OUR Dying CHILDREN: Where is the RIGHT to LIFE?

“No person shall be deprived of his life or personal liberty except according to procedure established by law”, reads Article 21 of the Indian constitution. Does “life” mean a mere mode of existence - an existence from birth to the natural decay of the body to death? Or does “life” mean living, breathing, existing through the means to subsist with the dignity of being, possessing the right to livelihood, health, to be treated equal of any physical and sexual identity, of caste and creed.

Then, what may you define “deprived”? Simply put, it means snatching, taking away, stripping, impoverished, keeping away from having the fundamental essence of life.

When things being equal, does this include children? Is this merely a presumption that it does, after all?

Children are the silent, the invisible, possessing no formal political voice to claim their identity to the “right to life”. If we are the custodians of their lives, then, why is it that India allows two million of her children under the age of five to die every year, through a deathblow of malnutrition, when it is clearly preventable and manageable?

Undernutrition is a violation of child right and right to life. A child’s right to food is an integral part of the right to life.

India has the dubious distinction of standing first in having the highest number of stunted children in the world, surpassing countries like Bangladesh, Nepal, Ethiopia and several Sub-Saharan African countries. Low height for age is indicative of stunting and of chronic malnutrition. The prevalence of underweight children in India is twice as high as the average prevalence of 26 sub-Saharan African countries put together. In India, the under five-mortality death was reported to be alarmingly high at 69 for every 1,000 live births in 2008. Five north Indian states: Bihar, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh account for nearly 55 percent of child mortality and with this, 65 percent of maternal deaths.

More than 19 million infants in the developing world have low birth weight. More than half are in South Asia; 8.3 million are in India

The Game of Survival for the Hungry Children

The health and nutritional status of India’s children has been in the danger zone for far too long. According to the National Family Health Survey (NFHS-3) 2005- 06, 48 percent or half of the India’s children under the age of five are chronically malnourished or stunted, with nearly 43 percent children underweight or have low weight for their age. This puts the survival of a child at grave risk, apart from having the potential to cause severe physical, intellectual and cognitive development that can cripple the child for life.

Research has proved that ensuring better childhood nutrition increases the adult productivity, thus enhancing the economic wellbeing of the individual, thereby ending the vicious cycle that poverty begets hunger.

The world looses 9 million children under the age of 5 each year, with two million children dying in India alone. Two thirds of these deaths are preventable: diarrhoea, pneumonia, malaria, measles, and HIV and AIDS account for nearly half the deaths. Undernutrition contributes to more than one third of these deaths.

Adequate food, care and attention health go a long way in protecting the child from diseases.

The colossal waste of fragile life is compounded by poverty, poor maternal nutrition, non-literacy, prevalent social norms, sanitation, and safe water supply. Truncated government policies, rising food prices, challenges in food production, high import of pulses, inadequate budgetary allocation on health further accentuate the problem, deteriorating the health and wellbeing of the vulnerable sections of the society. The mother and child are the vulnerable most. As you read this, children continue to die silently. The nutrition security of the country is seldom addressed with the seriousness it deserves.

Take the fallout of malnourishment – Anaemia. Anaemia is a deficiency of haemoglobin or red blood cells causing far-reaching damage on an individual. In young children, it results in increased susceptibility to infectious diseases, impairment in coordination, cognitive performance, behavioural development, language development, and scholastic achievement.

Anaemia in children under three years of age has increased to a far greater level from 74 percent to 79 percent in 2005-06 of NFHS-3. A mild decrease in severe anaemia is seen from 5 percent to 4 percent. Children (under three years) with low weight for height or wasted, has increased from 20 percent to 23 percent from NFHS-2 to NFHS-3, through there has been improvement in children with Stunting or low height for age.

Today, the prevalence of anaemia among married women between 15 to 49 years has risen from 52 percent (1998-99) to 56 per cent in 2005-06. 58 per cent of pregnant women suffer from anaemia.

A Healthy Mother, A Healthy Child

It is beyond any doubt that a healthy mother is unlikely to have a stunted, wasted or an underweight child. Anaemic and under-nourishment has a severe impact in pregnancy, the development of the fatuous and the newborn child, making it impossible for the mother to support the nutrition deficit of the child. It is found that mothers who have a body mass index less than 18.5 kg/m2 or underweight are likely to have undernourished children. This threatening the survival of the mother and child.

