OVER 70% of adivasis reside in the central region of India, which though resource rich, is home to the poorest people who have not benefited from social and economic development to the same extent as people in other regions. In some cases they may have actually suffered due to the anti-tribal, market oriented forest policies (as they depleted the gatherable biomass), or resulted in displacement from their ancestral lands. The lack of accountability of government personnel in these remote and sometimes inaccessible regions has also resulted in poor delivery of all government programmes, contributing to the utter neglect of the poor adivasis.

It is therefore not surprising that the proportion of adivasis – both adults and children – who suffer from malnutrition is far greater than the Indian average. Studies done by Subal Das, Kaushik Bose and Amaresh Dubey indicate that over half the adivasi adults have a BMI (Body Mass Index) below 18.5, which makes them chronically undernourished, as compared to 35% of all Indians.¹ The figures are more dismal for women and children. For instance, 71% of tribal women in Jharkhand suffer from various degrees of malnutrition. They often face complications during pregnancy and are at risk of delivering low birth weight babies. Undernutrition of mothers is usually passed on to children. Some of the reasons for this undernutrition among tribal women are an inadequate diet intake, ignorance, early marriage, poor access to health services and high morbidity due to unhygienic practices and surroundings.

A 2014 Unicef report² on nutrition and adivasis points out that only 2% adivasi children between 6 to 11 months were fed complementary foods in the recommended quality and frequency. Of the 634 children surveyed in Akkalkuwa block of Nandurbar district,3 378 were found to be malnourished and the number of girls among them was as high as 60%. In 2005, more than 98 children died in just three months and of these 71 children were found to be severely malnourished. The study also revealed that only 10% of malnourished children figure in government records. In effect, the government is unaware of as many as 90% cases of malnutrition. According to the survey, the number of third and fourth grade underweight children in April was 188, in May 185 and in June 138; however, the government records show only 20, 48 and 20 children as malnourished in these months. Under reporting is facilitated by collusion between field staff and their supervisors, who are thus able to evade responsibility for improving nutritional outcomes.

 

There are cases to show that the tribes are denied their right to food. Children of the Birhor tribal community in Madhya Pradesh do not have access to the right to education and right to a midday meal at the school as the teachers fear that the Birhor children will pollute the utensils.⁴ The human rights groups working on the right to food report that tribal children cannot access facilities provided by the anganwadi centre (AWC) under the Integrated Child Development Services (ICDS), and the chances of survival of a tribal child are low, with 71.4% of tribal children being malnourished and 82.5% anaemic.5

More generally, the Supreme Court order issued in 2004 recommended that all new AWCs should be located in habitations with high Scheduled Caste and Scheduled Tribe populations. Yet, many villages in Khandwa district where the Korku tribe live in large numbers, do not have AWCs in their areas. More than 60% tribal children in Jabalpur district were underweight. Micronutrient deficiency disorders such as anaemia and vitamin-A deficiency were common among them. Unhygienic personal habits and adverse cultural practices relating to child rearing, breastfeeding and weaning were also prevalent among them.⁶

Another study found that malnutrition among tribal children (0-6 years) in Thane district of Maharashtra was 68.7% while the incidence of severe underweight was 28.6%. The overall prevalence of stunting in the 0-6 year age group was 60.4% while that of severe stunting was 38.5%.⁷

 

The studies quoted above amply demonstrate that widespread poverty, illiteracy, absence of safe drinking water and sanitary conditions, poor maternal and child health services, and ineffective coverage of national health and nutritional programmes are major contributing factors for the dismal malnutrition indicators of tribal communities in Central India. They also suffer from many communicable, non-communicable and silent killer genetic diseases.⁸ Their geographical isolation and remoteness further affects the developmental process as qualified health workers refuse to work in these areas.

It is not only in tribal regions, but even in the so-called mainstream India that progress on nutrition indicators is disappointing. Perhaps other essays in this issue will discuss this in detail, so we could touch on the main findings here. First, the commonly held belief that food insecurity is the primary or even sole cause of malnutrition is misplaced. However, the focus in India is still on food, and not on health and care related interventions.

