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All you who sleep hungry tonight

By Harsh Mander

Persistent food insecurity is not just related to economic barriers to access food, but also to social barriers. A silent daily tragedy plays out in many homes and streets in our country, where millions go to sleep hungry. Women are likely to eat less in many families, and dalits face discrimination even in schemes like mid-day meals and the PDS. The discourse on starvation must shift from people dying of starvation to the socially-marginalised groups that are living with it

Large-scale famines have been overcome in contemporary India. The calamitous decimation of enormous numbers of people because they are denied access even to the minimum food necessary for bare survival, has mercifully passed into the pages of history. In the early years after Independence, a dramatic level of food insecurity, leading to famine and acute starvation, loomed perilously over millions of Indians. This was the result of a low level of production in an agricultural system that was inordinately dependent on a capricious monsoon, and extremely unequal distribution of land and food. With some land reforms, enhanced foodgrain production and improved distribution through the Public Distribution System, this danger substantially receded.

However, the battle has by no means been won. Public pressure and State action have not succeeded in overcoming hunger or the endemic denial of adequate nutrition. Many individuals, families and communities, in both villages and cities, continue to struggle with hunger, which for them is a way of life. They are usually people from the unorganised sector, such as landless workers and artisans, socially oppressed groups like dalits and adivasis, single women-headed households, destitute persons, persons with disabilities, old people without care-givers, migrant workers, urban street children and others. A silent daily tragedy continues to play out in many homes and streets in our country, where millions of people sleep hungry.

The persistence of malnutrition is acknowledged, to some degree, by policymakers in India, and addressed imperfectly, but absolute hunger or endemic starvation are far less accepted, studied or addressed. Attempts to enhance food security at the household level by targeted anti-poverty wage and credit programmes, and subsidised foodgrain from the PDS, bridged the unmet food needs of millions, to some extent. These attempts however did not touch intra-family inequities in access to food or strengthen the crumbling livelihoods of the poor. Hunger and starvation continue to lurk in the shadows.

When large numbers of people die of starvation, it occasionally captures the media's attention and there is transient public outrage. Government officials in every part of the country then hotly deny the existence of chronic hunger and deaths due to starvation. They claim that the deaths result from illness; some even quibble that people were just chronically malnourished, but not starving. I am unable to tell the difference.

The invisibility of starvation and destitution in the debates about food security derives in part from the problematic and narrow definition of starvation. Few people die directly and exclusively of starvation. They live with severe food deficits for long periods, and tend to succumb to diseases that they would have survived if they were well nourished. The government does not recognise these as conditions of starvation and insists that the deaths were caused by the proximate precipitating factor of infection.

Indian as well as international agencies typically do not keep records of the numbers of people living with or dying of starvation. The same denial underlines the work of official research agencies. India's government agencies at both the central and state levels seem to have trouble seeing the massive hunger that characterises the country. Highly technical research on nutrients often avoids facing the problem, which is deeply political, not technical. There is no hope of solving the problem of hunger if the Indian state refuses to see the acute distress.

We have to extrapolate from data to assess the extent of hunger in India. UNICEF estimates that in the year 2000, about 2,420,000 children in India died before reaching the age of five. It estimates that about half of these deaths of children under five are associated with malnutrition. We can thus estimate that more than a million children die in India each year from causes associated with malnutrition.

The number of adults who live and die under conditions of starvation is relatively unknown. The Planning Commission estimates that 8% of Indians do not get two adequate meals a day and in some pockets severe under-nutrition takes a toll. One estimate says that more than 200 million people go hungry and about 50 million are on the brink of starvation. The Food Insecurity Atlas of Urban India (2004) published by the MS Swaminathan Research Foundation and the World Food Programme, found that average urban calorie intake is lower than average rural calorie intake, and that average calorie intake has marginally declined in rural and urban areas in the last three decades.

