After that first depressing trip to Sheopur, I took two more trips over three months, when Uma called me to say that more children were dying. In Patalgarh, eight more children were dead although an anganwadi was functioning at this time. There were other places where children were sliding into the slow gulp of hunger and still, the administration continued to deny that the deaths were a direct consequence of lack of food.
Uma had prepared a list of severely malnourished children in the villages she visited, kids whose lives were in danger if they didn’t get immediate medical attention. By the time I visited, two of the names on the list had been struck off.
Their parents didn’t know what was wrong but they said that the kids looked like they were drying up from the inside, like grapes turning to raisins. Once again, the chief medical health officer (CMHO) refused to certify that starvation was a factor. Right from the start, CMHO RK Dixit had been on the defensive. The first trip I’d made, he had said something like, “Malnutrition is there, naturally. It is a tribal belt. It is remote. What can be done?”
The second time round, he was a little more aggressive. He said, “The tribals need to change their attitude and lifestyle.”
I had bitten my lips and reserved my retort for print, where I pointed out that one had little doubt that the tribals would indeed like to change their lifestyle. They would like to eat two square meals a day, to start with. Officialdom, each time one brought up hunger deaths, would dismiss reports. If I told them that I had visited the villages myself and had photographed starving babies, they would frown and come up with lines like, “It is in their culture”. Or, “They don’t care about children dying; they have so many that they don’t even remember”. Or, “They are accustomed to hunger.”
On this second trip, I discovered that a tribal person didn’t have to be in a remote place or a forest to starve. Some of them manage it right beside the highway. Karrai village, for instance, was barely two minutes from the highway. It even had a local health centre, an anganwadi, and a school. Yet, at least five children had died. Part of the problem was the anganwadis’ handling of records. The registers are ill-maintained and the workers do not seem to know precisely how old the child is. The weight and grade (of malnutrition, which is judged through severity, going up from grades I to IV) columns are often left blank. Many of the entries are completely bizarre.
For instance, there was one entry in the name of Priti, daughter of Ghamandi. Between February 2003 and December 2004, the child has been given seven different dates of birth. Between December 2004 and June 2005, no entries were made at all. Judging from the register, it would seem that the same child was born seven times, and also grew younger as time passed. This sort of irregularity can prove fatal, since it becomes impossible to judge the severity of the condition.
Usually, malnutrition is measured against a chart balancing height and weight parameters, but because malnourished children are often stunted, height-wise, it becomes impossible to determine the appropriate growth in terms of weight unless age is also brought in as a factor. Health workers now judge appropriate weight gain against approximate age. However, there are few birth registrations at hospitals or elsewhere, through the civil administration. Only 41.1 per cent of all births are registered in India, and in Madhya Pradesh, only 29.7 per cent. The figures are lowest for Bihar and UP, where malnutrition amongst children paints an equally bleak canvas.
This gave me a clue that there is a direct correlation between birth records and malnutrition. Most people, being illiterate, do not keep personal birth records. So it becomes very important that the anganwadi worker keep a record of birth along with each child’s health status and progress. Not doing so could well have dangerous consequences for the child. Officials say that it is not fair to blame the anganwadi workers because the ICDS (The Integrated Child Development Scheme, under which anganwadi centres function) is not equipped to deal with hunger on such a large scale. The ICDS is meant to provide “supplementary” nutrition. Each child under six is entitled to 300 calories worth of food from the anganwadi. Where do the rest of the 1,200 calories come from? So, there it was. Hunger comes from the lack of means to buy food.
In the case of the Sahariyas, it was compounded by corruption during ration distribution and fudging of work records under the employment guarantee scheme. Incidentally, Madhya Pradesh has a dubious record there as well. The food and civil supplies minister had gone on record to say that at least 54 per cent of the BPL ration cards in the state were found to be fraudulent and that fresh cards would have to be issued. When the new list was drawn up (based on a 1998 survey) it turned out that hundreds of poor families had been struck off the list.
Landless widows and old people suddenly found themselves elevated on the poverty scale. Women well over 80 had been put down on the records as being 40 years old. Under different circumstances, they might have been flattered, but now their names had been struck off the lists for old-age pension, widow’s pension and subsidised food rations.
In 2006, a Supreme Court-appointed team had visited some of these villages. Those who led the team found that Patalgarh was actually better off than the rest because, in the hue and cry following media attention on starvation, an anganwadi had been set up and temporary BPL cards were issued. Instead of the tribespeople having to walk a full day’s distance to get rations, a tractor was sent with the supplies, and though the tractor does not show up regularly, observers said that things were better this way.
The collecting of rations has now become a collective event, and it is harder to turn away groups of people or to push them around. Besides, the Rural Employment Guarantee scheme gives them work almost at their doorstep, and some money is starting to come in. A hundred days a year isn’t quite enough though. I had once heard an Adivasi woman pipe up at a rally: “Why do they talk of only a hundred days of work in a year? Do they think our bellies are on vacation for the remaining 265 days?” At any rate, nobody ever got the hundred days stipulated by law. Even so, to get work near your own village even a few days a month means a lot. It just about keeps you from starving, or being forced to migrate to the city.
The only glad tidings I received in 2006 were that the state was starting to do something after all. It started schemes like the Bal Shakti Yojana in 2005, through which a severely malnourished child can be brought to the hospital and admitted for up to 14 days. During this period, the child gets food worth Rs 15 per day, including high protein soya biscuits and milk. The mother also gets Rs 35 per day, so she can stay with the child, and Rs 100 as mobility allowance.
These centres are called Poshan Punarvas Kendra (Nutrition Rehabilitation Centre) and local officials have the freedom to establish linkages with local NGOs or community organisations to help establish bigger centres with better facilities.
Shivpuri, which also has a large tribal population and a serious hunger problem, had rolled up its sleeves and gotten down to work fairly quickly. It was the first district in the state to start implementing the Bal Shakti Yojana and had got four Nutrition Rehabilitation Centres up and running within months. The collector at this time was Dr Manohar Agnani, for whom I have developed a great deal of respect after running into him multiple times over the last few years.
In other districts, implementation was shaky and things did not seem to be above board. In a newly-opened centre in Sheopur, the mothers who had managed to bring their kids to the centre had not been told about their own allowances, and some had not eaten all day since they didn’t have the money. When the results of the eighth Bal Sanjivani campaign survey (2006) had come out, some officials had pointed out that things were improving. Madhya Pradesh still had 49.21 per cent of its children certified as malnourished, 0.91 per cent very seriously so, but the figure had surpassed their self-set target of 1 per cent by 2007.
In tribal-dominated districts, the figures were much worse. For Sheopur, malnourishment stood at 57.68 per cent of the child population, with 2.59 per cent being severe cases. Translate that into numbers and the percentages are heartwrenching. Consider this: at least 600 children in Sheopur will be dead by the end of next year (I made the visit in 2007) just because there wasn’t enough to eat.
Excerpted with permission from Bantering with Bandits and Other True Tales of India, Annie Zaidi, Aleph Book Company.