Why do governments in India refuse to accept mass malnutrition and starvation deaths, while the reality is so intensely stark, widespread and tragic?
Shaweta Anand Delhi
Even a preliminary inquiry concerning starvation in India would reveal numerous reports of entire families wiped out by chronic malnutrition. People get trapped in a negative spiral of poverty, malnutrition, starvation, unemployment, ill-health and severe immune deficiency till death comes to their rescue, releasing them from this unbearable misery.
Take the recent case of five starvation deaths in the Bariha family of Balangir district of Orissa between September and December of 2009, which were attributed to 'a medical condition' like malaria - the usual official practice of denial when it comes to reacting to such easily preventable deaths. "Research shows that even medicine does not work on an empty stomach, so people starving with chronic malnutrition are bound to die within a couple of days, despite last-minute medical interventions," said Prof Ritupriya Mehrotra at Jawaharlal Nehru University (JNU). "This is just the tip of the iceberg. Therefore, such deaths, when reported, should be used as a marker by the government to identify communities in need of urgent government assistance," she told Hardnews.
After the reported deaths in Balangir, the National Human Rights Commission (NHRC) was compelled to appoint a special team in March 2010 to investigate deaths in the Bariha family and prepare a detailed report on the underlying causes. The report is not in the public domain yet. Ironically, Damodar Sarangi, who led this special NHRC team, refused to share his experience of interaction with impoverished village survivors, trapped in the same vicious circle of poverty, starvation, unemployment and sickness - and already in the death-queue, awaiting their turn. Instead, he asked this reporter to file an RTI to get the required information.
The Kalahandi-Balangir-Koraput (KBK) belt of Orissa is one of the most starvation-prone regions in India. NHRC has made special recommendations to provide free cooked food to old, infirm and destitute people here in the past. "The problem is not so much about how many schemes there are. It is about how many get implemented and reach out to the people they're meant for. There are 22 central government schemes already in place that could benefit the people but actually do not," Devinder Sharma, a renowned food policy analyst, told Hardnews.
Dr Preet Rustagi, senior fellow at the Institute for Human Development (IHD), Delhi, said, "Besides other districts in India, we have identified the KBK belt where priority or urgent interventions are needed not just to ensure food security by enabling access to food, whichever the government scheme may be, but also to improve communication, infrastructure and literacy amongst women to improve overall well-being." IHD has studied eight Indian states on behalf of the UN World Food Programme to identify the most food-insecure groups.
"In an interim order of 2002 passed in the famous People's Union for Civil Liberties (PUCL) vs. Union of India and Others case (famously called the Right to Food case), the Supreme Court said no state in India should have starvation deaths or else the state administration would be held responsible. That is the reason why no government official will formally admit to these deaths as 'starvation deaths' or else they will have to face the heat. Starvation deaths like in the Bariha family are, therefore, said to be caused by anything but under-nutrition," said Pradeep Baisakh, a writer-activist who met some of the starving families in Balangir.
When Hardnews contacted Balangir Collector Sailendra Narayan Dey, he flatly rubbished media reports about starvation deaths and disconnected the phone after saying, "Deaths keep happening everywhere because of one or the other reason, mostly diseases. All these reports are false. You journalists make up stories. There are no starvation deaths here."
A collector who denies media reports about starvation deaths would obviously go on to deny any relief claims by members of the family. He will not accept that the deaths were due to (preventable) malnutrition in the larger community. "Had he acknowledged these starvation deaths for what they were, he could have put his act together and prevented further deaths by ensuring that the poor and needy get the food security benefits due to them. So you can only imagine the kind of suffering people are living in," said Kumaran from JNU, who is researching food security and hunger.
"Those left behind to fend for themselves when the head of the family starves to death, literally, beg to die themselves. Their situation is so deplorable because they have no financial assets left after everything they had is sold off to meet medical expenses in their last ditch effort to save the loved one. To make conditions worse, the promise of 100-days annual work under the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) stands broken because neither is work provided for even half of the days promised, nor are timely wages given. Instead of waiting for three-four months to get their dues, people migrate out in a desperate search for work to get money to buy food," lamented Baisakh, after returning from his field-survey. Land is not a sustainable source of income in the entire KBK belt as it is a drought-prone area with dwindling forests and natural resources, he added.
"How can we call the society we live in 'civil' when the degree of inequality between the rich and poor is so immense? Only the top five per cent are well-to-do, while, a sizeable percentage of farmers, widows, children and the destitute are either dying of under-nutrition or committing suicides every year," said Dr Vandana Prasad, joint convener, Jan Swasthya Abhiyan.