Official denials and petty technicalities cannot obscure the abiding shame of hunger-related deaths recurring in a country that produces enough grain to feed every Indian. Divergent interests may jostle for priority in public expenditure and resources in India. But it is difficult to imagine any responsibility of the State that is greater than ensuring that every person has access to the food necessary for survival, growth, health and well-being.

The feminisation of hunger

The fragile livelihood options of both the rural and urban people have grave implications for their food security. However, it is important to note that economic barriers to access to food exist along with social barriers. Gender inequalities in South Asia are the single most important social barrier. The adverse and declining sex ratio in India at 927 females per 1,000 males is, to a major extent, the outcome of the deep-rooted structural denial to girls and women of their equal rights to food and healthcare. Many micro-studies confirm the persistence of intra-family inequities; women not only eat the least and last, but in situations of absolute household food insecurity they may not eat at all.

This means not just a feminisation of poverty, but also of hunger. Women bear a disproportionately large part of the cruel burden of hunger. This is particularly ironical because women play a major role in ensuring the food security of their households by procuring, storing and cooking food not just for children but also for all members of the family. Their capacity to fulfil this role is hampered by other responsibilities, such as collecting fuel and water, which in turn has implications for household food insecurity.

Inadequate food often requires women to also seek employment for wages. Their infants, often left with younger siblings, are denied regular breast-feeding and exposed to unhygienic food and infections. Studies (such as Lisa Smith's 'The importance of women's status for child nutrition in developing countries'; IFPRI) have shown that more income in the hands of women tends to lead to higher nutrition for children. However, women who are themselves trapped in poor nutrition and health, have to secure the nutrition and health of their families, which they frequently do at the cost of their own health and nutrition.

Access to food in female-headed households is even more threatened. Pradeep Kumar Panda writes (in a 1997 book titled Female Headship, Poverty and Child Welfare: A Study of Rural Orissa, published by the Centre For Development Studies in Trivandrum), "Poverty and female headship are strongly linked in rural Orissa, India. For example, if we draw a poverty line that corresponds to 15% of the population who are poor, 12% of people living in male-headed households are poor as compared with 33% of people living in female-headed households. Labour force participation data indicate that female heads are more likely to work in the marketplace than women who are spouses of male heads of household. The differences are large: on average 74% versus 54%. The comparison of household expenditures indicates that female-headed households spend relatively less on higher quality food items such as meat, vegetables, milk and other dairy products. However, there is some evidence that they spend less on personal consumption such as alcoholic beverages. Overall, the differences are pronounced between these households. Finally, the findings show that children in female-headed households are disadvantaged both in terms of access to social services and actual welfare outcomes."

The government's food schemes are remarkably blind to gender barriers to food. The design of various programmes resolutely neglects the consequence of intra-family inequities. The ICDS (Integrated Child Development Services) in most parts of the country supplies weekly dry rations to expectant and lactating mothers. The fact that they collect the rations in large numbers is officially assumed to ensure better nutrition for women in the crucial child-bearing phase.

In my informal surveys in six states (Chhattisgarh, West Bengal, Andhra Pradesh, Tamil Nadu, Maharashtra and Uttar Pradesh) I did not encounter a single woman recipient of the rations who said that the food exclusively or even predominantly augments her own nutrition. The food is added to the overall household food basket. The same rules apply as to all other food, and even the pregnant woman will eat only what is left after all other members of the family have eaten. The same may be said of the otherwise laudable National Maternity Benefit Scheme, which transfers Rs 500 to an expectant mother and fondly hopes that this will translate somehow into better nutrition for the mother.

It is also remarkable that the targeted food programmes only focus on women's reproductive function. Women are nutritionally deprived at all other stages of their life cycle, but only this phase seems to attract official attention, reflecting the patriarchal viewpoint that only sees women as producers of babies. These programmes stress nutritional support for pregnant women in order to secure the health of the baby. They do not speak of nutritional support for adolescent girls who will be mothers in the future. They do not speak of such support as an end in itself, as the woman's right to food.

