The Malaise of Starvation Deaths

by Suranjita Ray

Though starvation deaths in 2019 seem incongruous in a country which claims to have conquered hunger, we come across reported experiences of such tragedies. This compels us to not only contest the claims of the State, but also to be concerned about the persisting paradoxes of hunger and starvation despite stuffed granaries and several social security measures. On July 8, Goutam Behera, a 17-year physically challenged youth, died after starving for five days in Nuapada district of Odisha. Nuapada is known to be home to such starvation deaths since long. As part of the undivided Kalahandi district till 1993 and one of the most backward KBK (Kalahandi-Bolangir-Koraput) districts, which have for long been referred to as synonyms of hunger and starvation, Nuapada has drawn the attention of policy-makers and social activists across the globe to probe and prevent such reoccurring phenomena.

Successive governments, both at the Centre as well as in the State, had to initiate several long-term action-plans to legitimise their concerns. Many a times the opposite ruling parties at the Centre and Odisha exposed each other’s negligence and failure to intervene in preventing such crises. What is worrying is that despite the National Food Security Act (NFSA) 2013, and several programmes to ensure nutrition and food security such as the Integrated Child Development Services (ICDS), Mid-day Meals (MDMs) and Public Distribution System (PDS), experiences of hunger and starvation are not uncommon.

The Indifferent State

It is rather shocking that even after repeated requests, both starving Gautam Behera and his 22-year-old sister Debanti Behera of Sargimunda village of Karlakot Panchayat under Boden block of Nuapada district were denied the Antyodaya Anna Yojana (AAY) card which provides 35 kgs of rice at a highly subsidised price to the poorest of the poor families. Instead, they were given a Priority Household Card (PHH) which entitled them to 5 kilograms of rice each, every month, which they had received last on May 25.

For nearly one-and-a-half months, the starving siblings had received no rice. After her brother’s death, Debanti was shifted to a shelter home at Komna. Though the block level officials provided ration card under the AAY, 70 kilograms of rice, and Rs 60,000 in addition to assurances for appropriate treatment for her illness, the response was extremely late. A three-member fact-finding team from the right to food campaign, Odisha Khadya Adhikar Abhiyan, visited the village on July 13.

Debanti narrated how Gautam used to stay overnight in front of the block office at Boden to meet the concerned block officials to get an AYY card. The State remained a silent spectator paying no heed to several appeals of the victims, villagers, social workers and even a few media-persons, to intervene to rescue the siblings from starvation. Therefore, such recurrences of starvation deaths raise ethical questions about the State. The negligence on the part of the State is serious and one needs to revisit some of the claims of redressal of people’s grievances by the Collector’s office.

Debanti narrates that had the public officials responded in the positive, ‘Gautam’s life could have been saved’. Debanti’s narrative not only reveals their traumatic experience for many long years but also the defiance of the callous State. What is worse is that in order to suppress the real cause of death, the Additional Block Development Officer persuaded to cremate the dead body without postmortem and insisted that the latter would lead to unnecessary legal complications.

The narratives of the starved contest the systematised understandings of hunger that supress, conceal and silence the genealogy of their subjugation and oppression. It provides insights to understand starvation as sites of continuous oppression, conflict and paradox that not only threaten one’s life, but also fail to generate sufficient livelihood. The process of being starved does not start with the biological collapse but a decline in the socio-economic conditions, which need not always culminate in mortality. Since hunger cannot be divorced from the experiences that make it up, the multiplicities and complexities of hunger and starvation need to be explained by examining the inter-connections of the constituted experiences.

Several studies find that the Odisha Government has discontinued with the emergency feeding programme for two lakh families in the poverty-stricken KBK region since April 2015 despite 13 cases of reported starvation deaths in the region during the past four years. Similar cases of indifference on the part of the State officials have been revealed in the reports of several fact-finding teams and research institutions. Though the death of 19 infants due to malnutrition in Nagada village in Jajpur in 2016 shocked the world, the government has done little to prevent everyday experiences of malnutrition that persist in the village.

Similar starvation deaths were witnessed in Jharkhand in 2017. Savitri Devi, a 58-year-old woman, died as she had nothing to eat. She was denied PDS rations since 2012 after her ration card was cancelled. The postmortem reports confirmed starvation as the cause of her death as no traces of food were found in the victim’s stomach. The officials were at unease with the report and claimed that it was illness and not hunger which led to her death. Santoshi, a 11-year-old, died in September 2017. Her family claimed that they had got no ration for six months. However, the Jharkhand Government claimed that she died due to illness.

While many such deaths cannot be related to starvation in strictly clinical terms, and the more immediate cause is illness caused by diarrhoea or pneumonia, the tragic reality remains that the starved often die because of both prolonged malnutrition and continuum distress, which renders them unable to with-stand common diseases and renders a person biologically weak. It was dreadful when the three sisters Mansi, Shikha and Parul, aged eight, four and two respectively, died of starvation in East Delhi’s Mandawali on July 24, 2018. It was suspected that the girls had not eaten for several days. The post-mortem report stated that the girls died of ‘malnutrition/starvation and its complications’. The second autopsy report confirmed no remittances of food in the girl’s stomach. It led to a political scuffling between the Aam Admi Party (AAP) and Bharatiya Janata Party (BJP). It is unfortunate that debates on important issues often turn into political disputes. While the AAP was accused that starvation deaths had occurred despite its campaign for doorstep delivery of ration, it retaliated that the BJP had blocked the former’s initiatives for the programme. The Congress Party also took the opportunity to allege that nine lakh eligible families in Delhi had not got ration cards despite applying for those. The fact-finding report of the Delhi Rozi Roti Adhikar Abhiyan stated several gaps in policy-framework and failure in the implementation of policies. The family was not receiving their legal entitlements. They did not have a ration card. No MDMs were served to children during school vacations. No community kitchens operated in the area. No Anganwadi functioned in the Saket block in Mandawali where the family had lived for several years. The ICDS records were fudged to cover up its massive failures.

