The recent report about children’s death due to malnutrition in Attappady of Palakkad district, Kerala is depressing. There are 46 such incidents reported from Attapady in last 18 months . The media reports and interventions trigger off discussions on nutritious status of Adivasies and other marginalized communities in Kerala. However the government and the departments concerned are trying to portray it as an isolated incident happening only in Attappady. They also come up with theories and expert opinions ranging from genetical and alcoholism to cultural practices of Adivasies, all of them essentially implicating Adivasies themselves are responsible for such tragic incidents and announcing packages after packages for AttappadyWhat is happening in Attapady is grave and gross violation of all notions of Human rights and needs urgent and meaningful intervention of the state. Nevertheless, we also should not forget that what is unfolding in Attapady is just a tip of the iceberg. In addition, there are media reports coming from different parts of Kerala citing similar incidents.
1 The recent report about children’s death 1 due to malnutrition in Attappady of Palakkad district, Kerala is depressing. There are 46 such incidents reported from Attapady in last 18 months 2 . The media reports and interventions trigger off discussions on nutritious status of Adivasies and other marginalized communities in Kerala. However the government and the departments concerned are trying to portray it as an isolated incident happening only in Attappady. They also come up with theories and expert opinions ranging from genetical and alcoholism to cultural practices of Adivasies, all of them essentially implicating Adivasies themselves are responsible for such tragic incidents and announcing packages after packages 3 for Attappady What is happening in Attapady is grave and gross violation of all notions of Human rights and needs urgent and meaningful intervention of the state. Nevertheless, we also should not forget that what is unfolding in Attapady is just a tip of the iceberg. In addition, there are media reports coming from different parts of Kerala citing similar incidents. 4 In this note, we are mainly looking in to the issue of malnutrition in Kerala, focusing marginalized communities namely dalit, Adivasies and Fishing communities. Malnutrition and marginalized in Kerala – A note 1 39 such deaths reported in the media from March onwards 2 Reporter TV 3 http://www.keralacm.gov.in/index.php/homenewtopnew/34-frontslider/1723-attapady 4 h t tp://w w w .india vision tv .c om/ 2 013/ 05 / 18 / 2 054 7 5.h tml h t tp://w w w .me diaone tv .in/ne w s/ 7 141/mon-05 2 0 2 013-0 7 4 9
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The recent report about children’s death1 due to malnutrition in Attappady of Palakkad district,Kerala is depressing. There are 46 such incidents reported from Attapady in last 18 months2.The media reports and interventions trigger off discussions on nutritious status of Adivasiesand other marginalized communities in Kerala. However the government and the departmentsconcerned are trying to portray it as an isolated incident happening only in Attappady. Theyalso come up with theories and expert opinions ranging from genetical and alcoholism tocultural practices of Adivasies, all of them essentially implicating Adivasies themselves areresponsible for such tragic incidents and announcing packages after packages3 for AttappadyWhat is happening in Attapady is grave and gross violation of all notions of Human rights andneeds urgent and meaningful intervention of the state. Nevertheless, we also should not forgetthat what is unfolding in Attapady is just a tip of the iceberg. In addition, there are mediareports coming from different parts of Kerala citing similar incidents.4 In this note, we aremainly looking in to the issue of malnutrition in Kerala, focusing marginalized communitiesnamely dalit, Adivasies and Fishing communities.
