Malnutrition killing children in India's Shanghai

Malnutrition is killing children in the Rafi Nagar slum in Mumbai


Geetanjali Minhas | February 14, 2011

As you reach Rafi Nagar in the Shivaji Nagar slums of north eastern Mumbai, a distinctive stench fills your nose. Plastic waste, wet and dry garbage are piled all around. Urchins holding babies in their arms loiter around . Over 600 tarpaulin, sackcloth and tinsheet huts dot the area, clumped together. Behind the cluster of these dwellings is an enormous mountain of refuse and scrap - livelihood for the 5.5 lakh Muslim migrants who live in Rafi Nagar and nearby slums.

Most of them are rag pickers earning Rs 100-150 a day - 70 percent of which they get to keep, giving the the rest to the agent who buys the refuse.

Rafi Nagar is a forgotten part of the city for the civic authorities - no power, no water supply. Sanitation remains a distant dream. The families that live here typically have 7-12 members.

But the hardest hit is even more basic than these elementary amenities of urban living - nutrition. The most vulnerable groups - women and children - are severely hit by malnutrition here.

A part of India's Shanghai is comparable to failed nations of sub-Saharan Africa. While skyscrapers and bridges over the sea seek to create the most modern urban landscape, the mountain of waste and the slums compete to blot each other's ugliness.

Ever since April 2010, cases of children dying due to lack of adequate nutrition has been on the rise here.

Good governnace should have ensured a primary health care centre and education centre, enough water, sanitation and drainage. But none has come Rafi Nagar's way.

The slum's extension, Rafi Nagar part II is worse off because it has not been declared an authorised slum yet.

Mother of two children, 19 year-old Reshma has been married for two years and is physically weak . On December 9, she lost one of her children  - her one and a half year old son. He had been sick fo a few days . At the time of his death, the boy weighed 6 kg, and had been suffering from diarrhoea.

Reshma's husband, 20-year-old Mohammad Salman is a rag picker. Salman has never used any protective gear while sifting through mounds of waste, looking for scraps he can sell. Sometimes he covers his nose with a piece of cloth, if the stench gets unbearable. Otherwise, the stench does not bother him. What does is the government's rank apathy to his existence. "Government money never reaches us," he says, disgruntled.

Rubina, 25, had five children until last year. Her eight-month-old daughter was malnourished and did not survive. Months later, she lost her two-year-old son. Her husband, a drunkard abandoned her after their youngest one, a five-day old girl died in September. Neighbours have been looking after her remaining children ever since when Rubina goes to work as a ragpicker during the day.

Jahanaara,a 29-year-old, lost her seven-month old son Asif last December. He had suddenly fallen sick. With no drainage in her house and three children, she is forced to clean the sewerage from her house manually. A hole in the ground serves as a soak-pit, which she empties every two-or three days.

Five months back, Shamshad Begum lost one of her twin children at birth. They were born underweight and premature at six and a half month into the term, weighing 900 g each . The one that survived the birth was kept in hospital supervision for three months and died 20 days after he was brought home. She blames unhygienic conditions, sanitation, water problems and inadequate nutrition for his death. She now has four children.

Dipping temperatures in city, lack of shelter and medical facilities have added to low immunity among infants and toddlers. The mothers are malnourished and anemic. They themselves are prone to infection due to lack of hygiene. Most of them have not even heard of family planning.

Each family has 7-8 children, women getting pregnant every year after marriage. Poverty, lack of education and awareness and religious beliefs are main causes of this state. As per the WHO guidelines for monitoring child growth between the ages of 0- 72 months that the state government has started implementing from June 2010 onwards a new born's ideal birth weight, is 3.200 kg, normal weight is 2.400 kg, moderate underweight is between 2.000-2.400 kg and severe underweight is below 2.000 kilos.    

The health check ups on 198 children conducted by Apnalaya, a community organistion that has been working for betterment of slum children in Shivaji Nagar since 2005 , have revealed that only 29 children were found to be of ideal weight, 23 children fell into the first degree of malnutrition, 54 in second degree and 92 were found to be severely malnourished. Similarly, in April 2010 health check up of a of total 374 children revealed that only 173 children had ideal weight , 116 were in first degree of malnutrition, 66 in second degree and 19 children were severely malnourished.

