That déjà vu feeling: A tribal child dies of malnutrition

[caption id=“attachment_1022781” align=“alignleft” width=“380”]  Image for representation only. AFP[/caption] Over two decades ago, when he was Maharashtra’s tribal development minister, Madhukar Pichad proudly displayed his sub-plan for the tribal communities. For the first time, the allocation was in proportion to the population. Nine percent of the population had been assigned nine percent of the state’s plan. This parity, he claimed at the time, was a sure way to neutralise the neglect of the tribes who suffered a legacy of inadequacies of all kinds.  Now, two decades later, as the steward of the same ministry, he visited the family of a Warli tribe infant, Priya Ajay Kirkira, who had died of malnutrition. At 11 months, she’d weighed only 4.5 kg. After being summoned by the Governor K Shankernarayanan to explain, Pichad has conceded that a large number of malnutrition deaths have indeed occurred in the area due to the non-availability of healthcare facilities. The baby had died en route while being taken to Jawhar, 20 Km from her home in Babdrechiwadi village. This death did not occur in a remote corner of Maharashtra but just 155 km from the state’s seat of government from where Pichad works. From Thane city, it is 130 km, and in a district which has the largest tribal population in the state. This is not the first time such a death has occurred. Government does not acknowledge this fact, but every year, the media exposes it. For the minister, the death of Priya marked a déjà vu moment. As DNA recalled, “way back in 1992, there were large scale child deaths in Jawhar after which the state government had initiated several measures which had worked initially, though things seem to have gone back to square one since the last two years resulting in large scale child deaths.” A health activist and researcher was quoted by Frontline in 2007 as saying, “Every hour in Maharashtra, there is an avoidable death of one tribal infant” due to malnutrition.  The article, which can be read in full here will give you sufficient reasons for dismay. Pichad now says “there is a lack of coordination between the tribal development department, the women and child welfare department as well as the health department, which needs to be attended on a priority basis” — a view shared by his predecessor. Babanrao Pachpute, who handed over charge to Pichad, had earlier complained that “there are 22 agencies on which the tribal development department has to rely for the works. One of the major works is building and construction” He wanted the tribal components to be hived off from other departments and handed over to the Tribal Development. Despite Pichad’s proud accomplishment of keeping plan allocations proportional to the tribal population little has changed in the past two decades. Let me recall a press conference held by the government then, with the same person holding the same portfolio. Media had reported malnutrition deaths during the monsoons. Three other ministers were also at the press conference, of Health, Employment Guarantee, and Civil Supplies. Questions flew thick and fast, and paraphrased, drawing responses that followed a set pattern: Question: Was the medicare system functional? Answer: All the primary healthcare centres were open and tribals could take their children there for help. Question: But did they have enough medicines? Answer: Plans have been allocated to them. We will have to inquire if medicines are on the shelves. Question: Are doctors working there? Answer: We have filled all vacancies. Question: But have they reported to duty, are they regular in attendance? Answer: We will have to find out about that. Since malnutrition is linked to availability of food, the focus then shifted to the public distribution system. Question: Are the ration shops working? Answer: Yes. We have no complaints of any being shut. Question: Are they stocked? Answer: Regular allocations of foodgrains are made. Question: But are these allocations regularly reaching the ration shops? Answer: We will have to enquire about that. Since use of the public distribution system was dependent on purchasing ability of the people, the attention moved to the Employment Guarantee Scheme, the predecessor of the MNREGA work. EGS has been in vogue in Maharashtra since the mid-1970s, and not without complaints. Question: Since jobs are scarce, and area has subsistence farming, what about the EGS? Without earnings paid on time after work is given, people cannot visit ration shops. Answer: There is a shelf of works which can be started moment the demand for it is made by at least 15 people. Question: Yes, but have such works been activated? Answer: We will find out about it. This explains how plans and budgets mean nothing, even if the numbers therein are upped. They have little impact on outcomes which have all to do with integrity in the ruling class. Other venal outcomes for others are the greater priority. Here is another example of casual conduct of the machinery which would, year upon year, show that funds assigned have been exhausted. If not, then they are spent in more or less one go in the month of March, bills prepared and paid on the night of 28 February. It is called the ‘March madness’, but with a method to it. Here is a recent example from Thane, where the academic year is already coming to the end of its first term. With an apparent intent of sending them to tribal schools, 350 teachers from non-tribal rural schools were transferred, but by pulling strings, not one took charge at the new place. Like doctors, teachers don’t like being posted to tribal areas. But these schools are deemed ‘functional’ because they have classrooms of a kind, though hardly any furniture, or at times, blackboards. And on the rolls, children are shown as being in attendance. There is a component called midday meals which is an incentive, at least for record-keeping, even if it is fudged. All the three components that are used for enhancing Human Development Indices (HDI) — schools as a proxy for knowledge, EGS for employment to drive up incomes, and health care centres for improving longevity, roughly explained — can be on paper, meeting the sub-plan requirements and allocations. But then, Priya Ajay Kirkira, by dying of malnutrition, can show reality for what it really is. The Governor will be shown statistics, and by the time an action plan — we are good at it, devising them — is formulated, and probably poorly implemented, another Priya Ajay Kirkira will surface with much the same issues. But be assured, the next time, you will sense the déjà vu, all over again.