"The high GDP is just an average number that hides the income disparities between the haves and haves-not. The rates of infant mortality and maternal mortality are so high in India, with 50 per cent children dying of under-nutrition and a large number of women dying of anemia. These are all preventable deaths that can be avoided by adequate, nutritious food that people should be able to buy, considering the steadily rising prices of foodgrains," she said.
"Starvation death, therefore, is not a technical or a medical issue, and should not be conceptualised as an individual's problem. It reflects a larger socio-economic reality that must be dealt with at a systemic, macro level," she explained.
Said Alaknanda Sanap, "In terms of fair distribution of the benefits of government schemes, people in north India face a higher degree of caste and class bias from administrators as compared to those in south India, even though there are other issues there." Sanap has researched provisioning under the Integrated Child Development Services (ICDS) scheme at the National University of Educational Planning and Administration, Delhi.
A groundbreaking writ petition filed in 2001 by PUCL in the Supreme Court regarding hunger in Rajasthan has led to the emergence of a Right to Food (RtF) campaign in India with the core demand of making the right to food and secure employment a fundamental right of every citizen as part of Right to Life enshrined in the Constitution. There have been 50 interim orders since then as the case continues.
Major Supreme Court orders regarding the RtF campaign have converted food and employment schemes into legal entitlements and achieved universalisation (expansion) of food entitlement programmes like ICDS through anganwadis and the mid-day-meal scheme in primary schools run or aided by the government.
NC Saxena and Harsh Mander (both top retired government officials) have been appointed commissioner and special commissioner to the apex court, respectively, to monitor all food schemes in the country. They have the authority to hold states accountable for not providing people their legal entitlements with regard to the right to food.
Saxena has experienced first-hand the high level of under-reporting of severe malnutrition by state governments. Despite documented hunger and destitution in the Kalahandi district of KBK, for instance, the official 'severe malnutrition' figure is a laughable one per cent. "Most state governments, in our experience, deny extreme hunger or starvation in their states and present wrong data. It is a serious problem that must be resolved urgently. Then there is the problem of governance. State-level administrators, especially in the ministry of women and child development, think it is an easy place to make quick money, especially after the recent hike in nutrition-related project funding. This attitude has to change. Thirdly, we need to decide upon a protocol to identify starvation deaths," said Saxena.
"The main challenge for us is to recognise hunger and starvation while it is happening, not after the deaths have taken place," said Harsh Mander. Revealing heartrending details about how poor people respond to hunger, he said, "There are some whose longing for food gradually fades away because they don't get it, others eat less and get habituated to low diet, or else find pseudo-foods for psychological relief. There are people in Orissa who beg for starch leftovers after rice is cooked by their neighbours. This starch is their main food. There are others who boil and eat grass and tubers, sometimes even poisonous ones, to fill their stomach even though the nutrition value of such food is zero. Some people, like the elderly, end up grazing cattle for the whole day to get two chapattis in return. So high is the level of hunger and destitution in India, but it becomes visible only when people die."
Identifying the challenges in dealing with the situation, Mander said, "We do have the famine code in a few states but what we don't have is a 'starvation code'. But before deciding on that, we need to adequately define and agree upon a common definition and some 'measurement' criteria for starvation." Saxena and Mander were speaking at a national conference on identification of acute hunger to prevent starvation deaths held recently in JNU.
The RtF campaign has led to a demand for a proper Food Security Act. The draft bill ran into trouble recently as the empowered group of ministers suggested clauses like a reduced entitlement of 25 kg food grain at Rs 3 per kg (as against the existing 35 kg at Rs 2 per kg), that too for a few 'targeted' people, even though the majority live below the poverty line. "The draft bill is a very unfair document that doesn't look at overall nutritional needs and multiple entitlements of everyone in society. Hopefully, the improved draft will be designed bearing in mind the larger issues of food production and distribution, and economic and agricultural policies, all of which tend to be anti-poor," said Dr Vandana Prasad.
Devinder Sharma suggests that if self-reliant, traditional food security systems are re-introduced in five out of six lakh villages of India, it would go a long way in significantly reducing the existing high level of nutritional and food insecurity. He said, "If only we could go back to our traditional roots wherein village community elders preserved foodgrains for collective or emergency usage - there would not be a single starvation death." He cited a popular saying in these self-sufficient villages, "Jide ghar daane, aude nyane vi syaane (a household with enough foodstock will obviously have healthy children/family members)." Are the state governments, and the aam aadmi government, listening?