ASIAN HUMAN RIGHTS COMMISSION - HUNGER ALERT PROGRAMME

Hunger Alert Update: AHRC-HAU-006-2009

 <http://www.ahrchk.net/ua/support.php?ua=HAU-006-2009 >
<http://www.ahrchk.net/ua/support.php?ua=HAU-006-2009>

June 2009

[RE: AHRC-HAU-003-2009: UPDATE (India): Two children suffer from
malnutrition in Khandwa district of Madhya Pradesh]

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INDIA: Home-based treatment for the malnourished children living in
remote rural area needs to be encouraged

ISSUES: Right to food; right to health; malnutrition; government
neglect

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Dear Friends,

The Asian Human Rights Commission (AHRC) has received updated
information regarding two malnourished children from a human rights
group based in Madhya Pradesh, Spandan Samaj Seva Samiti (Spandan).
One was taken to the district hospital to get treatment while another
was not. As the family live in remote rural village, they find it
difficult to take the child to the district hospital which is 100
kilometres away from the village. In addition, to this if the mother
takes the child to the hospital and remains with the child there is
no one who can take care of the other children and do the housework
in her place.

The AHRC recommends that the government provide special medical care
to malnourished children, not only by the Nutrition Rehabilitation
Centre but also by strengthening existing facilities and services in
the villages.

UPDATED INFORMATION:

Two-year-old girl Sumantra, accompanying her mother was taken to the
Nutrition Rehabilitation Centre (NRC) at Khandwa District Hospital in
May. She suffered from Severe Acute Malnutrition (SAM) which was
reported in AHRC-HAU-003-2009
<http://www.ahrchk.net/ua/mainfile.php/2009/3146/>
<http://www.ahrchk.net/ua/mainfile.php/2009/3146/>
.

In response to the AHRC's report, the Chief Medical Officer, Dr.
Laxmi Baghel visited Chadida village and encouraged the families of
the two malnourished children to take their children to the NRC for
proper treatment.

The district administration provided free transportation for Sumantra
and her mother to reach the district hospital which is 100 kilometres
away from the village. Sumantra was admitted at the hospital and
underwent nutrition and medical treatment for twelve days. She gained
weight after the treatment and is now able to crawl. The Anganwadi
Centre (AC; Child Care Centre) in the village also currently provides
dried rations for her either by AC worker visiting her home or by her
mother visiting the AC.

On the contrary, the family of the three-year-old boy, Sonaram could
not manage medical treatment for him at the district hospital.
Although Sonaram's parents were worried about his health, there are
other children to be looked after by mother. As they live in remote
forest area, the district hospital is too far away from their
village. The family are trying to take care of Sonaram at home whilst
looking after the other children and doing the house and farm work.

Both of the families were issued Antyodaya ration cards with which
the families can afford to collect rice and wheat at three rupees and
two rupees per kilogram respectively. Earlier, Sumantra's family had
an Above the Poverty Line (APL) ration card and Sonaram's family had
a Below the Poverty Line (BPL) card. The AC gradually started
functioning better by providing dried ration to the malnourished
children in the village. However, only 35 kilograms of rice and wheat
per month are given to each card holder which is not sufficient for
all family members.

ADDITIONAL COMMENT:

The rainy season in Madhya Pradesh starting from June is called
'season of death' as many children die of malnutrition and various
diseases during this period. Sixty-two children in Khandwa district
alone died of malnutrition since June 2008. The children from
different villages are currently being taken to the NRC at district
hospitals. For the details about the children's death in 2008, please
refer to the AHRC-HAC-002-2009
<http://www.ahrchk.net/ua/mainfile.php/2009/3139/>
<http://www.ahrchk.net/ua/mainfile.php/2009/3139/>
.

According to the Spandan, thirty children from Khalwa Block have been
already taken to the NRC. It seems that the district administration,
in association with the state government is making an effort to
prevent child death during this particular period by providing
nutrition and medical attention at the centre.

As was seen last year from the government announcement, particularly
from the Department of Women and Child Development, the parents who
have malnourished children are encouraged to take their children to
the NRC at the district hospital. It is also suggested to that they
do not remove the children from the NRC without letting the medical
officer know.

