INDIA: 22 children died of malnutrition associated with diseases for past two months in Sidhi district, Madhya Pradesh

CASE DETAIL (based on the fact finding report):

Dalit Adiwasi Mahapanchaayat and Mahila Adhikar Manch, local human rights organizations discovered 24 deaths related to malnutrition and other associated symptoms in last two months – 8 children in Ramgarh, 11 children including a newborn and his mother in Piprahi, 2 children in Karwaahi, and 2 children in Dudhmatia village.

Nine out of the twenty two children were not registered at the Angawadi (AWCs, child care centre) which is the most basic child health care unit at village level. In addition another twenty three children who are currently identified as malnourished in Ramgarh village are not registered either. The unregistered children have not been given any nutrition or food from the AWCs nor visited by AWCs workers.

Apart from unregistered children, other children coming to the AWCs have also not been provided with supplementary nutrition earmarked by relevant department. The AWCs in Ramgarh village merely provide rice and Dal to the children but do not provide them with supplementary nutrition for the children resulting in unbalanced diet. Likewise the food provided under the Mid Day Meal scheme (MDM) for the school students have only been a variety of pulse which does not meet the balanced diet.

Primary Health Centre (PHC) is an elementary public health institution at the village level. The villagers in Ramgarh or Piprahi find it difficult to access as it is 10 kilometers away from their villages. The post of multipurpose health worker has been vacant for years and the Auxiliary Nursing Midwife (ANM) in charge of immunization and check-up for the children has never visited the villages. Although doctors diagnosed that the children died of contaminated water, no one could deny the fact that all of them were malnourished.

Food distribution under the Public Food Distribution System (PDS) also fails to provide specified grains for the poor in Ramgarh village. Families below the Poverty Line (BPL) which hold a BPL ration card only collect about 25-30 kilograms of grain even though it is stated on the card that they were given 35 kilograms. Some collected less than 25 kilograms of wheat and only 7 kilograms of rice. The card holders including Rambhajan Baiga, Motilal, Radhe Shyam, Mahavir, Shivnath Balsa and Kunjilal visited District Collector to make an appeal on which there has not been any improvement so far. In addition, the opening days of the PDS shop is irregular. For instant in September, it only opened from 21st to 23rd.

Instead of appropriate and full implementation of the government schemes guaranteeing access to food and health, ANM and village Panchayat secretary who is in charge of reporting the situation is merely suspended since the deaths of 22 children were disclosed.

BACKGROUND INFORMATION:

Ramgarh is a small village mostly predominated by Baiga, Gond tribes and the Scheduled Castes (mostly known as Dalits) located in Kusmi Block, Sidhi district. The tribes live on the basis of pre-agricultural technology. They collect minor forest production for livelihood. However, they cannot access the forest any more since the area came under Sanjay Gandhi Tiger Reserve in 1984. Some of them are left with farmland which is neither fertile to cultivate sufficient crop nor irrigated. They have no other choice but to depend on government programmes of food and health security. Those who are not beneficiaries from the National Rural Employment Guarantee Act (NREGA) are forced to migrate to Gujarat or Uttar Pradesh to feed their families.

The failure of ensuring food security and prevention of child malnutrition has not been appropriately reported to the relevant authorities. The administrations do not have data on unregistered children at AWC who suffer from malnutrition as they believe that there is no malnourished child in the area. The department of woman and child development insists that they are not responsible for the children’s deaths as they died of malaria. The administration merely highlights the fact that the deceased children got sick while ignoring the fact that they were all malnourished and deprived of their rights guaranteed by government schemes. The ignorance and the denial of the administration show their negligence in ensuring right to food and eradicating child malnutrition.

Immediate measures should be taken to improve the absolute lack of facilities and resource at health institution which have been largely neglected so far. In Madhya Pradesh 67 percent are living below the poverty line and 60 percent of the children are undernourished while 73.9 percent of tribal women are anemic. One bed at public health institution is available for 2,425 persons, whereas more than 1300 posts out of 5005 posts for regular doctors are vacant.

It is reflected that the budget for health service accounts for merely 2.4% out of total state budget. Although the child malnutrition has been increasing for last five years, not even a single PHC has been built up. 1,659 out of 4,708 posts of medical officers are vacant and 1,098 posts of ANM are yet to be filled.

SUGGESTED ACTION:
Please write a letter to express your deep concern about 22 children's deaths from malnutrition associated with other diseases, as well as the increasing number of malnourished children who are at risk of dying.

