A number of factors, including poor access to healthcare and increased pressure to work in hazardous conditions, is causing the mortality rate to rise.
Akauna, Bundelkhand (UP): The Bundelkhand region is spread over about 70,000 square kilometres, covering 13 districts in the states of Uttar Pradesh and Madhya Pradesh. For outsiders, Jhansi and Khajuraho are the region’s most recognisable locations. Throughout the region, people have been enduring a prolonged period of drought and other adverse weather conditions caused by climate change and large-scale economic ruin. At the same time, they are grappling with socio-economic conditions characterised by injustice and inequality.
In the last 16 months, people’s distress has been made worse by the intensification of adverse weather conditions, particularly (but not only) extreme drought. This has caused three crops to fail in a row, without allowing any time for recovery. This writer held group discussions in about 30 villages in five Bundelkhand districts in order to gain an understanding of the situation. These discussions were held during five visits to the region over a period of 16 months. This was apart from several earlier visits.
While group discussions in several villages strongly suggest that people have become physically weak and vulnerable due to chronic malnutrition and undernutrition, and that the overall mortality rate is rising as compared to times when there is no drought, it may not be correct to call these starvation deaths. In many cases, a number of factors contribute to the higher morality rate.
Reasons for higher mortality
Some of these reasons include the fact that people have been exposed to acute and chronic malnutrition because they have had to subsist on a bland diet of rotis with salt and chutney, or frugal meals of watery potatoes or whatever vegetable is the cheapest to buy. People have been denied staple sources of protein, such as pulses and milk. Even this meagre diet has not been available to over one-third of the populations. In addition, the number of trauma deaths, or deaths caused by prolonged tension related to crop ruin, economic ruin and the inability to meet essential expenses have increased. The rate of suicide has also increased for the same reasons.
People are also dying because of a lack of access to proper healthcare. Although people are more vulnerable to a range of health problems, they are unable to access treatment because of the poor state of public health facilities in the region and the very high cost of profit-oriented private healthcare. In many cases, people may not even attempt to receive treatment for ailments and injuries. Another reason for the high morality rate is people’s involvement in hazardous work because of a lack of alternatives. People, including women and children, work in a weakened physical state, much beyond their capacity. Many migrants work in hazardous conditions, contracting prolonged illnesses including undiagnosed occupational diseases.
On June 3, I visited five hamlets in Kulpahar tehsil in Uttar Pradesh’s Mahoba district to ask people whether there had been a rise in the morality rate. Everywhere, people confirmed that the mortality rate had certainly risen from was normal. However, people said this with varying levels of emphasis, with some saying that there had definitely been a significant increase and other saying less emphatically that there was bound to be some increase in such extreme conditions.
In Akauna, villagers said that four people had died in the previous month. While two elderly people had died of natural causes, two younger men had clearly died because of physical weakness and their inability to meet medical expenses. Villagers also spoke of many being in a bed-ridden or helpless state.
In Arghatmau and Kainthora, villagers said that people in the villages were suffering from serious malnutrition and chronic hunger. As Parvati from Kainthora said, “It is very distressing for us to see our children becoming weaker and weaker before our eyes.”
In all these villages, households are becoming vulnerable as more and more youngsters are migrating, leaving elderly relatives to their own devices and sometimes leaving young children to their care. Some of these children appear to be very sad and badly in need of proper parental care, apart from clearly needing more and better food. Some were wearing torn and dirty school uniforms even on school holidays, probably because they did not have any other clothes.
All the villages also have people with serious medical conditions who have not received any medical treatment or support, despite suffering for a long time. For example, a young girl called Reshma in Arghatmau had not been treated for a very painful tumour. Her father, Thakur Das, said, “I am helpless. I just don’t have any money for her treatment.” Another young girl called Seema in the Basor hamlet of Mahuabandh village had not received any treatment or other help for brain damage. For chronically ill people, serious drought brings even more vulnerability and suffering because of widespread hunger and the pressure on people to migrate.
This is the first of a three-part report on Bundelkhand.