Addressing hunger will result in other gains too
The current set of entitlements also needs to be expanded to enhance access to nutrition and employment. For improving access to medical services, public health infrastructure and services need to be strengthened and, of course, budgetary allocations have to be substantially increased. Unfortunately, Ayushman Bharat does little to address these.Updated: Oct 23, 2018 11:56 IST
In the last four years, at least 61 people across 11 states died of hunger or destitution. Uttar Pradesh and Jharkhand top the list with 16 deaths each. The majority of the victims were adivasis or Dalits who lived on the margins. For example, all the families of Jharkhand that had such deaths had inadequate access to food and nutrition, employment and public health services. While several of the 61 deaths were investigated by independent researchers and activists, some are yet to be thoroughly inquired into.
But the pattern in the deaths is hard to miss.
The state of hunger worsened for the victims’ families after they were denied their grain entitlement under the Public Distribution System (PDS) and/or social security pensions. All those who succumbed to starvation could barely get anything to eat in the days before they died. At the time of the deaths, their families neither had food nor money. Even though most of them worked as agricultural workers, none of them got work under the National Rural Employment Guarantee Act in the recent past. A few children who starved to death were denied basic nutrition entitlements under the Integrated Child Development Services (anganwadi programme). In all the deaths, investigations by the Right to Food Campaign found out, the denial of socio-economic entitlements was due to poor implementation of the welfare programmes, exclusion due to their limited coverage or because of their mandatory linkage with Aadhaar.
Despite fulfilling the eligibility criteria, some households were not issued ration cards. For example, some families of Odisha were struck off the PDS list during the rollout of the National Food Security Act (NFSA) in the state. Similarly, some elderly and widows were not enrolled in social security pension. An important reason could be the cap on the total number of beneficiaries allowed under this scheme. Three musahar victims of a family in Uttar Pradesh fell prey to lack of public health services.
Of the 61 deaths, at least 21 took place as the victim or her family was denied an entitlement due to the mandatory linkage of welfare programmes with Aadhaar, our research shows. Some households could not buy subsidised foodgrain as their rations cards were cancelled for want of Aadhaar linkage. Some cardholders could not authenticate themselves at the Aadhaar based biometric point-of-sale (PoS) machine at the ration shop. Similarly, a few persons were denied their social security pensions as their pension accounts were not linked with their Aadhaar or the money was credited to someone else’s bank account linked to their Aadhaar without their knowledge. Some elderly victims failed to authenticate themselves at the PoS machines at the local banking correspondent.
These deaths are only the tip of the iceberg of the acute deprivation in India. They came out because of whistle-blowers or reports by the local media. But the responses of the central and respective state governments to these deaths have been abysmal, ranging from blatant denial to misguided and token actions, to say the least.
The state governments wasted no time in blaming illnesses for the deaths. In the 2017 winter session of the Parliament, the government denied the incidences of starvation deaths. After the death of Jharkhand’s 11–year-old Santoshi Kumari in September 2017, the food ministry issued a clarification that cardholders are not to be denied ration for the want of Aadhaar or failure of biometric authentication. Even after this order, at least 14 families across the country were denied their grain entitlement due to Aadhaar-related issues.
Rather than addressing the issues in the PDS, the food minister, Ram Vilas Paswan, suggested doorstep delivery of ration as a solution to eliminate exclusion. Problems related to social security pensions have not even been acknowledged. And the prime minister is yet to comment on these deaths. Most of the Opposition parties have failed to take the central government to task on starvation deaths and the widespread deprivation indicated by these incidents. Even though there were some protests locally, most notably in Jharkhand, they failed to generate adequate political action on issues of widespread starvation in the states.
The exclusion in PDS and social security pensions can be addressed by universalising these entitlements and removing the mandatory requirement of Aadhaar. One can draw a leaf from the recent decision of Odisha to fund inclusion of a large proportion of families in the PDS that were left out because of cap in the NFSA. Also, even though the Supreme Court has upheld that Aadhaar is mandatory for receiving government subsidies, the legislature can always rise to the occasion to give the poor respite from Aadhaar.
The current set of entitlements also needs to be expanded to enhance access to nutrition and employment. For improving access to medical services, public health infrastructure and services need to be strengthened and, of course, budgetary allocations have to be substantially increased. Unfortunately, Ayushman Bharat does little to address these.
Hunger needs to be tackled for its own sake. But there might also be some electoral gains in the process. With the general and several state elections looming, can one expect some action?
Note: The list of 61 deaths can be downloaded from https://drive.google.com/file/d/0B8BOT0emNxfqQkt6N243MFBMY1pGbndQVVZBakR1ZnYtdno4/view . It was compiled by Reetika Khera and Siraj Dutta, with contributions from Swati Narayan and the right to food campaign in Odisha, Jharkhand, West Bengal and Delhi
Siraj Dutta works on social policy in Jharkhand
The views expressed are personal