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

To support this appeal, please click here:

SAMPLE LETTER:

Dear __________,

Re: INDIA: 22 children died of malnutrition associated with diseases for past two months in Sidhi district, Madhya Pradesh

Children who died of malnutrition associated with diseases and two maternal deaths: 
Name / Father’s Name / Age / Date of Death (2009) / Name of the village / Registration at AWC

1. Rajwati, Roshabh Lal, 4 years, 25th September, Ramgarh, Yes
2. Ramavtaar, Shaksudan, 6 years, 12th September, Ramgarh, Yes
3. Archana, Lallu bhaiya, 3 years, 9th September, Ramgarh, Yes
4. Gori Shankar Shariman, 15 months, 4th September, Ramgarh, No
5. Babulal/Ramakant, Hira Lal, 11 months, 25th August, Ramgarh, No
6. Rani, Tejwati, 8 years, 23rd September, Ramgarh, registered in school
7. Anchal, Arvind, 5 months, 12th September, Ramgarh, No
8. Laala, Buddhsen, 6 months, 10th October, Ramgarh, No
9. Siya bai, Udaibhaan Singh Gond, 25 Years, 20th August (Maternal and Neonatal Death), Piprahi, Adult
10. Ram Kumar, Prembahadur Singh, 4 Years, 20th September, Piprahi, Yes
11. Lala, Shyamlal, 2 Years, 10th September, Piprahi, Yes
12. Preveen singh, Raghuraj Gond, 8 Month, 29th September, Piprahi, Yes
13. Kuber, Kemla Baiga, 28 Years, 29th September (Maternal and Neonatal Death), Piprahi, Adult
14. Buttu Rajkumari, Ramavtaar Baiga, 6 Years, 22nd September, Piprahi, Yes
15. Dadu, Sukh nandan Singh, 18 Months, 20th September, Piprahi, No
16. Bablu, Munna Singh, 12 Months, 2nd October, Piprahi, No
17. Suraj, Dalkeshwar Baiga, 12 Months, 2nd October, Piprahi, Yes
18. Gita, Rameshwar Baiga, 3 Years, 5th October, Piprahi, Yes
19. Ram Prakash, Gendalal Baiga, 6 Months, 6th October, Piprahi, Yes
20. Prakaash, Paarash Baiga, 5 Months, 8th October, Piprahi, Yes
21. Aashki Ram, Kumar Singh, 1 Year, 1st October, Karwaahi, No
22. Amit Singh, Ram Kumar Singh, 3 Years, 8th October, Karwahi, No
23. Rambhaj, Amritlal Loni, 13 Months, 13th September, Dudhmatia, No
24. Ajeet, Suryawali Loni, 10 Years, 13th August, Dudhmatia, registered in school

Location: Ramgarh, Piprahi, Karwaahi and Dudhmatia villages in Sidhi district, Madhya Pradesh
Time: from 13th August to 10th October, 2009

I am writing to you to express my deep concern about 22 children who died of malnutrition associated with other diseases and two maternal deaths for last two months. I am also writing to alert you to 23 more children becoming malnourished in Ramgarh village, Shidi district.

According to Dalit Adiwasi Mahapanchaayat and Mahila Adhikar Manch, local human rights groups, 22 children and two women died for last two months – 8 children deaths in Ramgarh, 11 children including newborn child and his mother in Piprahi, two children in Karwaahi, and two children in Dudhmatia village.

According to the doctors, the children died of contaminated water and the Department of Women and Children insists that they are not responsible for the children’s deaths as died of malaria. It is true that some of the deceased children had malaria however it is also true that all the deceased children were malnourished which the administration as well as doctors had ignored.

I have observed the reasons why the deceased children were malnourished are reflected the fact that all the government schemes guaranteeing right to food and health do not reach the tribal communities in Sidhi district who do not have adequate and sustainable livelihood.

The villages such as Ramgarh or Piprahi preoccupied by Baiga and Gond tribe have been deprived the accessibility to the forest after coming under Sanjay Gandhi Tiger Reserve in 1984. For these tribes, collecting minor forest product was main livelihood. Farmland in this area is also not fertile enough to cultivate crops.

Under this circumstance, the villagers have no other choice but to depend on the government schemes aiming to ensure right to food and health. However, it is discovered by the fact finding report that all these schemes fail to reach the poor tribes.

