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[Hunger Alert] INDIA: Another child died of malnutrition while fifty one children malnourished in Saledhana village, Madhya Pradesh

The Asian Human Rights Commission (AHRC) regrets to inform you that a child died of malnutrition associated with fever, diarrhoea and breathing difficulty on June 17, 2009. The human rights group, Samaj Seva Samiti (Spandan) based in Madhya Pradesh visiting the village on July 20 discovered that 70 percent of 72 children registered at Anganwadi Centre (Child Care Centre) are currently malnourished. However, the relevant government authorities fail to pay attention to these malnourished tribal children who may develop worsening health conditions causing premature death.

[Hunger Alert] INDIA: Another child died of malnutrition while fifty one children malnourished in Saledhana village, Madhya Pradesh

ASIAN HUMAN RIGHTS COMMISSION - HUNGER ALERT PROGRAMME

Hunger Alert Update: AHRC-HAC-004-2009

23 July 2009

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INDIA: Another child died of malnutrition while fifty one children malnourished in Saledhana village, Madhya Pradesh

ISSUES: Right to food; right to health; malnutrition; government neglect
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Dear Friends,

The Asian Human Rights Commission (AHRC) regrets to inform you that a child died of malnutrition associated with fever, diarrhoea and breathing difficulty on June 17, 2009. The human rights group, Samaj Seva Samiti (Spandan) based in Madhya Pradesh visiting the village on July 20 discovered that 70 percent of 72 children registered at Anganwadi Centre (Child Care Centre) are currently malnourished. However, the relevant government authorities fail to pay attention to these malnourished tribal children who may develop worsening health conditions causing premature death.

CASE DETAIL:

A two month old girl Reena Kishore died on June 17, 2009. She lived in Saledhana village, Khalwa Block, Khandwa district, Madhya Pradesh. Reena was malnourished with symptoms of high fever, diarrhoea and respiratory difficulty. Her parents took her to a private hospital nearby where her condition did not improve. They could not afford to take Reena to the public health institutes where are too far from their village.

Reena's father Kishore is a landless agricultural labourer. To support a family of four, similar to other villagers, he used to migrate twice a year to a neighbouring district to earn money. (for details on livelihood of Korku tribe, please refer to previous hunger alert). The family has a Below the Poverty Line (BPL) ration card with which they can collect rice at 5.65 rupees per kilogram and wheat at 4.15 rupees per kilogram. BPL card holders are only given 20 kilograms of rice and wheat by the ration shop. This is generally used up by the whole family within a week.

There are eight children who may face the same fate as Reena in Saledhana village. The number of malnourished children is listed below:

1. Mangal Rajaram, a two year and three month old boy, grade IV malnutrition, 6 kilograms weight
2. Pramila Munna, a three year and eight month old girl, grade IV malnutrition, 6.8 kilograms weight
3. Lucky Sukram, a three year and two month old boy, grade III malnutrition, 8.8 kilograms weight
4. Rany chander, a one year and four month old girl, grade III malnutrition, 5.8 kilograms weight
5. Durga Govind, a two year and two month old girl, grade III malnutrition, 6.8 kilograms weight
6. Divya Shanker, a three year and one month old girl, grade III malnutrition, 7.9 kilograms weight
7. Jeevan Mandilal, a three year and five month old boy, grade III malnutrition, 8.9 kilograms weight
8. Sukrai Shyamlal, a two year and four month old girl, grade III malnutrition, 7.3 kilograms weight

Results of field research conducted by Spandan on July 20 are as follows: out of 72 children registered at Anganwadi Centre (AWC; Child Care Centre), 70 percentage of the children are malnourished, 43 children are moderately malnourished and 8 children are severely malnourished.

All eight severely malnourished children have not received any medical attention to date.

In 2008, five children died of malnutrition in Saledhana village. However, the State and district administrative governments have not taken any substantial steps to eradicate child malnutrition deaths. They merely issued AAY cards (ration card for the poorest among the poor) to the families of the deceased children but did not fully implement any other care. And it is a year since the children died. Two out of the five families have yet to receive AAY cards due to overall inefficient bureaucracy and unnecessary administrative delays resulting from corruptive practices.