 

Second, the ICDS design needs a change. At present it targets children mostly after the age of three when malnutrition has already set in. Very little of the ICDS resources, in terms of funds and staff time, are spent on the under-three child,⁹ and this low priority must be reversed focusing more on improving mothers’ feeding and caring behaviour, improving house-hold water and sanitation, strengthening referrals to the health system and providing micronutrients. The basic nature of the programme should be changed from centre-based to out-reach based, as the child under three cannot walk to the centre and has to be reached at home. Another advantage of visiting homes is that the entire family, not just the mothers, are sensitized and counselled.

Third, ICDS faces substantial operational challenges, such as lack of accountability due to lack of oversight and an irresponsible reporting system. It appears that state governments actively encourage reporting of inflated figures from the districts, which renders monitoring ineffective and accountability meaningless. Objective evaluation by NFHS-3 shows that 40.4% of children were underweight in 2005-06, 15.8% being severely malnourished. However, the state governments in 2009 reported 13% of children as underweight, and only 0.4% as severely malnourished.¹⁰ Although reporting has somewhat improved, yet the Government of India’s (GoI’s) website shows the percentage of severely malnourished children (reported as grade III and grade IV children in the state data) in March 2013 was 0.07 in Andhra, 0.70 in Assam, 0.38 in Rajasthan and UP, and 0.18 in Tamil Nadu. Where is the problem then? India is as good as Denmark or Norway!

One district collector, when confronted with this kind of bogus figures, told the author that reporting correct data is ‘a high-risk and low-reward activity’! The former prime minister termed government’s performance as a ‘national shame’, but was not able to persuade the states to even accept that the problem exists.

And lastly, there are large-scale irregularities in the supply of supplementary nutrition provisioning (SNP) in violation of Supreme Court orders by engaging contractors for ICDS in many states such as Maharashtra, Karnataka, Uttar Pradesh and Gujarat.

 

A recent evaluation of ICDS in Gorakhpur by the National Human Rights Commission¹¹ showed that despite Supreme Court orders to provide hot cooked meals, all centres only supplied packaged ready-to-eat food, containing only 100 calories, as against a norm of 500 calories, with 63% of food and funds misappropriated. Being unpalatable, half the food ends up as cattle feed. The ready-to-eat food is produced in poor hygienic conditions. Some of the ingredients listed on the packets containing the finished product were out of stock at the time of the visit and the stocks of maize were barely enough to meet a quarter of the daily requirement.

The Government of India should discourage the distribution of manufactured ‘ready-to-eat’ food as it leads to grand corruption at the ministerial level. But unfortunately it has encouraged such tendering by laying down the minimum nutritional norms for ‘take-home rations’ (a permissible alternative to cooked meals for young children), including micronutrient fortification, thus providing a dangerous foothold to food manufacturers and contractors, who are constantly trying to infiltrate child nutrition programmes for profit making purposes.

 

Emerging economies have demonstrated that child undernutrition can be drastically reduced: Thailand¹² reduced the percentage of underweight children by half (from 50% to 25%) between 1980 and 1986; Brazil reduced child undernutrition by 75% (from 20% to 5%) from 1990 to 2006; and China reduced child undernutrition by 68% (from 25% to 8%) between 1990 and 2002.¹³ Even Vietnam, a country poorer than India, has seen a reduction in underweight children from 41% in 1996 to 25% in 2006.¹⁴ Therefore, nutrition improvement at a national scale is possible. However, economic growth is not enough; it needs to be coupled with effective policy and budgetary action, particularly for the most vulnerable: the youngest, the poorest, and the excluded.

In addition to the general shortcomings in the design and implementation of nutrition programmes, there are structural and specific limitations that adivasis face, as their record on all social indicators seems much worse than other social groups. These cross-sectoral constraints affecting adivasis are discussed in this concluding section.

When ICDS is not doing well in the country, one could expect even more dismal results in tribal regions, as discussed earlier in the paper. From the policy viewpoint, it is important to understand that tribal communities are vulnerable not only because they are poor, without any assets and illiterate compared to the general population; often their distinct vulnerability arises from their inability to negotiate and cope with the consequences of their forced integration with the mainstream economy, society, cultural and political system, from which they were historically protected as a result of their relative isolation.