I am informed that 9 out of 22 children were not registered at the Angawadi (AWCs; child care centre) which is the most primary child health care unit at village level. 23 children who are currently identified as malnourished in Ramgarh village are not registered either. The workers at the AWCs have never visited these children.

I am further informed that not only unregistered children but the children coming to the AWCs also have not been provided supplementary nutrition earmarked by the administration. The AWCs in Ramgarh village do not provide supplementary nutrition for the children resulting in unbalanced diet. Likewise the food provided under the Mid Day Meal scheme (MDM) for the school students have only been a variety of pulse which does not meet the balanced diet.

Primary Health Centre (PHC), an elementary public health institution at the village level is far away from the villagers in Ramgarh or Piprahi who find it difficult to access as it is 10 kilometers away from their villages. The post of multipurpose health worker has been vacant for years and the Auxiliary Nursing Midwife (ANM) in charge of immunization and check-up for the children has not visited the villages.

Food distribution under the Public Food Distribution System (PDS) also fails to provide specified grains for the poor in Ramgarh village. Below the Poverty Line (BPL) ration card holders only collect about 25-30 kilograms of grain whereas it is recorded on the card that they were given 35 kilograms. Some collected less than 25 kilograms of wheat and only 7 kilograms of rice. The card holders including Rambhajan Baiga, Motilal, Radhe Shyam, Mahavir, Shivnath Balsa and Kunjilal visited District Collector to make an appeal on which there has not been any improvement so far. In addition, the opening days of the PDS shop is irregular. In September, it opened from 21st to 23rd only.

Most of all, the failure of ensuring food security and prevention of child malnutrition has not appropriately been reported to the relevant authorities. The administrations do not have data on unregistered children at AWC who suffer from malnutrition, from which they believe that there is no malnourished child in the area under their responsibility. The ignorance and the denial of the administration show their indifference in ensuring right to food and eradicating child malnutrition.

I am in the opinion that absolute lack of facilities and resource at health institution should be raised. I have learned that in Madhya Pradesh 67 percent are BPL and 60 percent of the children are undernourished while 73.9 percent of tribal women are anemic. One bed at public health institution is available for 2,425 persons, whereas more than 1300 posts out of 5005 posts for regular doctors are vacant.

It is reflected the fact that the budget for health service merely accounts for 2.4% out of total state budget. . Although the child malnutrition has been increasing for last five years, not even a single PHC has been built up. 1,659 out of 4,708 posts of medical officers are vacant and 1,098 posts of ANM are yet to be filled.

Instead of appropriate and full implementation of the government schemes guaranteeing right to food and health, ANM and village Panchayat secretary who is in charge of reporting the situation is suspended since the children’s deaths were disclosed. I am in the opinion that only suspension of low profile public servants cannot be a solution.

I have studied the meaning of right to food based on International Covenant on Economic, Social and Cultural Rights (ICESCR) which the Government of India has ratified in 1979. It is not just to feed the poor. It is to ensure sustainable livelihood for the poor so that they can either produce sufficient food or get access to power. The adequate food is also based on knowledge of basic nutrition and care, as well as adequate water and sanitation causing certain sicknesses.

Until they are guaranteed, the government has an obligation to ensure right to food/health by government policy. I am in the opinion that India is the worst country in Asia facing child malnutrition and food insecurity extremely exposed in high economic growth.

In the light of this, I urge you to take immediate action to the victims suffering from food insecurity in Sidhi district by full implementation of all government schemes. Further, the government should make more effort to ensure sustainable livelihood to them. Most of all, I urge you to build up appropriate mechanism to ensure these rights.

I will look forward to your immediate action as well as long term plan.

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. 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

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

4. R. C. Sahni
Chief Secretary
Government of Madhya Pradesh
Mantralaya
Bhopal 462 004
Madhya Pradesh
INDIA
Fax: +91 755 2441751
E-mail: cs@vallabh.mp.nic.in

5. District Collector
Office of the District Collector
Sidhi, District - Sidhi
Madhya Pradesh, India
Fax: +91 7822 252204 / 252203

6. Mrs. Shantha Sinha
Chairperson
National Commission for the Protection of Child Rights (NCPCR)
5th Floor, Chnadralok Building, Janpath,
New Delhi
INDIA
Fax: +91 11 23731584
E-mail: ncpcr.india@gmail.com / shantha.sinha@nic.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.

Hunger Alert Programme (foodjustice@ahrc.asia)
Asian Human Rights Commission (ua@ahrc.asia)