Since the nature of ‘starvation deaths’ is always disputed, and governments are usually reluctant to declare starvation as the cause of death, to assume that they do not occur is fallacious. The everyday experiences of agony and craving for food have normalised hunger and starvation to an extent that they no longer remain anxieties, epic tragedies, or catastrophes that create an impact.

Urgency to Intervene

The persistence of hunger and starvation amidst overflowing granaries and buffer stocks, has brought the paradoxes of hunger, deprivation and its accompanying humanitarian crisis to the forefront of public attention. India is ranked at 103 out of 119 countries in the Global Hunger Index (GHI) 2018, with one in every five children of less than five years as wasted (low weight for height). While India has shown few improvements between 2000 and 2018 in the percentage of undernourished people that has dropped from 18.2 per cent to 14.8 per cent, child mortality rate that has halved from 9.2 per cent to 4.3 per cent, and child stunting (height for age) which has dropped from 54.2 per cent to 38.4 per cent over the same period, the prevalence of child wasting has worsened. It has increased from 17.1 per cent in 2000 to 21 per cent in 2018. Almost 3,00,000 children die every year because of hunger. Even when they do not die of acute starvation, tens of millions of children go to the bed hungry. About a third of the children are stunted/malnourished. Over half of adolescent girls and women are anaemic. While the Union Cabinet Minister for Women and Child Development expressed satisfaction regarding steps taken to reduce malnutrition, the urgency is to address the underlying causes of poor nutrition in India, especially amongst children, adolescent girls and women. The irony is that despite more than thirty Maternal and Child Health and Nutrition programmes/schemes under various Ministries and Departments, India has not been successful in preventing deprivation resulting in hunger, starvation and starvation deaths. The Govern-ment of India and United Nations World Food Programme in its malnutrition Report, Food and Nutrition Security Analysis, 2019, state that despite some progress in reducing the extent of chronic malnutrition in children, the percentage of stunted and underweight children is high in Jharkhand, Bihar, Madhya Pradesh, Gujarat and Maharashtra.

The government’s National Nutrition Mission and National Nutrition Strategy worked out for all 640 districts by NITI Ayog as Poshan Abhiyan aims at a Kuposhan-Mukt Bharat (malnutrition-free India) by 2022. The target of the mission is to bring down the proportion of stunted children in the age-group 0-6 years from 38.4 per cent to 25 per cent in the population by 2022. This would require doubling the annual rate of reduction in low birth weight, stunting and undernutrition by two per cent and anaemia by three per cent, each year.

By recognising ‘right to food’ as a basic legal right, the NFSA 2013, ensures legal obligation of the state which can be judiciously endorsed by popular action against an unresponsive administration that fails in its obligation unlike the earlier provisions in the Famine Codes and contemporary Relief Codes that imposed moral obligations to provide food as reliefs to the victim. However, a greater challenge for the policy-makers is to address the underlying causes of the enduring conditions which generate and perpetuate hunger and starvation for certain sections of society irrespective of the levels of food production, availability, procurement, distribution, food prices, economic growth, and development.

Since chronic hunger and starvation are systemic and cumulative deprivations associated with the long-term processes of structural inequality and powerlessness, persistence of hunger and starvation deaths need to be analysed in terms of the multiple causes which create deprivation and deny basic entitlements/resources required for minimum subsistence/livelihood to certain sections of society. The short-term relief strategies are important for those who are most food insecure, but long-term solutions to the alarming problem of hunger call for food sovereignty. There is a need to assess the continuum of distress beyond the period of extreme conditions of agony. Preventing hunger and starvation should not only be concerned with containing mortality. Though the relief measures to save life in crises are important, it is equally important to save the livelihood of the large mass of people who are vulnerable to the processes of impoverishment and famishment. The constitutional responsibility of the democratic state to secure basic rights to its people must not become the prerogative of the state.

The persistence of chronic hunger and the recurrence of starvation deaths must be seen both as morally outrageous and politically unacceptable in the context of the democratic transformations that have seen an unprecedented expansion of the social welfare state and its constitutional responsibilities to secure basic rights to the people. The state should ensure the right to access, ownership and control over basic resources to secure a certain normality of livelihood and the right to live with dignity. Freedom from poverty and hunger needs to be recognised as a political right in addition to being a basic right/human right. Only then, can KBK and similar situations elsewhere become a symbol of ‘freedom’ and ‘equality’, rather than being a symbol of backwardness, under-development, poverty, hunger, starvation, and famine conditions.

Suranjita Ray teaches Political Science in Daulat Ram College, University of Delhi. She can be contacted at suranjitaray_66[at]yahoo.co.in