It is a horrific case of complete governance failure and government apathy which local politicians and leaders have chosen to blame on rival parties absolving themselves of any blame whatsoever. Slum dwellers say that politicians come visiting them only during elections with tall promises of housing and basic amenities, put up centres to interact with them to fill up their vote banks. They next appear only five years later.

“When voting in this slum is legal why are slums not declared legal” asks one of the voters of Rafi Nagar. Besides lack of money, the Bombay Municipal Corporation is the other hurdle for constructing pucca houses.Caste-based politics has been used as a tool to exploit poor. The SRA  scheme has overlooked the fact that families with 5-6 members cannot stay in 270-square-feet-rooms. Further, as per statistics provided by Apnalaya , with each passing year number of child deaths have increased . Four children died in the year 2005-06, seven children died in the year 2006-07,eight in 2007-08,nine in 2008-2009 and thirteen children died in the year 2009-10. While five children died in April 2010, four children have died in the first 17 days of Dec 10.

Abu Asim Azmi, the local MLA (declared richest politician in Maharashtra) visited the slum after a media expose on the condition of the slum. He absolved himself of any blame and put the onus on previous congress government and ruling UPA government and said, "Poverty and malnutrition in Bhiwandi is not a new phenomenon. Children here have not died due to hunger but poverty. Funds for development are diverted for corruption therefore strict regulations are required for development.”

He added that he has taken up the issue of declaring Rafi Nagar a slum with the collector and until then basic facilities will not be available to the people here. “Mafia in slums is puncturing pipes to divert water added Azmi.

Explaining the reasons for exclusion of grants to these slum people Dnyaneshwar Tarwade, assistant director, Apanalaya says that the government has not listed them under BPL as only people with an income of Rs 1,250 a month or below are considered in BPL category. These people with an income of Rs 3000-5000 per month do not qualify for it. Secondly, the state govt has already exhausted its quota of BPL vacancies specified by central govt and for that reason they are not able to qualify for various govt schemes. Govt issues ration cards under PDS in four different categories like Antodaya ration card , BPL and Annapurna ration card etc . There is no guarantee for provisions under above poverty line (APL) he adds.

Sixty five percent of Mumbai's population lives in slums. Considering such a figure, government grants seem negligible and insufficient and there is extreme shortage of staff to implement most government schemes.

“It is a constitutional right to live anywhere in India. Similarly poor in Mumbai should not have any cut off figure. The government must provide affordable housing to poor so that they do not encroach land. Builders look for high profits and for that reason they are not interested in slum rehabilitation projects” says Tarwade.

"The state govt has not uniformally distributed basic amenities like water connections , sanitation, drainage, roads, health and educational services .Supplementary and public distribution system needs to be strengthened as this is widening the poor –rich gap further. If the government efficiently makes use of its various schemes it can greatly help the poor. Though the government is spending huge amount on its integrated child development scheme, its less for more approach, insufficient staff and officers is hampering its progress. Going by the government guidelines there has to be one supervisor for 25 aanganwadi’s , and one child development project officer (CDPO )for 100 aanganwadis," he adds.

At the Shivaji Nagar slums, there is just one CDPO for 200- 300 anganwadis, who also doubles as a protection officer under Domestic Violence Act and one supervisor for 80- 100 aanganwadis. A separate Integrated Child Development Scheme Centre has been put in place for Shivaji Nagar slums . For all official concerns 135 aanganwadis are functioning in Shivaji Nagar slums.

Tarwade suggests the following to address the problem :

- The government needs to tighten its monitoring system where a formal mechanism for community based monitoring has to be developed.

- All stakeholders i.e. the government, NGO’s , media and community must form a strong partnership to come together and work on the issue.

- The urban migration of population is a national issue . The government specifically must address this issue of urban poverty and bring in schemes for it.



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