Barwani (Madhya Pradesh), Jan 16
If you ask about her child, Sita Devi's eyes well up with tears. A
few months ago, her eight-month-old kid died in her arms. Although
she managed to take her daughter from her impoverished Sagmal
village to the Barwani District Hospital, it was too late.
"Still we tried our best," said a senior doctor in the hospital,
adding it was a case of severe malnutrition. "But the child had
stopped responding to medicines."
Thousands of children in Barwani's tribal villages and adjoining
districts face similar fate. Grinding poverty, illiteracy and lack
of awareness, besides the failure of public health-care system, are
making the situation worse, reports Grassroots Features.
The government and other agencies have launched many programmes.
However, tribal areas remain largely untouched. The much-hyped Bal
Sanjeevni Abhiyan scheme launched in the state has, many say, failed
to ensure nutritional security to tribal children.
In August 2006, two-year-old Jyoti Naval Singh died in the district
hospital due to acute malnutrition. Her illiterate parents fed the
ailing infant a 'sugar solution' they thought would cure her. When
her condition deteriorated, on the advice of a NGO they took her to
the hospital.
Madhya Pradesh has the largest number of malnourished children in
the country, with 80,000 cases of severe malnutrition. The mortality
rate is 87 per 1,000 live births, very high compared to the south
Indian states. Over 55 percent of the children are born under
weight.
According to the women and child welfare department, 1,026 cases of
malnutrition were reported from various blocks in Barwani, from
January to October 2006. In 2005 the figure was 1,652. Sendhwa and
Thikri blocks are worst affected with 266 and 227 cases
respectively.
Of these only a few get medical attention.
"Hundreds of deaths due to malnutrition go unreported," said Val
Singh, a tribal activist. Symptoms include tuberculosis, diarrhea
and vomiting. "Therefore, many a time doctors say the cause of death
is something else, not malnutrition."
Although medical facilities are often available at block levels,
they remain out of reach for illiterate tribals. In some hospitals
there are unused facilities due to insufficient staff.
For instance, in Patti block hospital there is no one to operate an
X-ray machine. Patients have to depend on private clinics in Barwani
town for tests.
A survey conducted by a NGO found about 75 percent of pregnant women
anemic in tribal areas. It also revealed expenses on health a major
cause of tribal indebtedness.
A tribal family in Bokarata sold their one-acre plot for a paltry
Rs.5,000 to treat their child with a defective kidney. But that
still could not save the child.
Grinding poverty and ineffective, 'costly' public healthcare are
forcing tribals into cheaper 'options' like black magic and
traditional cures. Superstition also contributes.
"If you want medical attention, you should bribe the doctor,"
declared Madhuri Ben, leader of the Jagrit Adivasi Dalit Sangathan.
"Medicines meant for free distribution are taken away and sold by
doctors in their private practice."
Talking about the failure of public health-care, Madhuri recounted
the recent experience of a critically ill child taken too late to a
government hospital.
Doctors scolded her parents saying: "These tribals are so stupid. Is
this the time to bring the child?"
Of course the child died. "But the real reason for the delay was the
parents did not have enough money to bribe the doctors," she added.
"They had worked two days to mobilize the required amount."
There are many dimensions to malnutrition. Lack of development and
access to medical facilities also cause malnutrition deaths. In many
villages beyond Bokarata there are no roads. The only mode of
transportation is donkey.
Patients, including pregnant women, are carried on stretchers for
five or six kilometers to reach the nearest motor able road. Then
they have to wait for hours for a bus to the nearest hospital 15
kilometers away.
Experts say hunger causes more than 50 per cent of the deaths of
infants below four in Barwani. The Women and Child Development
Department has tried to provide 'daliya' (porridge) and 'panjiri' (bulgar)
to children up to the age of six.
But it has failed in rural areas. The government is running the
mid-day meal scheme for primary school kids, but hundreds of schools
are closed due to absence of teachers.
Fertility is also very high in tribal areas. Many tribals procreate
more because they do not know how many kids will survive. "I have
one son and three daughters' admitted Amar Singh Wascala. "But I
need one more son to look after me in old age."
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