Malnutrition and marginalized inKerala – A note
1 39 such deaths reported in the media from March onwards2 Reporter TV3 http://www.keralacm.gov.in/index.php/homenewtopnew/34-frontslider/1723-attapady4 http://www.indiavisiontv.com/2013/05/18/205475.htmlhttp://www.mediaonetv.in/news/7141/mon-05202013-0749
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Source: National Nutrition Monitoring bureau1Children at the age group of 0-6 constitute 9.95% of state’s total population.2 Surveysincluding National Family Health survey (NFHS) and National Nutrition Monitoring Bureaugive a critical picture of malnutrition among children in kerala. NFHS -3 data reveal that One-quarter of children under the age of five years in the State are either stunted or growthreflects a process of failure to reach linear growth potential as a result of suboptimalhealth and/or nutritional conditions3. 16 per cent are wasted or thinness indicates inmost cases a recent and severe process of weight loss, which is often associated withacute starvation and/or severe disease. 23 percent are underweight indicating too thin fortheir height and 23 per cent are underweight, indicating chronic and acute under-nutrition.The rate of severely malnourished children is higher in Kerala than that of Tamil Nadu andAndhra Pradesh.4
Malnutrition amongchildren in Kerala
1 National Institution Monitoring Bureau2 http://www.censusindia.gov.in/2011-prov-results/paper2/prov_results_paper2_kerala.html3 http://www.who.int/nutgrowthdb/about/introduction/en/index2.html4 Government of Kerala – economic Review 2012
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Astonishingly the data tells us that between NFHS -2 and NFHS -3 there is no significantprogress has been made even though state policy on children adopted in 2004 talks about inlength on combating the problem of malnutrition! It is also suggesting that the stateinstitutions that are designed to address the issue failed miserably.The infrastructure facilities available with 32115 AWC are pathetic. A study conducted byRIGHTS during the year 20121 found that 41% of ICDS centers do not have their own buildings.(Those centers which work in their own buildings are congested and not enough have spacewith any standard!!) 85% ICDS centers do not have electricity connection, 73 % No drinkingwater facilities, No gas connection for 72%, No toilets for 55% , No play ground for 94% and43% do not have separate kitchen. What is alarming is that the ICDS service provided only to25.1%2 children in the state between the age group 0-6, in other words state does not haveany clue about the health or nutritious status of 75 % children in Kerala!The pattern of budget allocation in the state budget is also a sign of state apathy towards theissue. “ICDS expenditure as a percentage of total revenue expenditure of state is just around 0.6 percentduring the entire tenth and eleventh plan period. It needs to be seen how the increase in number of beneficiariescan be managed with a static allocation of financial resources to ICDS.”3
1 ICDS and Panchayath Budgets2 http://wcd.nic.in/icdsdatatables.htm ( state reports)3 Mid Term Appraisal of the XI Plan of Kerala - Planning commission of India
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In addition, all most 80-85 % of the ICDS budget spent on salaries alone and the governmentwas able to provide service to AWC’s by using funds of other nutritional programs.More over the Auditor General tabled its report on ICDS in the Kerala Legislative assemblyduring the budget session 2013, gave dismal picture and the report was literally blasts thegovernment by following comments1:The department was not preparing any long term perspective plan. In the
absence of the plan, there were deficiencies in creation of new AWCs andinsufficiencies in the delivery of services to beneficiaries in variouscomponents in ICDS .
There was a shortage of 8,619 Anganwadi Centres (21 per cent) in theState. Fourteen additional Anganwadi Centres (AWCs), sanctioned in2005 by GOI, were yet to be operationalized.
Many functional AWCs in the test checked ICDS projects werefunctioning in rented premises and lacked basic infrastructure facilitieslike safe drinking water, toilets, etc.
The percentage of child population who were not immunized againstPolio and DPT in Palakkad and Malappuram districts were respectively36 and 31.
The objective of universalization of Supplementary Nutrition Programmewas not achieved as 56 to 66 per cent of the identified beneficiaries werenot covered under the Scheme.
The percentage of malnourished children below the age of six years in theState ranged between 27 and 39. Test check of records in Idukki,Malappuram, Palakkad and Thiruvananthapuram districts indicatedthat 110 out of 1180 children who died during 2011-12, were severelymalnourished.
GOI guidelines stipulating periodical weighment of child beneficiariesunder Supplementary Nutrition Programme to assess their nutritionalstatus was not adhered to during 2007-12.There are number of other statistical reports and information are now available with thegovernment and in the public domain to prove that malnutrition is a serious threat in thestate. However, state still refuse to accept the fact and tend to believe and make the society tobelieve that malnutrition is a phenomenon remains only in some Adivasi pockets in the state.As we have discussed earlier, most of the child population in Kerala did not came under themonitoring net of the state, then who are these children in the data?In spite of the existence of low income rates, the incredible achievements in the life index issaid to be the core of Kerala development’1’. One of the points highlighted as specific to Keralamodel development is that the distribution of economic services based on equality and socialjustice has been obtained. The statistical data of achievements in health and educational sectorshave been constantly evoked as the signs of victory of the model. While ‘Kerala developmentmodel’ gained national and international appreciation as an adaptable development ideal,the experiences of the marginalized of Kerala was entirely excluded from the much acclaimedstatistical information and academic studies. The troubled realities of the marginalized werehidden in the much-hyped statistical wonders produced in time to time by the defenders ofthe model. “…... When a Malayali who compares health care in kerala that in developed countries
chooses, when it comes to dalits, to llok towards Bhihar, it is offensive in two ways. First, by establishing thenotorious and appalling massacres of dalits in Bihar as the sole forms of oppression that Dalits face….”2
2 kerala Padanagal, Kerala Shastha Sahithya Parishath3 Sunny M Kapikadu- No alphabet in sight
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While discussing Horizontal Inequalities that persist in Kerala among Dalits, Adivasies andfishing communities Human development report 2005 pointed out “….There is no denying one’slocation within the network of social affiliation substantially affects one’s access to resources…”. The definingfactor of malnutrition is the “Socioeconomic inequality”, as explained by different WHO1documents, is the degree to which childhood malnutrition rates differ between more and lesssocially and economically advantaged groups and their access to the resources. It is veryclear that the Dalit Adivasi and fishing communities the ‘out layers’ of Kerala Developmentand their social economic deprivation made children of these communities become mostvulnerable when it comes to the questionof malnutrition.
