* Rajesh Manjhi, from Harvanshpur village in Vaishali, lost his seven-year-old daughter to AES a fortnight ago. Manjhi, with just a ration card to show for the government’s role in his life, has now moved to Lalganj, about 10 km away, with his five children, to escape the shadow of disease.
* Raj Kishor Ram, who lost his four-year-old son to AES a fortnight ago, lives in a thatched house in Muzaffarpur’s Jagarnathpur Dok village. Again, his only link to the government is a ration card.
IT’S A common thread running through the stories of patients and families in Muzaffarpur and Vaishali, the Ground Zero of the latest AES outbreak in Bihar that has led to 130 deaths so far — their lives have largely been untouched by state and central schemes, from health and nutrition to sanitation and social welfare. With the Supreme Court Monday seeking a report on the outbreak, The Indian Express spoke to 12 families of AES victims in this arc, all of them from SC and EBC communities, and found none of them even had a toilet at home.
Most of them said the only benefit they get from the government is the 5 kg of rice or wheat for each member and kerosene at subsidised rate through ration cards. Some said they have received Ayushman Bharat health cards that entitle them to cashless medical care in government or private hospitals for up to Rs 5 lakh. But then, they said, no one has told them how to use the cards.
Bihar’s AES crisis: ‘Heat, humidity, malnutrition make Muzaffarpur susceptible’
When contacted, Bihar Health Minister Mangal Pandey said: “We are coordinating with the Social Welfare Department on the progress of schemes. But our top priority now is to boost health services in Muzaffarpur.” Bihar Chief Secretary Deepak Kumar has ordered a socio-economic survey of over 650 AES-affected families to address malnutrition and sanitation.
On the ground, meanwhile, the disconnect is obvious. Consider this:
RATION CARDS: Most of the 12 families have ration cards. A yellow card holder under the Antyodaya Anna Yojana, a central scheme to provide subsidised food to the poorest, gets a fixed 35 kg of grain at 5 kg per person. “We were told by some families that we miss out on buying ration during a month, the scheme would lapse. So many of us have not utilised it. Besides, the dealers do not give us any additional grain,” says Chaturi Sahni of Harvanshpur village in Vaishali.
POSHAHAR YOJANA: Experts say malnutrition and dip in sugar levels are key reasons for the spread of AES. And according to the 2015-16 National Family Health Survey 4 (NFHS-4) report, 48 per cent children below five in Bihar were found to be affected by stunted growth. But under the Integrated Child Development Scheme (ICDS), a child between three and six is given free meals: khichri (Monday), pulao (Tuesday), khichri and milk (Wednesday), halwa (Thursday), rasiya and egg (Friday), and khichri (Saturday). Besides, mothers with children below three get to take home ration of 3 kg rice, 1.5 kg lentils and pulses, and 500 gm soyabean.
However, AES-affected families from Saraiya in Muzaffarpur said that what they actually get is far lesser. Raj Kishor Ram said his children get only khichri and pulao at anganwadis, never milk and egg. AES-hit families in Kanti and Bhagwanpur blocks, in Vaishali, also said that they get only khichri under the scheme.
AYUSHMAN BHARAT: An employee at the Saraiya Community Health Centre said that of about 3.8 lakh people in the block, only 28,000 have got Ayushman Bharat cards. At Harvanshpur in Vaishali, some residents showed envelopes with the cards still inside. They said they had not used the cards because they are still waiting for someone to explain what it means. Employees at the health centres in Mushahari and Kanti said the scheme is “picking up but there is a great need to make people aware about how to use the cards”.
KANYA UTTHAN YOJANA: Under this state scheme, mothers of girl children who have turned two and have completed the vaccination schedule, get a one-time payment of Rs 2,000. But several of the 12 families in the AES-affected area had not heard about the scheme. “There are about 700 houses in this village of Manjhis. I have not heard of anyone benefitting from this scheme. Most of us have never been to school and do not know about many of the government schemes,” said Chandrashekhar Manjhi of Harvanshpur.
PRADHAN MANTRI MATRU VANDANA YOJANA: Under this central scheme, a pregnant woman gets Rs 6,000 for tests, delivery and subsequent vaccination of children. “There are some beneficiaries, but there is little awareness about it,” said a health worker in Harvanshpur. In Saraiya and Kanti, too, several residents are not aware of this scheme. “It is the job of government representatives to tell people about such schemes,” said Anita Devi of Mirzapur village in Kanti who lost her three-year-old son to AES.
MUKHYAMANTRI CHIKITSA SAHAYATA KOSH: The state government has earmarked a fixed fund for BPL families to help treat critical diseases, with or without surgery, within and outside Bihar: Rs 60,000 for cancer with surgery, and Rs 20,000 without surgery; Rs 35,000-Rs 90,000 for heart ailments; Rs 1,50,000 for serious kidney ailments and Rs 15,000-Rs 25,000 for brain tumour surgeries; and, for other ailments. But no one in the SC and EBC settlements of Saraiya, Kanti, Mushahari and Bhagwanpur knows about this benefit.
SWACHH BHARAT: The Bihar government has promised to make the state Open Defecation Free (ODF) by October, with help from the Centre, but there are complaints of bribes of up to Rs 2,000 being demanded by local officials. “The worst part is that we have to construct the toilet first and then seek reimbursement. Had we been able to make a toilet on our own, what is the need for government help?” said Devi from Mirzapur.
NAL JAL YOJANA: Devi, however, proudly displays the plastic tap in front of her house. Most of her neighbours have it, too. “It runs only two times a day, but we are getting clean drinking water,” said Devi, who also praised Bihar Chief Minister for the “good electricity supply”. But residents of Narayan Bheriyahi and Harvanshpur said the scheme has not reached them. In the Mahadalit village of Jagarnathpur Dok, the scheme is yet to reach the 50 homes.
MIDDAY MEAL: The one bright spot amid the despair among the AES-hit families is the midday meal scheme, which is being run in 75,000 schools catering to 2.5 crore children. “We have complaints about the quality of food but then, you cannot get a better meal for Rs 5 in these parts,” said Birendra Sahni of Sivuri Bihanbara village in Saraiya.
PRADHAN MANTRI AWAS YOJANA: None of 12 AES families has benefitted from this central housing scheme — they live either in thatched houses or those made of mud and brick with thatched roofs. In Harvanshpur, Chandrashekhar Manjhi pointed to the houses of some neighbours that were constructed under the scheme years ago. All of them had plaster peeling off from the ceiling.