Wednesday, September 26, 2007

Starving in Madhya Pradesh

Hungry and dying


Hunger and malnutrition stalk Madhya Pradesh villages despite schemes to improve the services of anganwadis and nutrition centres.


At Kairi Chowka village in Raisen district. There is no anganwadi here and the nearest ICDS centre is about three kilometres away.

HUNGER is unpalatable. For a government that wishes to assert that it is not callous, it is particularly so. But hunger, with a capital H, is a pill that millions of people in Madhya Pradesh continue to swallow.

In 2005 and 2006, Frontline reported acute malnutrition from Sheopur and Shivpuri districts in Madhya Pradesh. Since then, there has been some change: new schemes have been announced; the recruitment policy for anganwadi workers has changed; there is a new menu for the anganwadis; and more Nutrition Rehabilitation Centres (NRCs) are being opened. Anganwadis are Integrated Child Development Scheme (ICDS) centres.

However, it would be wise to keep in mind that not all changes have been positive. According to the 2005-2006 National Family Health Survey (NFHS-3), the percentage of underweight children in Madhya Pradesh increased from 54 in 1998-99 to 60, and the percentage of wasted (extremely malnourished) children from 20 to 33.


Many changes over the past decade have pushed villagers who once had enough to eat into a spiral of food insecurity and the uncertain arms of the public distribution system (PDS). There appears to be a direct link between access to forests and hunger in tribal hamlets. Madhya Pradesh has 29 national parks and reserved forest areas, and each of them has meant displacement and deprivation for the tribal people. Take Balharpur village in Shivpuri for instance, less than an hour's drive from Shivpuri town.

About eight years ago, its residents, most of them belonging to the Sahariya tribe, were moved out of the Madhav National Park and dumped upon a stony, non-irrigated tract of land near the highway. Earlier, they had lived close to a river and had water for both farming and drinking.

During the non-farming season, they collected and sold tendu leaves, herbs and honey to be able to buy things needed to supplement their diet. Each family had cows and goats. While moving, the villagers set their cattle free near the Balhar Mata temple in the forest. They were certain they would not have access to grazing land in the New Balharpur village. They were right.


Today, the village has neither fields nor cattle nor jobs. What it does have is people like Makkobai. Her husband and one son already dead and confronted with the prospect of losing her other son and daughter-in-law, she was forced to sell off her roof.

Each family was given built houses, without toilets or taps, when they relocated; rough slabs of stone placed in a lattice formed the roof. Makkobai sold these stone slabs for Rs.2,500. She sleeps in other people's houses.

Makkobai should have been entitled to a health card, issued under the Deen Dayal Antyodaya Upchar Yojna, which would have provided the family free medical treatment worth Rs.20,000. But she does not have one. Another widow, Bisna, shrugs off the suggestion of visiting hospitals. "What will the doctor do? There's nothing to eat anyway." Like others in her village, she is almost entirely dependent on subsidised PDS rations. Everybody does not have a "yellow card", the Antyodaya ration card, which marks the Sahariyas as the poorest of the poor. The Sahariyas are entitled to them, being a Primitive Tribal Group. Not surprisingly, malnutrition amongst the children is plain to see, even to the untrained eye.

They also claim that the Guna Grameen Kshetriya Bank allows each family to withdraw only Rs.8,000 of the Rs.20,000 given as compensation for displacement. And most of it has been spent repaying loans taken at interest rates as high as 100 per cent. The rest of the money was set aside for "land development" purposes.

The very phrase "land development" makes villagers spit in anger. Jamna, an elderly widow, told Frontline: "What are you supposed to do with your stomach until this land gets developed? And how will the land be developed without water? All we have is one functional hand pump."

The men have been forced to migrate to places such as Ghati-Gaon near Gwalior, where there is work in the stone quarries. They live a whole month in the quarries and return with no more than Rs.500, and often with tuberculosis as well. There are 26 widows out of a total adult female population of 87.