Dalits constitute around 10% totalpopulation of the state. 81% of scheduledcaste population lives in villages, 95.6% areagricultural labors and wage labors1. The60% of scheduled caste live in 25906scheduled caste colonies in Kerala2.Children compose 12% to total dalitpopulation3. Exclusion of dalits from socio–economic field of the state is a reality inKerala. At least, those who defend Keralamodel now accept the fact that there areexcluded communities from the so-called development. There is nothing to be surprised about acommunity, in which 70% are wage labors and 83% hold less than 10 cents of land, more than60% living in ghettos, lag behind over all development4.1 http://www.who.int/bulletin/volumes/86/4/07-044800/en/1 Census data 20012 Kerala Institute of local administration – under RTI3 Economic review 20114 RIGHTS report- lessons of discrimination in development
Dallit
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Percentage of children under 5 year classified as malnourished according to anthropometric of nutritionalstatus, Kerala
The chart above exemplifies the miserable malnutrition status of Dalits in Kerala. In differentstages of malnutrition, State average is 24.5 (Height for age) 15.9 (Weight for height) 22.9(weight for age) while Dalits lags behind 33.7, 16.5 and 25.4 respectively. In addition, differentdevelopment indices devised by the planning board and other government departments suchas poverty, and district variance in progress etc, the districts that have large concentration ofdalits and advisees far below the state average.
At national level, population ofAdivasies is above 8% to the totalpopulation; while in KeralaAdivasies constitute just 1.41percent to total population. TheAdivasies in Kerala are not onlygeographically concentrated, butare overwhelmingly rural. Highestconcentration of Scheduled Tribesis seen in Wayanad district (37.36%) followed by Idukki (14 %) and
Adivasi
1 Census data 2011
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Palakkad (10.8 %) and these three districts together account for over 60 per cent of STs inthe State. The costal district of Alappuzha has the lowest percentage2 (0.15%). Childrenconstitute about 14 % of Total Adivasi population.
Above chart is a survey conducted by national nutrition monitoring bureau on Tribal childrenup to the age of 12 months. Among Adivasi children in Kerala presence Severe under weight(9.1%), severe stunting (32.2) and severe wasting (7%). In all other age groups, the resultsare more or less the same. Planning commission of India in its ‘Kerala development report1’place it straight “… rural poverty among adivasis in Kerala persists and comes to more than two-and-halftimes that of the rural population of kerala in general. Adivasis constitute only around one per cent of thestate’s population, nearly one-fouth of them still live below the official poverty line; the actual incidence ofpoverty among them could be even higher, this high incidence of poverty among adivsies points to thevarious dimensions of social inequalities prevalent in the state ….” What is unfolding in Attapadi todayis manifestation acute hunger and poverty among adivasies in kerala.
1 Kerala Government Economic review 2011
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“..Fishermen community still remains underprivileged in Kerala. Nine districts of Kerala havecoastal areas. The Kerala coastline running to about 600 kms forms 10% of India’s coastline.The number of fishermen of Kerala is estimated at 189200, one-fifth of traditional fishermenin India. People living in the long coastal belt have all the disadvantage of environmentalmismanagement. Congested living, lack of safe drinking water and sanitation, highprevalence of water borne diseases, low immunization status and family planningachievements1…..”. The statistical information about fish that has been caught and theforeign currency earned by the country and its share to GDP and SDP are available with thegovernment even with weekly breakup! Sadly the government has or conducted anysurveys so far to review the socio-economic profile of fishing communities. In real terms,the health indices of fishing communities are more or less same as Dalits and Asdivasies.Theeradesha Samrakashna Samithi a grassroots organization working among costal peopleconducted survey in 2012 in Alapad Panchayath. Alappad panchayath contain 8 of the fishingvillage out 222 fishing village in the state. Survey found that 54 % children belw the age of 0-6are malnourished!
Fishing communities
1 http://planningcommission.gov.in/plans/stateplan/index.php?state=b_sdrbody.htm1 Kerala Government Economic Review 2011
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It is evident from the chart that apart from poor delivery of service, infrastructure facilitiesavailable for marginalized communities also extremely pitiable and far bellow from the stateaverage and yet another example of ‘service to the poor is poor service’ .
