A commission of enquiry into the state of nutrition in Uttar Pradesh has found extreme malnutrition and starvation. The finding of malnourished children eating silica laced mud was perhaps the low point of this enquiry.

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In continuation of our previous letter reference no. JCE/841/U.P dated April 5th, 2010 regarding the enquiry to assess the cases reported of poor children eating silica – laced mud in Ganne village and to look into the status of implementation of food related welfare schemes under our purview in various parts of the district. Ms. Arundhati Dhuru, Adviser to the Commissioner’s for Uttar Pradesh had convened the Commission of Enquiry with help of Prof. Jean Dreze.

A detailed report on the findings of Enquiry Commission is enclosed with this letter. The summary of the findings of the Enquiry Commission as follows:
1. Total 90 % of the children examined are suffering from acute malnutrition of Grade IV.
2. There is total collapse of food security related schemes and 80 % (high percentage and all poor) people are deprived of their entitlements.
3. People are living with starvation and hunger due to acute poverty.
4. Children are eating mud which may have been developed due to calcium and other vitamins deficiency due to living with starvation and hunger.
5. Prima facie evidence indicates anemia and other deficiency also among women and men.
6. The situation is aggravated due to severe water shortage.
7. There is strong indication that people are living in conditions of bonded labour which need further investigation and their access and control over livelihood resources is main reason for acute poverty and situation leading to hunger.
8. As evident from testimonies from villagers and also from district administration this particular community of Kol people who are residing in this block are facing similar situation like prevalent in village Ganne and need immediate intervention.
9. Elected representatives and administration have failed to secure people’s access to right to food and failed to protect the life and livelihood of families in affected village and community.
10. There is need to develop comprehensive plan which needs urgent intervention to deal with acute malnutrition, guaranteeing people’s right to food and their access to food security schemes, developing inclusive package not only for affected village but for the entire Kolh community.

A harsh picture emerges from enquiry of Commission. The problem of poverty and hunger needs to be tackled to address the issue of acute malnourishment and probable deaths. In this context, we would like to make the following recommendations:

Immediate Action required:
1. All severely malnourished children and those adults suffering from long and/or severe illness should be immediately attended to by the district administration including hospitalization. Many of them may need to be in ICU and do need intensive on- site intervention.
2. A centre to treat children suffering from “Severely Acute Malnourishment” SAM needs to be established in the area.
3. A household survey need to be immediately conducted and administration should ensure that food grain is provided to families which are facing severe food crisis. As pradhan has failed to fulfill his duties it will be better that administration takes the responsibility to ensure the reach of food grains.

Recommendations for ICDS
It must be ensured that all sanctioned AWCs that are not “operational” become functional immediately, as per Supreme Court orders.
It should be ensured that all children are covered by AWC as per Supreme Court’s direction of universal coverage and mini AWC should be started in villages where reaching to AWC is a constraint.
All AWCs must be provided with all necessary facilities (clean drinking water, storage facilities, basic furniture, cooking utensils, weighing scales, medical kits, charts, toys, etc) so that they perform their requisite functions.
State must ensure hot cooked meal is provided in these AWCs. As an emergency measure the quota of cooked meal and SNP should be doubled.
The quality of training programmes for AWWs needs radical improvement, they should be made sensitive to special needs of Shankargrh block.
A second AWW needs to be appointed who will take care of children under three years who are home based, and will also pay attention to pregnant and lactating mothers.
A special health need assessment need to be done to ensure that children do not develop deficiencies.

Recommendations for MDM
State will have to take special drive to increase the enrollment of children in school and increase and regularize their attendance.
As an emergency measure MDM should also be provided to children who are not enrolled in school and are out of schools.
State must ensure the proper functioning of MDM as a priority. To cope with nutritional requirement the quota of MDM should be doubled.
As harsh summer approaches and food insecurity increases MDM should be continued during summer months even when school closes for vacation as often done in drought affected districts.
A detailed health assessment of children needs to be done and then assistance of nutritional institutes and health experts need to be taken to design MDM food to increase protein and micro-nutrients supply in MDM.
A smooth fund flow needs to be ensured so MDM is not discontinued due to fund crunch.
Though nutritional and cost norms have recently been revised it is becoming increasingly difficult to provide pulses and vegetables in MDM. State should ensure that special assistance in convergence cost is provided so that pulses and vegetables are included in MDM.
As an emergency measure state should provide MDM to all old and needy persons who are suffering from hunger and starvation. (As was done in Bundelkhand as drought relief measure)
A verification of existing beneficiaries needs to be done to ensure that ineligible people are not benefited.
State must ensure all eligible persons are covered by NOAPS.
An immediate action should be taken to pay installment to all beneficiaries immediately and rule out corrupt practices.

Recommendations for NMBS
NMBS is meant to meet nutritional need of women during pregnancy. It is imperative that state ensure that women are covered by NMBS. In an area where women are also involved in hard labour work it is important that nutritional needs are taken care of as in all probability they do not earn enough and face unemployment during pregnancy. This is vital as pregnancy period should not augment poverty and hunger. As an extra emergency measure women can be provided food at ICDS and / MDM centre.

Recommendations for TDPS
State must ensure that all entitled families having BPL and AAY card get their full quota of 35 kg every month at stipulated prices.
Though there are limitations on BPL and AAY quota state must ensure that really eligible people are beneficiaries of BPL and AAY quota. A true verification is required to rule out bogus and ghost card holders.
Ensure that the full month quota of grain reaches the FPS dealer in the first week of every month.
Enforce the Supreme Court order allowing purchase of grain in instalment.

Recommendations for NREGA
In an area where livelihood is in crisis and people have to work as bonded labourers proper implementation of NREGA can provide the required thrust to tackle the employment crisis and also provide push to socio-economic development impacting and reducing poverty.

State must ensure through special drive that people get job cards, apply for work and work is provided and they are paid as per the rules. It need to be ensure that proper plans are made and works are carried and completed while ensuring all workers rights and rules and principles of the Act.

The land is rocky and water shortage is serious concern. NREGA has large scope for water shade works and surface water harvesting and watershed development works should be taken on emergency footing. An effort can be made to take help of watershed experts and NREGA activists to ensure the implementation of the Act.

We do hope that you treat this matter with utmost urgency and take steps so that the people in Shankargarh block are provided with all the support to ensure their food security and livelihood.

Kindly send us an action taken report within two weeks of receipt of this letter.
Thanking You.
With Regards,
Dr. N.C.Saxena,  Harsh Mander

Cc: Ms. Arundhati Dhuru, Advisor to the Commissioners to the Supreme Court, Uttar Pradesh.
Prof. Jean Dreze, G B Pant Social Science Institute, Allahbad