Health

Poor Implementation of Schemes Behind Malnutrition Deaths in Maharashtra’s Palghar

Malnutrition is worsened by a dearth of specialty doctors, unawareness about healthcare schemes and a severe lack of purchasing capacity among tribals

Over 600 children so far this year have died due to malnutrition in Palghar district. Credit: PTI

Over 600 children so far this year have died due to malnutrition in Palghar district. Credit: PTI

About 107 kms from Maharashtra’s capital city Mumbai lies the Palghar district, where over 600 children so far this year have died due to malnutrition. The district also happens to be the constituency of the tribal development minister Vishnu Savara. Even though the media has created much hue and cry over these deaths, the state government has continued to a turn blind eye to the grievous issue.

It was the National Human Rights Commission (NHRC) that took suo motu cognisance of the media reports and on September 22 issued a notice to the state government seeking a report on the malnutrition deaths. The NHRC also observed that such a huge number of deaths of children in a year amounted to a violation of the right to life and health of the victims.

Instances of malnutrition and the resultant deaths from it are not new in Palghar, which is predominantly a tribal district. According to Hemendra Patil, who sought information on it through an RTI application, “Every year 300-400 kids die due to malnutrition. The number of death of kids is 512, 485 and 600 for the year 2013-14, 14-15 and 15-16 respectively. The number of malnourished kids is not less. Palghar has a severe number of malnourished kids – 1,465, which means that they need immediate treatment. Moderately malnourished kids number 5,864. Thus the district has overall 7,230 malnourished kids and blocks Makhoda, Vada, Vikramgad and Jawhar are the worst affected.”

The death of two-year-old Sagar Wagh – who weighed 4.6 kg – on August 30 brought the issue of malnutrition in focus. When the tribal minister Savara finally went to visit the family of the victim after two weeks, they refused to meet him.

Answering the media’s queries about the high number of deaths, Savara said, “So what?”, which did not sit well with the people. RTI activist Patil points out that “3,663 kids are battling with malnutrition in the constituency of Savara.”

Vivek Pandit, the head of Shramjivi Sanghatana – a voluntary organisation that works on the issue of malnutrition in Palghar – said, “there is no dearth of welfare or healthcare schemes, but their implementation is the issue. Tribals who are affected by poverty and illiteracy are not aware of the government welfare and healthcare schemes.”

Malnourished childrem in Mokhada Government Hospital.

Malnourished children in Mokhada Government Hospital. Credit: Varsha Torgalkar

Pandu Malak, the sarpanch of Shirson Pada, Mokhada block, said, “Schemes are marred by one or other issue. For example, Rs 25 is allocated per person per meal for pregnant and milking women under Dr. Abdul Kalam Amrut Ahar Scheme. It is impossible to have nutritious food in Rs 25. Anganwadi workers who implement the scheme are reimbursed the amount and that too after six-seven months. Not surprisingly, the scheme is a failure.”

Patil revealed that “12 out of 13 posts of Children Development Project Officers who address malnutrition in all eight blocks of the district are vacant. There is not a single paediatrician and gynaecologists in the primary health centres across the district. Patients have to be taken to Nashik or Thane, the adjoining districts, in an emergency.”

The collector of the district, Abhijit Bangar, acknowledged the loopholes in the system. “More than 50% posts of specialist doctors like paediatrician and gynaecologists are vacant and the administration is trying to fill the vacancies. Vacancies of CDPOs are also a serious issue. But the state government should fill those posts and we have already submitted the report.”

Stating the immediate steps that the government has taken, Bangar said, “We have done check up of all children across the district in August and September. We have restarted the Village Child Development Centres – the scheme to address malnutrition – with Rs 1.2 crore. Till now, 2,834 children are admitted in these centres. The district had four child treatment centres where malnourished children are treated under residential program. We have increased them to eight so that people do not have to travel.”

A malnourished child taking treatment at Mokhada Governmnet Hospital. Credit: Varsha Torgalkar

A malnourished child taking treatment at Mokhada Government Hospital. Credit: Varsha Torgalkar

Pandit added that “each family is supposed to get 35 kg of grain through public distribution system. But many PDS shops remain closed or give only 15-20 kg of grain. Many tribals do not have ration cards.”

Bangar said that he would look into the matter.

Pandit, offering an explanation to the root cause of the matter, said, “These are not malnourishment deaths. These are starvation deaths. People do not have purchasing capacity, they have no money to buy food or admit their children in schools. Kids are not malnourished; their entire families are malnourished.”

“Malnourishment is a symptom of a disease. The real problem is a lack of employment opportunities. Only land and forest can avail livelihood opportunities here in Konkan area as no industry or service industries are developed. The terrain is hilly and rainwater goes to the Arabian Sea. No irrigation projects have been designed and built in the last 60 years. The government needs to develop land and forest to provide a livelihood. They could have availed employment through Mahatma Gandhi National Rural Employment Guarantee Act.”

Collector Bangar acknowledged the fact that the lack of opportunities is the major issue. “We have begun skill development programs for youth. They will be given jobs once they complete the programs. We are also providing help to women through self-help groups by assisting them financially to buy sewing machines and so on. Garment industries will commission them orders of stitching. This way we are trying to avail employment opportunities.”

“Due to nonavailability of water, farmers cannot harvest twice in a year. Hence we have dug more than 300 lakes across the district. This will help farmers to harvest twice a year controlling on migration. Palghar is now selected for Jalyukta Shivar scheme and next year the work will be continued.”

Mahadev Sawra, whose son died due to malnutrition on September 26. Credit: Varsha Torgalkar

Mahadev Sawra, whose son died due to malnutrition on September 26. Credit: Varsha Torgalkar

Activists, however, point out, “We have a number of schemes and funds. The issue is their poor implementation. Schemes and funds do not reach beneficiaries. ”

Meanwhile, the incidents of death in the district continue. On September 26, a five-year-old weighing 11.8 kgs from Mokhada died on the way to a hospital.