The death of midnight’s child

But ideas rooted in Constitutional values are irrelevant to contemporary wielders of power. They have been writing and relentlessly amplifying another Constitution of India, illicit but dressed up as Public Policy or Special Law.

In one section of this clandestine Constitution, the sarkar has thoughtfully discounted the Right to Life of children born in deprived families, mindlessly submitting to UNICEF formulae. Why UNICEF? One can only assume that friendship with UNICEF always earns you all-expense-paid-plus-dollar-allowance trips to famous cities of the world.

Take the Integrated Child Development Scheme (ICDS). It sets up anganwadis in villages and urban slums for the purpose of providing nutritional and other health support to pregnant mothers and children between 0 and 6 years. But the Government’s conceptualisation of ‘health’ of citizens thwarted by ‘developmental’ distortion is extremely harmful and most components of ‘assistance’ to assure life and good health end up depriving children further. The health appraisal parameters of children born in disadvantaged families and the responses to their needs are disdainful of children’s right to life, equity and special caring. Sixty-six child deaths per thousand live births every year, an unaccounted number of still births and lakhs of under-nutritioned children throughout the country show that the ICDS is flawed.

The ICDS mainstay, the anganwadi workers (AWs) meticulously register the names of the women and children entitled by the Scheme, and those dead. They laboriously maintain records of the weights of children from the day of birth till they attain age 6 or not; or become frail day by day. They conscientiously ledger the count of children struggling against the wasting metabolic process and the snuffed out lives. And they record the amount of khichdi (worth crores nationwide) fed.

A mammoth multi-tiered hierarchy of paramedics, field supervisors, doctors, health administrators, project officers, CEOs, secretaries of at least four departments, and occasionally UNICEF-sponsored surveyors peruse AWs’ registers. But children die and government collects number counts. Because the ICDS begins and persists with a negative concept of child life and health.

The ICDS’s a priori position is that children from disadvantaged families are not likely to enjoy normal health and/or thrive. As UNICEF explained in ‘Children and Women in India—A Situational Analysis, 1990’, a village or slum child weighing up to 20 per cent less than it ought to is classified as ‘normal’. A child with up to 30 per cent less weight is in the ‘mild’ Grade I of malnutrition. When she or he loses another 10 per cent, ie weighs 61 per cent of average, the child is not considered critically vulnerable, but simply ‘moderate’ Grade II.

The metabolic systems of children weighing up to 50 per cent or less than normal start feeding on the child’s own flesh to sustain life. Such children suffer brain damage and retrieval of their mental and physical health requires extraordinary efforts. The ICDS has camouflaged the expression for the children who use the leftover proteins in their own bodies as fodder to cling to life as simply ‘Grade III and IV.’

The ICDS does not take cognisance of health deficiencies (except like blindness) or specific vulnerabilities or even stunting of bodies. For the ICDS there is simply a single indicator of a child’s health—weight for the age. Even for this measure, the ICDS allots the lowest possible standard.

As has been recorded by hunger demographers and economists world over, as nutrition inputs dip, the child’s body adjusts by growing less. It starts stunting. The standard ICDS response to the slow ruining of a child’s life is a once-a-day feed of few morsels of khichdi.

When, in the negative glare of media, the sarkar packs desperately ill children into rural health centres, the parents are held hostage. In the mid-’90s, during tours of Melghat villages where about a thousand children die every year in a small tribal community of two lakh, I discovered that parents begged to be freed from these health centres to be able to take their children home to die. They preferred such a course of action than walking several kilometers holding their child’s dead body close to their chests.

Here is a reality check from Maharashtra, which claims a lower death rate of 45 per thousand. Last year, in 15 tribal districts and in Pune, nearly 5,800 children died. Yes, Pune. India’s most happening IT destination. In this upwardly mobile urban centre, 1,561 infant lives disintegrated before they had a chance to joyously romp and squeal. Another 1,273 were born dead.