 

Post-independence, the requirements of planned development brought with them the spectre of dams, mines, industries and roads on tribal lands. With this came the concomitant processes of displacement, both literal and metaphorical – as tribal institutions and practices were forced into an uneasy existence with or gave way to market or formal state institutions (most significantly, in the legal sphere), tribal peoples’ found themselves at a profound disadvantage with respect to the influx of better equipped outsiders into their areas. The repercussions for the already fragile socio-economic livelihood base of the adivasis were devastating – ranging from loss of livelihoods, land alienation on a vast scale, to hereditary bondage.

What has been the impact of government policies on tribal livelihoods? Where should central and state governments focus to improve the situation? To answer these questions we quote in detail from a Planning Commission (2000) document:

‘As tribal people in India perilously, sometimes hopelessly, grapple with these tragic consequences, the small clutch of bureaucratic programmes have done little to assist the precipitous pauperization, exploitation and disintegration of tribal communities. Tribal people respond occasionally with anger and assertion, but often also in anomie and despair, because the following persistent problems have by and large remained unattended to: land alienation; indebtedness, relation with forests, and government monopoly over MFPs, and non-implementation of the Forest Rights Act, 2006; ineffective implementation of Panchayats (Extension to the Scheduled Areas) Act of 1996 (PESA, 1996) for Schedule V areas; involuntary displacement due to development projects and lack of proper rehabilitation; shifting cultivation, such as podu; poor utilization of government funds; and poor delivery of government programmes.’

 

A recent Unicef study (2014) confirmed that land alienation and displacement without adequate rehabilitation have been important causes for tribal impoverishment.

Many issues that need urgent attention are under the jurisdiction of Ministries of Environment and Forests, Rural Development, Panchayati Raj, and others, where they often do not get much attention. It is unfortunate that the Ministry of Tribal Affairs (MoTA) does not give sufficient attention to the important problems of the tribals on the plea that many of these subjects such as land alienation, displacement and PESA are outside their jurisdiction. Even so the ministry should play a more activist role in addressing these issues by pursuing adivasi concerns with the relevant ministries.

When a new ministry is set up to focus on the marginalized people, it is expected that it would take a holistic view of their problems and coordinate the activities of all other ministries that deal with the subjects impinging on the work of the newly created ministry. The new ministry, however, takes a minimalist view of its responsibility and reduces itself to dealing with only such schemes (distribution of scholarships and grants to NGOs) that are totally outside the purview of the existing ministries. Such an ostrich-like attitude defeats the purpose for which the ministry was created.

 

For instance, policies relating to minor forest produce (MFP) are often dictated by a desire to maximize state revenues, and not the welfare of gatherers, who are often tribal women. However, this issue has never been raised by MoTA. The revenue interests of Orissa can be judged by the fact that during the period 1989-2001, the state government earned revenues of Rs 7.52 billion from kendu leaves (KL). The total wages earned by KL pluckers during the same period was only Rs 3.87 billion. The high incidence of royalties on KL needs to be contrasted with royalties collected on a major mineral, where labour is organized, e.g. royalties are Rs 30 per tonne on bauxite, but a whopping Rs 12,000/tonne on KL!

Even when the ministry was asked to oversee the implementation of the Forest Rights Act (FRA), it failed to do so faithfully.¹⁵ Despite the fact that the main intention of FRA was to promote community participation and management, the study shows that community rights over MFP etc, have been recognized in negligible cases.

Apart from poor utilization of funds, tribals have also suffered because of the poor quality of governance. Programme delivery has deteriorated everywhere in India, but more so in tribal areas, where government servants are reluctant to work, and are mostly absent from their official duties. Massive vacancies exist in tribal regions in the face of acute educated unemployment in the country. A Unicef study on Jharkhand revealed that one of the main constraints faced by the National Rural Health Mission (NRHM) was a lack of skilled manpower. In the two districts visited, Sahibganj had less than 50% positions in place, while East Singbhum, with better infrastructure, it was around 54%. Other major reasons identified by this study for low utilization appeared more due to a lack of systemic controls, such as lack of monitoring, and lack of understanding among the staff regarding the implementation of rules.