Given the fact that the NRC merely pay attention to the SAM including
stage III and IV, many children who suffer from malnutrition still
remain at home without proper treatment. It was already observed in
previous hunger alert
<http://www.ahrchk.net/ua/mainfile.php/2009/3139/>
<http://www.ahrchk.net/ua/mainfile.php/2009/3139/>
 that even some children taken to the NRC last year were sent back
home as the doctors did not diagnose them as SAM patients although
the children suffered from malnutrition.

Moreover, the parents find it difficult to take care of other
children and their housework while they stay with the malnourished
child at the NRC. Often the NRC is far way from villages, which in
itself is an impediment for the villagers, in addition to their
difficulty to cope up with the life in the towns which is alien to
them. Both of the families in this case have to manage farming
everyday which also makes it difficult for them to stay away from
home for long periods.

A mother accompanying her malnourished child is expected to receive
65 rupees a day for her own meals and the daily income which she
loses due to having to attend to her child at the NRC. The amount is
earmarked as the official minimum wage in Madhya Pradesh. However,
the minimum wage of the agriculture workers (65 rupees) is lower than
other industry sectors (93 rupees). Despite soaring food prices as
well as the rising costs of goods, the minimum wage of the
agriculture workers remains much lower than the actual cost of
living. The government takes it granted merely because the
agriculture workers are traditional and unskilled labour although the
population of the agriculture sector accounts for more than 60 percent
of the total industry. In addition, a number of small-scale-farm
owners even do not pay minimum wage to the agricultural labourers in
practice.

Most of all, considering the living conditions of the tribal
community, it is recommended to provide special medical care to the
children in all stages of malnutrition, not only at the NRC but also
in the village through the existing facilities such as AC which will
be more prompt and effective. Thus the parents also can manage to
look after other children, house work and farming whilst remaining at
home.

On 12 June, the Department of Women and Child Development announced
that they plan to select 250 villages out of a total of 1000 that are
prone to food insecurity and child malnutrition, in order to provide
special attention to the children by strengthening the ACs in the
village. The villages in Khalwa block occupied by the Korku tribal
community have lost many of their children to malnutrition. The
community still have a number of malnourished children who should be
given priority.

SUGGESTED ACTION:

Please write a letter to the authorities named below to express your
concern for the children and their families. The AHRC is also writing
a separate letter to the UN Special Rapporteur on the Right to Food
and on the right of everyone to the enjoyment of the highest
attainable standard of physical and mental health respectively
calling for intervention.

To support this appeal, please click here:
<http://www.ahrchk.net/ua/support.php?ua=HAU-006-2009 >
<http://www.ahrchk.net/ua/support.php?ua=HAU-006-2009>

SAMPLE LETTER:

Dear __________,

INDIA: Please provide medical care for the malnourished children not
only at the Nutrition Rehabilitation Centre but also within the
villages, Madhya Pradesh

Children suffering from malnutrition:

1. Sonaram Manag Kasde, three years old, suffering from Sever Acute
Malnutrition

2. Other malnourished children from Khalwa Block currently admitted
at the Nutrition Rehabilitation Centre of Khandwa district

Location: Khalwa Block, Khandwa district, Madhya Pradesh

I am writing to express my concern about the malnourished children in
Khalwa Block in Khandwa district who do not receive appropriate
medical care to escape from starvation and malnutrition.

I have learned that the Asian Human Rights Commission (AHRC) has
reported in April 2009 the case of two children who were suffering
from Severe Acute Malnutrition living in remote rural area in Khalwa
Block, Khandwa district.

I am informed that one of two children reported in that case received
treatment at the Nutrition Rehabilitation Centre (NRC) after the Chief
Medical Officer visited the village and encouraged the parents to take
the child to the NRC. It is good to hear that the child and her mother
were provided with transportation and medical care by the government.
I am informed that the child gained weight and now is able to crawl
around.

However, I am concerned about the second child, Sonaram, who could
not receive appropriate treatment at the NRC. I am informed that
Sonaram's family could not take him to the NRC since the family could
not afford to stay away from home leaving other children and their job
which is their only source of income and since the NRC is far away in
the town. As of today Sonaram is yet to receive an appropriate
treatment.

This exposes one of the practical yet important deficits of the
treatment scheme. Instead of the patients reaching the NRC, the
facilities provided at the NRC must reach the patients, particularly
in the rural backdrop, were the patients reside in remote areas away
from town. The treatment programme must be geared to ensure that
while one child receives treatment, the rest of the family must not
be pushed to starvation since the earning member in the family is
forced to leave his or her job to accompany the child.

