor and provide them basic health care facilities," Jayadev Jena said in the Assembly. As the Opposition slammed the government over the deaths, Routray said the health care system in the district would be overhauled.

nullah

Ironically, the Naveen Patnaik government has not built a single new hospital since it came to power in 2000. It has only added one community health centre to the 157 CHCs that existed in 1998.

The malaise in Orissa's health care system is symptomatic of the larger problems afflicting the backward Koraput-Bolangir-Kalahandi (KBK) region. Infant and maternal mortality rates as well as malarial death rates are high, with the authorities admitting that the death counts are under-reported. Doctors, government officials and teachers treat posting to the region as a punishment. Once a doctor or a government official gets posted to these districts, he/she lobbies hard for a transfer to the non-Adivasi or coastal districts. Not surprisingly, hundreds of posts have been lying vacant in the KBK region for years. The government on its part is content with paying lip service to the development of the region.

As the politicisation of the deaths continues, the basic issues of food security and health care of Adivasis in Dongiriguda and elsewhere in the backyards of the State seem to have taken a back seat.