 

The law pertaining to involuntary displacement has been discussed since 1998, and although a new law has been enacted, it has yet to be implemented, though it is well established that tribals suffer most when new projects lead to involuntary displacement. MoTA should be empowered to pressure the states to change their laws in conformity with PESA and FRA. A white paper should be prepared by the ministry relating to governance in forest dependent villages, including huge vacancies and absenteeism of staff. The ministry must develop a meaningful partnership with advocacy organizations to produce credible reports in order to put pressure on other ministries that ignore tribal interests.

The outcome of policies and programmes pertaining to the issues that are critical for tribal livelihoods are not frequently assessed by the concerned ministries. There is perhaps a need for capacity enhancement within MoTA, and its counterparts in the states, which should periodically evaluate the results of government interventions in tribal regions. Such reports should be used for advocacy with other ministries, who have been vested with the responsibility to ensure that basic justice and development reaches the adivasi. These studies should also assess whether basic services in education, health, or nutrition are reaching the tribal hamlets.

Therefore, a systemic change is needed in the way state tribal departments function; their approach must change from simply spending budgets through narrow departmental schemes to knowledge based advocacy with other concerned ministries/departments. MoTA should highlight the failure of governance that deprives the poor adivasis from accessing elementary services, and put pressure on the concerned ministries and state governments to ensure better policies and delivery.

The Planning Commission should also regularly monitor the impact of existing policies on the tribal population and engage itself with the concerned sectoral ministries. In addition to spending financial budgets, departments should also be conscious of the impact that policies (or the lack of it) have on the marginalized peoples. Policies and budgetary provisions, despite the rhetoric, have not been integrated so far. Changes in policy or laws are not seen as an integral part of the development process because these have no direct financial implications. One lesser known reason for this isolation is that development and planning in India are associated with spending money. That planning means expenditure, and this will lead to development is the mindset behind such beliefs. The Indian planner unfortunately has still to understand the difference between planning and budgeting. This is where a systemic change is needed in India. In addition to spending budgets, we need to give equal importance to non-monetary issues such as institutions, laws and policies.

 

Footnotes:

1. Subal Das and Kaushik Bose, ‘Nutritional Deprivation Among Indian Tribals: A Cause for Concern’, Anthropological Notebooks 18(2), 2012, pp. 5-16; and Amaresh Dubey, Poverty and Undernutrition Among Scheduled Tribes in India: A Disaggregated Analysis. IGIDR Proceedings/Project Reports Series, 2009, Mumbai.

2. Nutrition and Adivasis. Unicef, New Delhi, 2014.

3. http://infochangeindia.org/agriculture/books-a-reports/malnutrition-amongst-maharashtras-tribals-how-bad-is-it.html

4. http://www.humanrights.asia/news/ahrc-news/AHRC-STM-129-2009

5. http://www.alrc.net/doc/mainfile.php/alrc_st2010/591/?print=yes

6. V.G. Rao, Rajeev Yadav, C.K. Dolla, Surendra Kumar, M.K. Bhondeley and Mahendra Ukey, ‘Undernutrition and Childhood Morbidities Among Tribal Preschool Children’, Indian J Med Research 122, July 2005, pp. 43-47.

7. A.L. Khandare, V. Siruguri, A. Rao, K. Venkaiah, G. Reddy and G.S. Rao, ‘Diet and Nutrition Status of Children in Four Tribal Blocks of Thane District of Maharashtra, India’ (nutrition status of children), Pakistan Journal of Nutrition 7(3), 2008, pp. 485-488.

8. R.S. Balgir, ‘Tribal Health Problems, Disease Burden and Ameliorative Challenges in Tribal Communities With Special Emphasis on Tribes of Orissa’, accessed at http://www. rmrct.org/files_rmrc_web/centre’s_ publications/NSTH_06/NSTH06_22.RS.Balgir.pdf

9. Planning Commission, 2012 Report of the Working Group on Nutrition for the 12th Five Year Plan (2012-17), New Delhi.

10. IAMR, India Human Development Report, New Delhi, 2011, p. 140.

11. http://nhrc.nic.in/Reports/misc/SKTiwari _Gorakhpur.pdf

12. http://www.righttofoodindia.org/data/garg-nandi07thailand-reducing-child-malnutrition.pdf

13. http://www.unicef.org/india/reallives_ 5901.htm

14. http://www.unsystem.org/scn/Publications/SCNNews/scnnews36.pdf

15. http://fracommittee.icfre.org