It is no surprise that the horror story of malnutrition and death revealed by this paper in booming Mumbai earlier this week did not capture public imagination as the unfolding scandals of India do.
The 16 children who died since April in Shivaji Nagar, an urban slum in northeast Mumbai, come from that vast swathe of invisible India that we in the middle and upper classes so efficiently blank out.
Shivaji Nagar is a nowhere place, the kind that exists beyond the imagination of middle India. You will find Shivaji Nagar in the midst of middle-class Govandi, an exurb that showcases modern Mumbai. Govandi has housing towers with aspirational names, such as Raheja Acropolis. It has pharmaceutical companies and call-centres. It has one of Asia’s largest slaughterhouses and a top-quality think tank (the Tata Institute of Social Sciences) and a pleasing green belt. Its neighbourhoods indicate how people in India’s distant middle-class suburbs form professional communities that replace the old bonds of caste — so you find Tata Nagar, Indian Oil Nagar, Teachers’ colony, Municipal Colony.
Shivaji Nagar is a blank space, where people are bound by poverty and to some extent, religion (most residents are Muslim migrants).
To make the journey to Govandi is to understand how blank spaces pass us by.
Hop aboard a Harbour Line train from CST, the grand, gothic rail gateway to south Mumbai, home to the Ambanis and Tatas. Govandi is the second-last station before Mumbai officially ends. The trains reduce speed as they trundle within handshaking distance of the brick-tin-and-sackcloth homes that line the tracks. Beyond Govandi’s dirty station, the train fords a creek and speeds up as it re-emerges into the India that people like you and I inhabit — to the office towers housing new economy enterprises and the shiny granite-floored stations of New Mumbai.
The dank lanes of Shivaji Nagar, the eyesores you turned away from, are also a part of emerging India. The people here are from the backcountry — more than 300 million Indians are migrants — trying to create a foundation for their children’s tomorrow. These foundations cannot survive without state assistance, and when cracks develop, it is the youngest that fall through first. There are two reasons: One, stifling bureaucracy stops most migrants from using the subsidised food network once they leave home. Two, malnutrition is hard to prove because it is never the direct cause of death. It ravages the body and its immune system, leaving disease to do the actual killing.
No area has been studied as closely as Shivaji Nagar, but state government data estimate that 3.5% of slum children below six die of malnutrition in Mumbai every year. In September this year, 21,081 children across Mumbai’s blank spaces were found to be “severely malnourished”, meaning they needed immediate hospitalisation (it isn’t clear if that happened); 90,947 were moderately malnourished.
Mumbai has other malnutrition hot spots, many in the heart of the city. Number six on the list with 9.93% of its slum children malnourished is Colaba in south Mumbai, a five-minute stroll from towers where a square foot of space could cost up to R1 lakh.
UPA chairperson Sonia Gandhi hopes the forthcoming Right to Food Act will address the problem of hunger, but it will not directly address malnutrition, especially in rapidly urbanising India. (A third of Indians already live in cities; in 20 years, more than half will do so).
Malnutrition can be addressed if the government urgently reforms what is now the world’s largest programme to meet the health and nutritional needs of children under six, the Integrated Child Development Services (ICDS).
The Shivaji Nagar deaths show that the scheme is too centralised and ponderous to help the urban poor. Malnutrition in a city like Mumbai is more than a national shame: future national productivity and India’s demographic dividend are at stake at a time when a booming, urban economy with the world’s youngest population requires a strong, skilled workforce. Many malnourished children may not die but they tend to be intellectually and physically disadvantaged throughout their lives, vulnerable to disease and learning disabilities.
Money isn’t the issue. The 2010-11 national budget for the ICDS is R7,806 crore. In Mumbai, the state government does run anganwadis, or crèches, in slums. The Centre contributes two-thirds of the R1,700 crore Maharashtra will spend this year on anganwadis; the state will pay a third.
Mumbai’s ICDS is primarily a management failure. There are 33 ICDS projects across the city but no project manager. How hard is it for the state and Centre to sit down and say, ‘Look this isn’t working, it’s a priority, so let’s sit across the table, vow that no child will die and tackle malnutrition as we would a metro railway or airport — with deadlines and fixed responsibility.’
Instead, in old-India style, a committee appointed by the Maharashtra chief minister and headed by the chief secretary will examine the issue of urban malnutrition, doubtless to point out well-known flaws and submit, in time, a report that will likely join an older pile of reports.
Maharashtra’s new chief minister Prithviraj Chavan is well meaning and has been sent to clean up the corruption-ridden state. He could save time and money if he scrapped this committee and instead used his influence with the prime minister to merge state and central ICDS operations, get a professionally qualified bureaucrat (or a professional from outside), to revamp the outdated system of malnutrition management in Mumbai. If this person can scrub malnutrition deaths from Mumbai within a year, it could become the template for cities nationwide. Think about it Mr Chavan. It is possible.
To read stories and columns in the ‘Tracking Hunger’ series, go to www.hindustantimes.com/trackinghunger