In 2007, the then governor of one of our states was so alarmed by reports of people starving to death in a particular district that he decided to go and check the reality on the ground. The scenes that greeted him were so pathos-filled that the governor fainted. He was bundled into his car and sent off in the general direction of the Raj Bhavan.
The government of that state had a reputation for burying its head in the sand despite evidence of its below par performance. The gubernatorial visit prompted the finance minister to make a whirlwind tour of the district, at the end of which he duly promised a ‘special package’.
After that the bone of contention was whether the deaths were caused by ‘poverty’ or ‘starvation’. Apologists for the government argued that poverty caused by whatever reason is a valid one for people going hungry, leading to all sorts of vulnerabilities and a few (unfortunate) deaths. The failing is not of the government, but bad karma. The other view, articulated eloquently by Nobel Prize winning economist Amartya Sen, holds that any death from starvation — whatever the source of the malaise — speaks of a breakdown of governance in a democratic setup. A person, however poor, has entitlements assured directly through government programmes, the success of which is key to the political survival of a regime.
Seven years later, I was shocked to come across a report in a leading newspaper that there were six ‘starvation deaths’ in that same district over a five-day period immediately preceding the dateline — June 28. Sure enough, an official denial followed. The food minister claimed that the deaths occurred for reasons ranging from cerebral stroke to low birth weight. But a doctor of a government hospital in the area was quoted as saying that cases of malnutrition existed “in plenty” in the cluster under question.
As it happened, I was at a multilateral conference themed ‘Action on the Call’ in Washington DC that week with health ministers from 25 countries analysing the past two years’ record in fighting preventable infant and maternal mortality. One of the important facts we were reminded of at the event was that poor nutrition is one of the most common reasons for high infant mortality in India. We are losing 1.4 million children under the age of five years annually, of whom 756,000 are infants, because we have failed to develop an efficient mother and child care system.
The connection between the newspaper report and my experience at that meeting made me face the truism that in the middle of the second decade of the 21st century, no government can escape the information explosion that constantly throws up inescapable facts. I see chronic hunger as a public health problem. Once I admit it as all-pervasive in India, it becomes my duty to address it as a major challenge before my government. Having been a World Health Organization adviser for many years, I cannot, after sitting on this chair, turn away from the fact that more than 27% of the world’s undernourished population lives in India.
Call it starvation deaths, or death from hunger or low calorie intake, the phenomenon is pervasive in a large number of states. The Centre is capable of coming out with recommendations on identifying clusters of the population going hungry and the protocol for addressing their immediate needs so as to prevent deaths. In KS Fitch’s Medical History of the Bengal Famine there is a reference to a manual that was published by the British government in India in 1904 detailing provisions for the regular collection of information pertinent to the apprehension and prevention of mass hunger conditions in rural India. One of these directives asked district officials to announce public projects in the areas suspected to be affected by large-scale hunger. The ploy was to attract able-bodied men to a single place so as to enable the officials to interview them as to their eating patterns.
I wonder if the manual is still around. Its implementation today would depend on the plethora of government development programmes becoming more simplified and accountability standards being fixed. Rural India today is awash with pro-poor programmes — ICDS, Antyodaya, MGNREGA, Aanganwadi, ASHA, to name only a few — but there has been no great transformation in calorie intake disparities. For instance, in the tribal pockets of one of the southern states recognised for its high human development indicators, an alarmingly high number of children die each year owing to diseases linked to malnourishment.
A vigilant media can keep a government on its toes not only by bringing to public attention the phenomenon but also by helping educated readers wade through specious logic that is ingrained in government responses. The Bengal Famine story was broken by a newspaper representing British interests in India. It exposed the devastating effects of Winston Churchill’s scorched earth policy against the Japanese who had just taken over Burma and were threatening eastern India. Food was exported from Bengal for the war effort but three million people in the province died during the great man-made calamity. The British government tried to censor the Press but it did not work and eventually had to veer around to providing relief and rehabilitation.
Richard Stevenson in Bengal tiger, British lion: an account of the Bengal famine of 1943 writes that neither Mahatma Gandhi nor Jawaharlal Nehru nor any other Congress leader made any statements at the time of the famine or afterwards. Perhaps they unwittingly bequeathed the tradition of apathy to contemporary leaders. Famines as mass catastrophes belong to the past, but the polity has got to own up to the fact that millions of Indians are still going to bed hungry every night. Facing the truth is half the battle won.
Harsh Vardhan is Union minister of health and family welfare
The views expressed by the author are personal