BACKGROUND INFORMATION:

Saledhana village is a remote rural village where the Korku tribal community live. The villagers, in fact, do not have accessibility to such public health institutions as the Nutrition Rehabilitation Centre (NRC) or Primary Health Centre (PHC) which are very remote from the village. In addition, the NRC does not provide medical treatment for the accompanying sicknesses such as diarrhoea, wasting, and respiratory difficulty usually associated with malnutrition. Only supplementary rations for children under the age of six are provided by the AWC.

There are two AWCs in the village. One is run by the administrative authority and another is run by the community with the help of a human rights group, Spandan. Since five children died of malnutrition in the village last year, it was found that about fifty children under the age of six could not attend AWC of which there was only one at the time. After submitting an application for an additional AWC last year on the basis of the Supreme Court Order on Integrated Child Development Scheme (December 2006), the community with the help of Spandan immediately started running AWC by themselves. The villagers were quite aware that it would be a time delay for the authorities to give an order and launch AWC requested by the villagers.

According to records of the Supreme Court Order (December 2006) for the Integrated Child Development Scheme (ICDS), Madhya Pradesh is one of three states providing a low percentage of service (59.9) followed by Manipur (0) and Assam (13.5).

As the authorities did not provide facilities to this AWC while the application was in process, the community itself tried to manage such basic resources as food and second hand toys. All the community members are poor but they share rice and pulse among themselves for their children's sakes. Second hand toys are provided for free from an NGO based in the city. Ms. Pramila, a community volunteer, comes to the AWC daily taking care of fifty children all day. For their part, the authorities began to provide supplementary grain and vaccines from January 2009 on and are currently building a centre for them.

AWC management is participatory and community oriented in contrast with that of the administrative authority which is authoritarian and institution oriented, often displaying negative and negligent attitudes. Delaying tactics are part of the administrative procedure stemming from corruption. They act like a chronic disease pervading the landscape and which are taken for granted. Nonetheless, immediate and more progressive provision of health care and nutritious food for the children is still urgently needed.

SUGGESTED ACTION:
Please write a letter to express your deep concern about a child’s death and eight children currently suffering from malnutrition in Saledhana village. Please take note that five children had died of malnutrition in the village in 2008.

The AHRC has also written a separate letter to the Chief Justice of the Supreme Court of India and to the UN Special Rapporteur calling for intervention on the Right to Food and the right to the highest attainable standard of physical and mental health possible.

To support this appeal, please click here:

SAMPLE LETTER:

Dear __________,

RE: INDIA: Another tribal child died of malnutrition while fifty one children malnourished in Saledhana village, Madhya Pradesh

Child who died of malnutrition associated with other diseases:
Reena Kishore, a two month old girl, died on June 17, 2009
Children suffering from malnutrition:
1. Mangal Rajaram, a two year and three month old boy, grade IV malnutrition, 6 kilograms weight
2. Pramila Munna, a three year and eight month old girl, grade IV malnutrition, 6.8 kilograms weight
3. Lucky Sukram, a three year and two month old boy, grade III malnutrition, 8.8 kilograms weight
4. Rany chander, a one year and four month old girl, grade III malnutrition, 5.8 kilograms weight
5. Durga Govind, a two year and two month old girl, grade III malnutrition, 6.8 kilograms weight
6. Divya Shanker, a three year and one month old girl, grade III malnutrition, 7.9 kilograms weight
7. Jeevan Mandilal, a three year and five month old boy, grade III malnutrition, 8.9 kilograms weight
8. Sukrai Shyamlal,a two year and four month old girl, grade III malnutrition, 7.3 kilograms weight
The families of the deceased children who died of malnutrition in 2008 have yet to receive an AAY card:
1. Nandini Kamal Singh, 18 months old, died in August 2008
2. Daughter of Pramila Raju, eight days old, died in August 2008
Location: Korku tribal community, Saledhana village, Khalwa Block, Khandwa district, Madhya Pradesh

I am writing to express my deep concern about another child who died of malnutrition associated with accompanying illnesses and fifty one children who are currently malnourished in Saledhana village alone.

I am informed that a two month old girl Reena Kishore died on June 17, 2009. She suffered from malnutrition associated with high fever, diarrhoea and respiratory difficulty. Her parents took her to a private hospital near their village where her health condition did not improve.

