Shahdol/Bhopal: The heartbreaking condition of two-and-a-half-year-old Sajan Baiga, who lost the battle against severe acute malnutrition, on 1 May points out the problem of hunger in several districts of Madhya Pradesh.
Sajan, who hailed from Salaiya village in Pali block of Umaria district, had been taken to the All India Institute of Medical Sciences (AIIMS) in Bhopal last month. Appalled doctors had immediately started his treatment, but even a week of high-end care failed to bring about any improvement in his condition.
Sobbing over the phone, his mother Bolchi said, “My heart is broken…He could not even drink water.”
Bolchi and her husband Balmik are among the hundreds of parents who have lost their children to malnutrition, while Sajan was one of the 20,000 severely malnourished children in the state’s Shahdol division alone. Similar cases have been found in other divisions with tribal population.
Though the problem is more than three decades old, inaction on part of three successive state governments of the BJP (from 2005 to 2018) and the current Congress government, which came to power in December 2018, has worsened the situation and resulted in a rise in the number of malnutrition deaths.
In Shahdol division, children of Baiga, Gond, and Kol tribes are prone to malnutrition. Similar is the condition of Sahariya and Bharia tribes in the state.
Two-year-old Sandeep from Balohd village of Manpur block in Umaria is another example. The toddler had been vomiting and coughing, and had diarrhea, his swollen belly and sunken eyes completing the grim picture. His mother Sunita Kol appeared lost in her own frail world and was oblivious to this correspondent’s questions.
Much debate, no action?
Dr VK Jain, Pali block medical officer, said, “Sajan was brought to our nutrition rehabilitation centre (NRC) with a body weight of around two kg, which is less than half the normal weight for his age. He showed all the signs of severe acute malnutrition, the most dire stage of hunger. Hence, he was shifted to Bhopal AIIMS for further treatment but died before a surgery of the oesophagus.”
Swarochis Somvanshi, collector of Umaria district under which Pali block falls, said, “Sajan was brought to the NRC too late. It took us hours to convince the family to let us take him to a better hospital. A drive has been launched, and we are working on a mobile app to map such children and women.”
Shahdol division consists of Shahdol, Umaria, Anuppur, and Dindori districts. Around 5,000 children across the division are acutely malnourished, while another 20,000 are fighting other stages of malnutrition.
Shobhit Jain, commissioner of Shahdol division, said, “The root cause is lack of awareness, and to tackle that, the health department must undertake special measures.”
Women and child welfare department MP and Principal Secretary JN Kansotiya, however, was quick to issue a defence. “Sporadic cases may have taken place in Shahdol, which I’m not aware of, but malnutrition alone isn’t responsible for these deaths. Local conditions, awareness, education, and transportation also play a part. There are ample rehab programmes; no new programme is needed.”
Is the state manipulating numbers?
But if one were to go by numbers, it would appear that the women and child welfare department in Bhopal has been bungling facts. In 2016, the state government reported 17 percent children in Madhya Pradesh to be underweight, but the fourth National Family Health Survey (NFHS) put the figure at 42.8 percent.
In 2016, widely reported deaths of over 50 children in Sheopur district had even forced the then BJP government to announce a white paper; however, it never materialised.
Data tabled in the Madhya Pradesh Assembly in 2018 reported underweight and severely underweight children in 51 districts — 11,83,958 and 1,03,083, respectively.
The data also revealed that 556 infants aged below a year and 5,559 children between the ages of one and five died between February and May 2018 due to “other” reasons, an alleged modus operandi of the government to escape the responsibility of malnutrition deaths.
Thirty Madhya Pradesh districts fall in the “high burden district” category under the Strengthening and Nutrition Improvement Project of Integrated Child Development Services, a flagship scheme of the Union government.
Madhya Pradesh’s plan of action...
Though Madhya Pradesh has been spending in an unrestrained manner to tackle malnutrition, corruption plaguing every step of the process has hampered actual change.
The state women and child welfare department annually spends Rs 1,200 crore for providing nutritional diets. For supplementary nutrition, it has fixed a daily budget of Rs 6 for children aged between six months and six years, Rs 7 for expecting/post-partum mothers, and Rs 9 for severely underweight children.
In Madhya Pradesh, 84,465 aanganwadis and 12,670 mini-aanganwadis have been approved. Also, to cope with child health issues, 54 special newborn care units, 60 newborn stabilisation units, seven paediatric intensive care units, and 315 nutrition rehabilitation centres have been established.
But while children between the ages of three and six years are given fresh meals through the Sanjha Chulha programme, families with children aged below three are given ready-to-eat dietary supplements to take home, which has turned out to be a major source of bungling of public money.
…and the problem with it
Since 2004, the Supreme Court had been pressing for a mid-day meal delivery system in aanganwadis, but it was only in 2009 that the state started the nutritional programme by setting up MP Agro Enterprises, a joint venture with three private firms — Murliwala Agrotech, JVS Foods, and Anil Industries — wherein the government only has a 30 percent stake.
The ready-to-eat dietary supplements — 120 g each of halua premix and bal aahar premix, and 125 g of khichdi daily — meant to be prepared and distributed by self-help groups are looked after by the private companies. The stock and delivery registers are maintained extensively, but the items seldom reach the needy.
CAG audits between 2006 and 2013 revealed that the supplements had reached only 32 percent children. The 2013 CAG report said Rs 196 crore was paid as VAT for the ready-to-eat products, and that had it been cooked meals, the tax could have been saved.
With the then BJP government already having made a mess of the issue, it suffered another blow after the Congress came to power. The party had raised the scam in nutrition supply to children and women extensively during its election campaign, promising to uncover the irregularities and punish the guilty. However, much to activists’ chagrin, the Kamal Nath-led government renewed the existing companies’ contract.
Local activist Neerja Baiga said, “Execution of the government scheme is poor, and the benefits don’t reach the needy. In case of nutrition, most of the distribution is made in registers only. If everyone is registered, and they have people’s data, why do amenities not reach them, and why are children dying? The ground staff is involved in malpractices, which is rampant because the tribals are unaware of their rights. More awareness among our people is necessary to safeguard them.”
As per the NFHS-4 (2015-16), Madhya Pradesh had an infant mortality rate of 51 for every 1,000 live births and the highest under-five mortality rate of 65. Since 2004, nutritional diet worth over Rs 7,500 crore has been distributed, and yet, the situation continues to be dire.
Calls to Imarti Devi, Madhya Pradesh’s women and children welfare minister, went unanswered, even as her secretary responded, “Madam is busy in election campaign.”
Number of malnourished children in Madhya Pradesh over the years
(UW — Underweight; SUW — Severely Enderweight)
(Author is a Bhopal-based freelance writer and a member of 101Reporters.com.)
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Updated Date: May 16, 2019 22:46:31 IST