Another village in Shivpuri district, Amola, which was displaced in August 2006 to make way for the Manikheda dam project, presents a gloomier face. It is now home to Lakshmi, the six-month-old baby who has just returned from the NRC in Shivpuri. She was discharged after 14 days but remains a "grade four case" – severe malnutrition that, if untreated, will lead to death.

The village has no pucca houses, and the administration did not provide toilets either. The Sahariya women are distraught since people of other castes or communities refuse to let them use their fields. They even threaten to bury the women alive if they attempt to enter their fields.

Even the five quintals of grain, which was promised as interim relief for displacement, did not materialise. Some families got pattas but others were already farming the same strip of land. Most of the villagers migrate or work for contractors, filling dumpers with sand for Rs.20 a day, or walk to the nearest forest area and cut wood.


A young woman, Kusna, threw an axe and a small bundle near this correspondent's feet and sat down. She had been collecting wood all day, which she sold in the nearest town market for Rs.30. "The bus fare cost me Rs.10. What was left bought me this bundle of leaves, which I will cook tonight as vegetables. Earlier, we could collect gum, honey, herbs. Now what?"

Now, there is the iffy dependence on rations and the struggle to obtain "yellow cards". Even this battle is an uphill one. Recently, the panchayat secretary was suspended after he was arrested for irregularities. He had allegedly tried to sell Below Poverty Line (BPL) cards for Rs.500 each.

The day Frontline visited Amola, an unidentified man had dropped in earlier, claiming to be the new secretary. While he was yet to take charge, the villagers alleged that he was already asking for bribes: Rs.10 a card. Little wonder then that as budgets for schemes grow, so does food insecurity and the great corruption initiative. In Sheopur district, there were instances of gross irregularities concerning the National Rural Employment Guarantee Scheme (NREGS). Frontline found such irregularities in Patalgarh village in 2006 too, where several children died of malnutrition.

According to Uma Chaturvedi, a fellow of the Right to Food Campaign for Sheopur, there are fresh attempts to fudge cards. "For example, in Naya Gaon in Vijaypur block, which is one of the 28 villages displaced for the Kuno National Park, people worked for and were paid for two to four days on an average, but all the cards have entries stating '77 days'. The villagers met the District Collector to complain about the resultant embezzlement in May, but so far no action has been taken."

She added that in other villages in Sheopur, such as Rohni and Ranipura, people are demanding wages pending since March, or compensatory unemployment allowance, but, again, to no avail.

CM's backyard


MAKKOBAI WITH HER surviving son. She had to sell off the stone slabs that formed her roof and now sleeps in other people's houses.

Sachin Kumar Jain, who works with the Right to Food Campaign, admits that the State government at least has the decency not to turn a blind eye to hunger. "Under pressure from the media, the Supreme Court and civil society groups, the government acknowledged the problem; even the bureaucracy has shown some political sensitivity. Yet, hunger is a problem even in Budhni [in Sehore district], which is part of Chief Minister Shivraj Singh Chauhan's constituency."

According to reports by Raju Kumar who works with Vikas Samvad, Bhim Kot, one of the villages in Budhni block, is rife with malnourished children. "We weighed the children and found that 24 out of 25 were malnourished. Nineteen years later, and despite having corresponded with the C.M., they still don't have an anganwadi or access to health care."

Despite policy changes, major loopholes remain. Safe drinking water is not considered a part of crucial nutritional needs. In villages such as Kairi Chowki in Raisen district, there are 10 hand pumps, of which only one functions.

There is no anganwadi in Kairi Chowki either, which is also part of the Chief Minister's parliamentary constituency (he was a Lok Sabha member when he took over as Chief Minister). The nearest ICDS centre is about 3 km away.

Here, when the new ration cards were released, many people found their names struck off the BPL list. Among them were people such as Munshi Lal, who is in his 80s but receives no longer the old-age pension.