I have learned that her family has no accessibility to public health institutions such as the Nutrition Rehabilitation Centre (NRC) or Primary Health Centre (PHC) which are quite remote from their village. When she became acutely sick and malnourished, her parents had to rush her to a private hospital to get emergency treatment. Despite their efforts, Reena was not able to recover.

I am informed that Reena's parents are landless agricultural labourers. Her father used to migrate to work in the neighbouring district to support his family of four. Her parents found it difficult to provide nutritious food for all the family and even more difficult to care for Reena well. I am aware that many tribal villagers are under the same stressful living conditions.

I am surprised to learn that about 70 percentage of the children registered at Anganwadi Centre (AWC) in Saledhana village are malnourished. According to Spandan, a local human rights group who visited the village on 20 July, 43 out of 72 children are moderately malnourished and 8 children are severely malnourished. AWC merely provided supplementary grains for these at risk children. I am of the opinion that this is not sufficient to allow the malnourished children to recover.

I have investigated that last year in Saledhana village, five children died of malnutrition. All died under the same situation and conditions as the current malnourished children. Neither the public health institutions nor the administrative authorities initiated any care or follow-up for these malnourished children in this remote rural area.

However, now in 2009, despite the fact that a child died and many other children are severely malnourished, no immediate, affirmative action has been taken. It is reflected in the fact that there has been no substantial steps taken to ensure food and health security in the village. The administrative authority merely declared that they would try to eradicate malnutrition and encouraged the parents to take their malnourished children to the NRC. I am of the opinion that it neither is helpful. I have learned that the Asian Human Rights Commission (AHRC) has been reporting on the ineffective and incomplete practices of the NRC in merely treating severe malnourishment without attending to the accompanying diseases. It points to the fact that the present emergency health care for malnourished children fails to prevent child deaths and the eradication of malnutrition.

I am further informed that the authorities have not issued an AAY card to two out of five families who lost their children last year. Despite the fact that a year has passed, the authority continues to neglect its duty of care and promises made to the public.

I, therefore, urge you to take immediate action to prevent child deaths from malnutrition and to ensure food security by:

1. Providing nutrition as well as proper medical treatment for children suffering from any stage of malnutrition associated with other sicknesses at the NRC;
2. Providing supplementary grains and appropriate follow-up nutrition for all malnourished children at AWC;
3. Paying special attention to malnourished children who do not have accessibility to the NRC;
4. Providing AAY cards to Kamal Singh, Pramila Raju and Reena’s families;
5. Providing clean water and hygienic sanitation facilities;
6. Ensuring food security by providing farm land, education and facilities to increase productivity.

I am looking forward to your immediate intervention in this situation.

Yours sincerely,

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PLEASE SEND YOUR LETTERS TO:

1. Krishna Tirath
Minister of Women and Child Development
Government of India
INDIA
Fax: +91 11 2331 4788
E-mail: krishnatirath@yahoo.in

2. Alka Sirohi
Secretary
Department of Food and Public Distribution
Government of India
INDIA
Fax: +91 11 2338 6052
E-mail: secy-food@nic.in

3. Principal Secretary
Ministry of Health & Family Welfare
Nirman Bhavan
Maulana Azad Road
New Delhi - 110011
INDIA
Fax: +91 11 2306 1751
E-mail: hfm@alpha.nic.in

4. Mr. Shivraj Singh Chouhan
Chief Minister
Madhya Pradesh
INDIA
Fax: +91 755 2441781

5. R. C. Sahni
Chief Secretary
Government of Madhya Pradesh
Mantralaya,
Bhopal 462 004
Madhya Pradesh
INDIA
E-mail: cs@vallabh.mp.nic.in

6. S.B. Singh
District Collector
Khandwa District, Madhya Pradesh
450001
INDA
Fax: +91 733 2224233
E-mail: singh.sb@mp.gov.in

7. Country Director
World Food Programme
2 Poorvi Marg, Vasant Vihar
New Delhi 110057
INDIA
Fax: +91 112 615 0019
E-mail: wfp.newdelhi@wfp.org

8. UNICEF
73 Lodi Estates
New Delhi 110 003
INDIA
Fax: + 91 11 2462 7521 / 11 2469 1410
E-mail: newdelhi@unicef.org

Thank you.

Right to Food Programme (foodjustice@ahrc.asia)
Urgent Appeal Programme (ua@ahrc.asia)
Asian Human Rights Commission

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