Hunger, Food and Nutrition Security

It must be noted that despite the tall claims of the green revolution and the surplus of food grain production having increased from 50.82 in 1950-51 to 200.88 million tonnes in 1998-99, the production of coarse grain and pulse has not increased. The government today imports large scale of pulses, making it unaffordable for the poor.

Thus, there is a dramatic decline in the per capita consumption of the essential pulses (the vital protein element) to merely 34 grams per day. The government is unable to fill the crevice of cost, availability, distribution and fiscal expenditure.

The nutritionally vulnerable child, adolescent girl, expecting and lactating mothers face the brunt of the nutrition crisis and ill health the most. The public distribution system (PDS) do not distribute pulses, oil, locally available coarse grain to the poor margins of society who access the PDS. If measures are taken to encourage the consumption, cultivation of course grain and pulses, then this can fill the nutritional gap of a household.

Who Are the Children that Suffer the Most?

As gruesome as this may be, it is important to delve into the plight of tribal and dalith children. They are caught in the quagmire of social inequality, political alienation, discrimination and exclusion. Consider this: the neonatal mortality of the Scheduled Tribe (ST) and Scheduled Caste (SC) is far greater at 46.3 to 34.5 among non ST/SC/OBC. Infant mortality rate is 66.4 in ST/SC to 48.9 among others. This only proves that the nutritional deficiencies are at a heightened state among disadvantaged groups. Young children from the disadvantaged castes are more susceptible to a chronic stunted, wasted, and underweight nutritional status than children from other “upward” castes. This shows that the accessibility to health care, clean drinking water, access to education, landlessness, migration and insurmountable poverty are factors that cripple the normal development of a child that belongs to the “other” side of the caste barrier.

Little Done is Half Done

Over the past few years, several attempts have been made to plug the dismal health record of mother and child in the country with the introduction of the Integrated Child Development Services (ICDS) and Mid Day Meal Scheme. The ICDS address the nutritional status of children under six years, lactating mothers and adolescent girls (only two adolescent girls per angawadi). The Mid Day Meal tackles the nutritional flux and classroom hunger of children from 6 to 14 years.

Though much is done, much remains to be achieved. The out-reach of the ICDS centres or Aganwadis fall short in its coverage. Only 30 percent of children from 6 months to 6 years have access to an anganwadi. This means that over 80 percent the children of this age group have no access to any day-care centres. The universalization of the ICDS is far from being a dream. The Supreme Court had earlier ordered the opening of 14 lack aganwadi centres with specific coverage given to SC/ST, urban slums, and other disadvantaged habitations.

Promise to Create a World Fit for Children

There lies promise in the impact of the health and nutrition interventions made in the past eight to nine years. Clearly, there is a decline in infant mortality and severe malnutrition.

However, even with more than 10 lack operational aganwadis, the functioning of the aganwadis needs systemic support to ensure its true efficacy. The need to upgrade the day care to anganwadi- cum-crèches would be the lifeline to working mothers (mostly from the unorganized sectors) who can leave their children behind in the day-care centre, while they earn their bread.

Taking heed to the Supreme Court intervention at the colossal rotting of food grain, the United Progressive Alliance (UPA) government has finally made a decision to reach PDSs in 150 districts in the neglected -rural -poverty-belt of Bihar, Chhattisgarh, Jharkhand, Orissa, Assam, eastern Uttar Pradesh, Madhya Pradesh and Rajasthan.

National Rural Health Mission (NRHM) has helped in strengthening the public health systems through the induction of the grass root workers like the Auxiliary Nurse Midwife (ANM) and Accredited Social Health Activist (ASHA). Today they play a pivotal role in ensuring that maternal and infant mortality is checked by encouraging institutional delivery, counselling and support on breastfeeding practises, guidance on maternal and child health, information dissemination on maternity entailments among other things.

Our Tomorrow

We have a promise to keep: to save our children from the perils of hunger, starvation, malnourishment and death. We owe it to every child that we will create an environment that is equal, fair and just, where a child is nurtured to grow to his/her full potential. This world belongs to them, despite their silence. They have a right to the earth beneath, the sky above, the wind and water around them. If we cannot do everything in our power to lessen the burden on their delicate lives, we would have done a disfavour to ourselves.

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