Talking endlessly
about human development would be worthless and incomplete without quoting
Mahbub ul Haq whose brainchild was the Human Development Report. According to
him, development is to be understood in terms of the people and each activity
is to be analyzed to see how much people participate in it and benefit from it.
He supports that kind of development which puts people at the centre stage.
When we think about human development, children are a section which should not
be neglected. To borrow the words of the former U.S. President Herbert Hoover,
‘children are our most valuable resource’. It should not be forgotten that the
very destiny of our nation is dependent on this growing generation. Children
need extra care since they are our supreme assets and the human resource for
the days to come. It should be remembered that if they are not treated
properly, their futures would end up in danger. Health is a major factor in the
phase of growth of a child and if the children are denied the opportunity to enjoy
nutritious food, the condition will be worse than what we can imagine. This
report throws light on child malnutrition in the Indian state of Kerala,
focusing the specific case of Attappady, a tribal block in the Palakkad district. Various reports show that the current level
of malnutrition in India is unacceptably high. According to UNICEF,
malnutrition is more common in India than in the Sub-Saharan Africa. One in
every 3 malnourished children in the world lives in India and the levels of
malnutrition varies across different states here. The state of Kerala has a high literacy rate
(including female literacy), improved health infrastructure, better nutritional
achievements etc. and this is reflected in the various indicators of
development. Kerala has performed well in spite of its comparatively lower per
capita income. Though there are many reasons to boast of the achievements by Kerala,
it should be noted that the development of the state is uneven. Attappady,
being one of the largest tribal settlements in the state is one such pocket
which suggests that something is wrong in Kerala too. But Keralites, when
talking about the grandeur of their homeland, which is known by the sobriquet ‘God’s
own country’, fail to realize the plight of people living in the tribal areas. Attappady
had been in news since many years for the child deaths which occurred here due
to malnutrition. The infant mortality
rate here is 66 per 1000 against the state figure of 14.1 and the maternal
mortality rate is 7 per 1000 compared with the state figure of 1.3 per 1000.
Many cases of child and women deaths in the area often go unreported. It would
not be wrong in saying that most of the people here are deprived of even a hand
to mouth existence. They face many challenges and hardships to make both the
ends meet. People (even children) are seen begging for alms to have a meal and
the scenes of this kind are pitiful. NDTV news featuring Attappady gives it a
title- 'The land of dying infants and weeping wombs'. The reasons behind these deaths, keeping aside
the protein malnutrition are many and the ones to be stressed are as follows
Premature delivery of the infants
·
Poor or improper health facilities
·
High incidence of maternal anaemia
·
Ineffective functioning of the health and social welfare departments
and government hospitals.
The most saddening
part is that the people with sickle-cell anaemia do not get proper treatment
and the children with this disease die in their early childhood unless they
receive medical attention. Over and above the issue of low incomes for the jobs
available, unemployment adds to the existing woes of the Attappady people, too
many of whom are undernourished and sick. The farmers here, who earlier owned
their own land, have declined into poverty, allegedly after the land mafia
occupied their land. The worst affected were the women and children. Most
of the Attapadi tribals don’t have cultivatable land since the lost their
lands. Now Attapadi has nearly 260
landless tribal families. This brought about a change in their food habits and
lifestyles too. Earlier they used to eat rich nutritious food cultivated in
their farms. Now they eat substandard rice provided by ration shops for Rs.1 a
kg.
Newspaper reports
show that 38 infants had died from January to august this year in Attappady.
And it is known that the total number of deaths is around 60, taking the case
of the last one and half years. Various surveys conducted in the region reveals
that all the children here suffer from varying degrees of malnutrition. Adding
to this, another survey showed that 98 per cent of pregnant women in the
village are malnourished, which in turn results in underweight babies, many of
whom are malnourished and are likely to die within a few years of birth. There are even sexual abuses in these tribal
regions which give rise to unwed mothers. But such cases are prevalent in
regions of Wayanad district of Kerala. And also, Attappadi girls get married at
an early age. They might not be aware of the fact that negative health
consequences are linked to early marriage.
Early marriage is associated with early child bearing. Studies show that
the risk of death following pregnancy is twice great for women between 15-19
years than for those between 20-25 years. Maternal mortality rate can be up to
5 times higher in the age group 10-14 years. According to UNICEF, the infant
mortality among the children of very young mothers is higher than those among
older peers. Like the children here these young mothers also do not get proper
nutritious food. It would not be wrong in saying that acute protein deficiency
in the diet of adolescent girls, pregnant women and lactating mothers is one of
these primary issues behind these child deaths. It should be noted that abortion rates among tribal women is also
on the rise. Very few tribal women attend neonatal clinics and visit the
hospital for delivery. Their personal hygiene is also poor. Malnutrition and
poor hygiene are also factors leading to the high rate of abortions.
All of us would be
aware of the Integrated Child Development Services scheme (ICDS) aims at
improving the nutritional and health status of children in the age group below
6 years. It also focuses on reducing the indices of mortality, morbidity and
school dropouts. Providing a package of services to children below six years
and to pregnant and nursing mothers, such as supplementary nutrition, immunization,
health check-ups, referral services and pre-primary education also come under
the objectives of the scheme. Child care centers called ‘Anganwadis’ which form
the backbone of the ICDS scheme are also located in these tribal hamlets. But
they are providing nutritious foods like milk, eggs, banana etc. Being a
resident of Kerala, I have seen the way anganwadis function in other rural
areas, which are comparatively better off
than Attappady. All they provide is upma and green gram. So, the case with
Attappady on which the Government doesn’t show much concern can be guessed. The
poor people who remain trapped in the web of poverty and malnutrition are not
asking the Anganwadis to conduct educational meetings and offer advice about
nutrition or family planning, as done in some other parts of the country. But
the people feel that these child care centers have the obligation of providing
nutritious food atleast. Though there
are three government primary health centers (PHC), one community health centre
(CHC) and 27 subcentres in this area,
they are not providing sufficient medical facilities. There is lack of medical
staff and the ones who are there do not have proper qualification. The Kerala
government provides the people ragi which is their staple food. But that is in
vain because of the unavailability of grinding mills and lack of proper
transport facilities.
It is to be kept
in mind that malnutrition limits development and the capacity to learn. It also
costs lives: about 50 per cent of all childhood deaths are attributed to
malnutrition. Malnutrition in children is not affected by food intake alone; it
is also influenced by access to health services, quality of care for the child
and pregnant mother as well as good hygiene practices Malnutrition in early
childhood has serious, long-term consequences because it impedes motor,
sensory, cognitive, social and emotional development. Malnourished children are
less likely to perform well in school and more likely to grow into malnourished
adults, at greater risk of disease and early death. Here we have seen the case
of Attappady. There are hundreds of Attappadys around us, which many a time go
unnoticed and do not get proper attention of the Government. So the states
should be pressed to take initiatives to provide better health care and
education, not only for the children but for the parents too. Common practices
such as allowing all the males of the household to eat first goes some way to
explaining the 83 per cent rate of iron deficiency anaemia among Indian women.
The trend in Kerala is also not different and we have known this from the
instance of Jayamma in Martha.C.Nussbaum’s ‘Women and development’. Kerala might aspire to attain the Millennium
Development Goals (MDG) of eradicating hunger and poverty, reducing child and
maternal mortality etc. but unless these areas are seriously taken, there may
not be any change in the conditions prevailing in the darker sides of Kerala.
So it is essential to make some necessary steps from the part of government to
make the state bereft of child problems and death. Let us hope that there will
be a qualitative change in the situation soon.
No comments:
Post a Comment