In the neighbouring hamlet of Dhoop-Ghata, things are better. Many of the families have a cow or a goat and some chickens, and they are peacefully allowed to graze their animals, without interference from the forest administration. There is an anganwadi and the worker is efficient. The nurse makes regular visits and the children do not appear to be severely undernourished.

Even so, life is terribly hard. The women set out at 3 a.m. They walk to Abdullaganj, the largest market in the area, to sell a bundle of firewood, for as little as Rs.40. Then they walk back, cook the noon meal and start walking again – to the forest to collect wood.

A visit to the NRC in Shivpuri district is both heartrending and educative, in the context of the demographics of hunger. Nearly all the mothers and children admitted are Sahariyas. Phuliya, a woman from Khaniyadana block, had brought along her two-year-old girl Choti – all skin and bones. While she acknowledged that she got her full ration regularly, there was not much she could do to help her own child: all she could feed the baby was dal and roti.

The NRC officials claim that they also have a hard time keeping the mothers in hospital for 15 days. Most women are worried about other children left behind at home. In the attempt to save one, they dare not risk losing the rest.

The Director of the Department of Women and Child Welfare, Kalpana Shrivastava, agrees that the main problem is that whatever the State provides can only be supplementary nutrition, whether it is through ICDS or mid-day meals. It is hard to tackle malnutrition if hunger is a chronic problem.

The State has been trying. From only daliya or panjeeri, the menu at anganwadis now includes poha, laddoo and halwa-puri. The process is also decentralised, with the money for supplies being sent directly to a joint account between the anganwadi worker and the local mothers' committee. There are also attempts to "celebrate" every Tuesday as Mangal Divas, wherein pregnant women will be treated to a godh-bharai, birthdays will be marked, and so on.

Pockets of chronic malnutrition will be allotted Rs.6 a child, instead of Rs.2, whereby children will get three meals at the anganwadi. The worker and helper will also be paid extra.

Kalpana Shrivastava also claims that, in compliance with the Supreme Court's orders, all ICDS centres sanctioned in 2007 will be made functional by the end of September. "The new nutrition policy will make a difference, but things take time to fall into place." Organisations such as the United Nations Children's Fund are also focussing on nutritional rehabilitation. Dr. Manohar Agnani, former Collector of Shivpuri, who was instrumental in setting up the model NRC in 2006, is now a consultant for UNICEF.


The target is to get 100 NRCs up and running by the end of the year and 313 by 2008. However, UNICEF State Representative Hamid El-Bashir agrees that there is a need to scratch the surface. "The ICDS is an excellent programme; it is wide-reaching and ambitious. But the State government also needs to look at income and unemployment. We can treat the symptoms, not the cause."

Yet, the NRCs are a much-needed measure in a State, which confronts the certainty of a definite number of hunger-related deaths every year. Even if the situation is improving slowly, it still looks very bad once you translate percentages into numbers. According to the 10th survey of the Bal Sanjivani Abhiyan in the State, 47.5 per cent of children under six are malnourished, of whom 0.67 per cent suffer from severe malnourishment.

This is down by 0.11 per cent from the ninth survey, but, as Dr. Agnani points out, "with an average rate of 30 per cent mortality [for the severely malnourished], this means that hundreds of children will die this year. In Sheopur district [which accounts for 2.56 per cent of the severe category], up to 600 children could die."

It is a frightening fact that, despite the best efforts of concerned groups and recent policy changes, within a year, 600 children in a single district will have died because there was not enough food to eat.

Sachin Kumar Jain offers another sombre reminder – most of the dead and dying will be Dalit or Adivasi tribal children. "Do you know why the Sahariyas are a Primitive Tribal Group? Amongst other parameters, it is the fact that their population is decreasing or stagnant. It is true that they bear more children, but it is also true that most of the children die. This is the result of a policy of exclusion. Schemes are only a petty compensation for depriving people of their rights."

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