As the parent has to look after other children, housework and farm
work for a living, they find it difficult to take the child to the
NRC at the district hospital which in Sonaram's case is 100
kilometres away from the village. The tribes living in remote forest
area are also not familiar with town life which is another reason for
them not to stay away from the village for long period of time. In
addition, the subsidy given to mother for three meals a day and daily
income is not sufficient to manage it. The existing scheme and service
provided through agencies like the NRC must therefore be made
available in the village.

Most of all, considering the living condition of the tribal
community, it is recommended to provide special medical care to the
all stages of malnourished children not only at the NRC but also in
the village through the existing facilities such as AC which will be
more prompt and effective. Thus the parent also can manage to look
after other children, house work and farming at home whilst remaining
at home.

I am of opinion that to eradicate child malnutrition and to ensure
food security, the government needs to take more active and prompt
action by fortification of village level of medical service and
nutrition supply.

I am aware that on 12 June, the Department of Women and Child
Development announced that they plan to select 250 villages out of
1000 villages that are vulnerable to food security and child
malnutrition, in order to provide special schemes for the children by
strengthening the ACs in the village. The villages in Khalwa block
occupied by Korku tribal community who have faced many child deaths
and who still have a number of malnourished children should be given
priority.

I am looking forward to your positive and effective action for all
the malnourished children in Madhya Pradesh.

Yours sincerely,

--------------

PLEASE SEND YOUR LETTERS TO:

1. Renuka Chowdhury

Minister of Women and Child Development

Government of India

INDIA

Fax: +91 11 2307 4054

E-mail: [email protected] <mailto:[email protected]> <[email protected]>

2. Justice Mr. Balakrishnan

Chief Justice of India

Through the Office of the Registrar General

Supreme Court of India

1 Tilak Marg, New Delhi

INDIA

Fax: +91 11 2338 3792

E-mail: [email protected] <mailto:[email protected]> <[email protected]>

3. Principal Secretary

Ministry of Health & Family Welfare

Nirman Bhavan

Maulana Azad Road

New Delhi - 110011

INDIA

Fax: +91 11 2306 1751

E-mail: [email protected] <mailto:[email protected]> <[email protected]>

4. Mr. Shivraj Singh Chouhan

Chief Minister

Madhya Pradesh

INDIA

Fax: +91 755 2441781

5. R. C. Sahni

Chief Secretary

Government of Madhya Pradesh

Mantralaya,

Bhopal 462 004

Madhya Pradesh

INDIA

E-mail: [email protected] <mailto:[email protected]>
<[email protected]>

6. S.B. Singh

District Collector

Khandwa District, Madhya Pradesh

450001

INDA

Fax: +91 733 2224233

E-mail: [email protected] <mailto:[email protected]> <[email protected]>

7. Country Director

World Food Programme

2 Poorvi Marg, Vasant Vihar

New Delhi 110057

INDIA

Fax: +91 112 615 0019

E-mail: [email protected] <mailto:[email protected]>
<[email protected]>

8. UNICEF

73 Lodi Estates

New Delhi 110 003

INDIA

Fax: + 91 11 2462 7521 / 11 2469 1410

E-mail: [email protected] <mailto:[email protected]> <[email protected]>

Thank you.

Right to Food Programme ([email protected]
<mailto:[email protected]> <[email protected]>
)

Urgent Appeals Programme ([email protected] <mailto:[email protected]> 
<[email protected]>
)

Asian Human Rights Commission

 <http://www.ahrchk.net/ua/support.php?ua=HAU-006-2009 >
<http://www.ahrchk.net/ua/support.php?ua=HAU-006-2009>



-----------------------------
Asian Human Rights Commission
19/F, Go-Up Commercial Building,
998 Canton Road, Kowloon, Hongkong S.A.R.
Tel: +(852) - 2698-6339 Fax: +(852) - 2698-6367



-- 
W A Laskar
Freelance Reporter and Human Rights Activist
with Barak Human Rights Protection Committee,
http://bhrpc.net.googlepages.com
15, Panjabari Road, Darandha, Six Mile,
Guwahati-781037, Assam, India
Cell: +919401134314

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