Breakdown in Balangir

[Thanks to Dr Sanjib Kumar Karmee for sharing this in Kalahandia yahoo group.]

Hindustan Times, March 29, 2010
Priya Ranjan Sahu, Hindustan Times

As one of India’s 300 million officially poor people in one of its most impoverished districts, Kantamani Nag bought 25 kg of rice every month at Rs 2 per kg — five times cheaper than market rates — a fine example of the world's most sprawling subsidised-foodgrain network.


Of the sprawling cradle-to-grave national anti-poverty effort on which the Centre will spend more than Rs 1.18 lakh crore in 2010-11 to create a more inclusive, just India, only the Public Distribution System worked for the Nags — sort of.

Nag (40) kept half the rice for his wife and three children. He sold the rest, creating what is now unofficially called “subsidised-rice income” for the poorest in this western corner of Orissa, where the official poverty line is Rs 356 per month, or about the cost of an appetiser in a metropolitan five-star hotel. When Nag, wizened beyond his years, sold his subsidised rice (sometimes tea leaves and soap as well), it sent him into a death spiral that appears to play out like this across Balangir:

The rice that isn’t sold typically lasts 10 days or less. The family works odd jobs or begs rest of the month. Weakened without enough food, they fall ill for about 100 days each year. They borrow money to pay medical expenses. To repay the loan, they join the 100,000 who migrate to brick kilns and stone mines in Andhra Pradesh.

When they return, they are weaker; many die, not by starvation but from chronic hunger and malnutrition.

Nag’s family ended up working in the kilns and mines for six months every year. These trips took a toll on their weakened bodies. They took more loans to meet medical expenses. The last loan was Rs 20,000 at 10 per cent interest.

“After a time they found it difficult to repay,” said Kasturi Nag (42), Kantamani’s sister-in-law, who narrated their tale on a warm spring day in their western Orissa village of Kurenbahali. “As a result, they started eating less food.”

Growing, gnawing hunger

Breakfast for the Nags was a handful of puffed rice and tea without milk. Lunch was pakhal, watery rice, with an onion.

Dinner wasn’t very different — on the few days the Nags had any.

Hindustan Times recorded similar patterns in journeys to 55 families in 27 villages in Balangir, where 62 per cent of all families officially live below the poverty line across 6,575 sq km, more than four times larger than the National Capital Territory of Delhi.

In interviews, many officials in Balangir confirmed that they were witnessing a deepening cycle of poverty.

It could explain how millions of hungry people are slipping through the cracks nationwide; how shoddy implementation imperils well-meaning, ambitious national anti-hunger programmes; how mothers become malnourished, giving birth to more malnourished children than anywhere else in the world.

Every year, 3,000 pregnant women are admitted to Balangir’s hospitals. “More than 50 per cent are anaemic, malnourished,” said Dr Purnachandra Sahu, Balangir’s chief district medical officer. Theoretically, help is available, through the Integrated Child Development Scheme (ICDS), the world's largest programme for nutritional and school needs of children younger than six, administered through 1.4 million centres nationwide.

Though 80 million children are theoretically covered, one in two Indian children is malnourished, the world's worst rate.

In Balangir, there are free vitamins, proteins and medicine available.

The Nags appear to have used these centres at some point. The evidence: Their children are alive (though their condition isn't clear). For severely malnourished children, there’s Rs 500 to be had from the Chief Minister’s relief fund.

Sahu opened registers of Nutrition Day — held on the 15th of each month to provide dietary support to children — to show how about 3,000 malnourished children under age six are brought to Balangir’s 14 primary health centres every month. Sahu said 53 per cent of all children at his centres are malnourished.

In 2009, official ICDS figures say 87 children, or 0.04 per cent suffered the most severe malnourishment, grade IV, which means they needed urgent medical attention.

“The children are malnourished because in most cases the mothers are malnourished,” said Pratibha Mohanty, Balangir district’s social welfare officer.

The death rate of children under six is worsening. In 2006, 48 children died in every 1,000, rising to 52 the next two years; in 2009 it was 51, according to district health records. Balangir’s cycle of poverty continues into adulthood.

Most patients who come to Balangir hospitals today are anaemic, have gastrointestinal infections or are directly malnourished, according to district health records.

Stopping migration would certainly help already weak villagers. Theoretically, the Nags need not have migrated.

The world’s largest jobs-for-work programme, the National Employment Guarantee Scheme (NREGS), is supposed to help people like them, assuring them 100 days of employment every year. The national NREGS budget for 2010-11: Rs 40,000 crore, more than a third the size of the defence budget.

Here in Kurenbahali, there were no NREGS jobs in 2009. Thus far, there’s no sign of work this year either. “People would not migrate if NREGS works are done regularly through the year,” said Paleswar Bhoi (35), a villager.

Slippery statistics
Instead of the required 100 days, Orissa has provided no more than 35 days of work each year. Across most of Balangir’s 1,792 villages, NREGS work isn’t available for a full month in a year, HT’s inquiries revealed.

Sanjay Kumar Habada, project director for the district rural development agency, has another set of figures to share: NREGS projects across Balangir employ more than 30,000 people, whom the administration pays “We pay them Rs 30 lakh every day,” said Habada. It isn’t much use to the poorest.

Of the 240,000 people registered under the NREGS in Balangir, only 476 (0.2 per cent) live below the poverty line, according to the website of the Union Ministry for Rural Development.

Like a number of Balangir villagers dying in their 30s and 40s — the exact numbers are uncertain — Nag died in February 2008, officially of fever. His wife Kulbati (32) lived for 18 months more before dying of tuberculosis.

The statistics will not record the chronic hunger or malnourishment that possibly made the Nags susceptible to disease.

Officially, they died natural deaths.

Theoretically, the Nags’ children should, even at this stage, have been able to claim help from the state.

When the sole earning member dies, the family is eligible for Rs 10,000 under the National Family Benefit Scheme, created after a Supreme Court order.

The grant is supposed to be paid within four weeks of death: More than 15,000 applications are pending with the Balangir district administration “over years”.

No one can say how many years.

Nag’s sister-in-law, Kasturi, has never heard of such a scheme.

“I gather that many people fail to provide death certificates,” said Balangir Collector Sailendra Dey. “I have instructed officials to help people in submitting the death certificates so that the amount can be disbursed to the beneficiaries.”

Local lawyer Bishnu Prasad Sharma said the grant needed only an authorisation from a local ward member or sarpanch.

Bisnu Sahu, a naib sarpanch (village headman), said he never knew he had such authority. “No one ever told me,” he said.

The district collector, the chief administrative official, implied this was indeed the case. “I have asked officials to make people aware of the scheme,” Dey said.

Back near the Nags’ abandoned hut, Kasturi explained why a severe pain in her leg didn’t allow her to join her husband, son and daughter-in-law in the desperate migration south.

Where are the surviving Nags, the two daughters and a son, aged between seven and 16? Gone, said Kasturi, to that brick kiln in Andhra Pradesh.

For another generation, Balangir’s death cycle has started.

(The Hunger Project is a Hindustan Times effort to track, investigate and report every aspect of the struggle to rid India of hunger. You can read previous stories in this series at www.hindustantimes.com/hungerproject)