Separate ration cards for women and men would be useful, so that the woman is able to access subsidised food even if the couple separates. Universal coverage under the Antyodaya scheme is imperative for all women-headed households. EGS and other employment programmes must ensure equal wages for women and men. They should also move beyond labour at public works to include a range of social tasks that are in conformity with women's skills and aspirations.

Women and women's organisations can be inducted to implement and monitor various food schemes. Self-help groups run by women have successfully piloted the production and distribution of mid-day meals and supplementary nutrition for small children in the ICDS. This can be extended to the PDS.

For a family living with absolute hunger, "nutrition-counselling" and the supplementary nutrition provided by the ICDS or mid-day meals can only touch the periphery of the crisis of a child's survival and health. As with starvation deaths, the ICDS intervenes only after the child shows symptoms of severe malnutrition. The PDS is meaningless if a family or individual lack the economic means to purchase even subsidised food.

Schemes that are designed to provide some kind of social security cover to the most vulnerable social groups, such as old age pensions, and the Annapurna scheme for food for old people without care-givers, have not been strengthened. Few states have widow pension schemes, which must be implemented all over the country The Antyodaya scheme for food allocations to the poorest families shows promise, but given the government's record of implementation, it may not amount to much.

Caste as a determinant of hunger

In addition to poverty and gender, many social barriers prevent people from securing their rights to food-barriers of caste, tribe, disability, religion and stigma. People in these groups carry a disproportionate burden of poverty and thereby of hunger. They face barriers to access to food even if they have the economic means.

A recent study illustrates the nature of these barriers for dalits in accessing government food schemes. The study, titled 'Caste discrimination and food security programmes', was done by Sukhdeo Thorat and Joel Lee, and published in the Economic and Political Weekly in September 2005

The study found that mid-day meals served in "a locality non-threatening to dalits (a dalit colony as opposed to a dominant caste locality)" were at 12 and 19% respectively in Rajasthan and Tamil Nadu. The number was 47% in Andhra Pradesh. ICDS centres are located mainly in upper-caste settlements. This prompted the commissioners to recommend to the Supreme Court, in a writ petition filed by the PUCL (Peoples Union of Civil Liberties) in 2001, that SC/ST settlements should be given priority for future ICDS centres. The court accepted the recommendation. But more than a year after the order, the Sixth Report of the Commissioners speaks of failures by all the state governments to implement the order, or even to survey SC/ST settlements. The vast majority of dalit children must continue to enter an area of heightened vulnerability and tension to get their mid-day meal or supplementary nutrition under the ICDS.

As many as 52% of respondent villages in Rajasthan, 24% in Andhra Pradesh and 36% in Tamil Nadu (a three-state average of 37%) report problems of caste discrimination in the mid-may meals programmes. Up to 48.3% of villages report the dominant castes' opposition to dalit cooks. The second most common issue, at 31%, is segregated seating- dalit children must sit apart from dominant caste children during the meal. A more intensified practice of segregation, by which dalits and dominant caste children are served entirely separate meals, is reported by 9.2% of respondent villages. And 9.2% report that teachers discriminate between students by giving inferior or insufficient food to dalit children. About 2.3% of the respondents identify other problems.

The opposition to dalit cooks manifests itself in many ways. When local administrators are putting the mid-day meal programme into place, dominant caste members intervene to block the hiring of dalit cooks and instead favour dominant caste cooks. Where a dalit cook does get hired, dominant caste parents begin sending their children to school with home-packed lunch boxes or require their children to come home for lunch. In any event, the children are forbidden to eat food prepared by the dalit cook. In another strategy, dominant caste parents or community members pressure the local administration to dismiss the dalit cook on any pretext, and instead hire a dominant caste cook. Sometimes, dominant caste parents campaign to shut down the mid-day meal scheme in the village school. Some dominant caste parents react to the hiring of a dalit cook by withdrawing their child from the school and admitting the child to a school where the cook is not a dalit.

The 2003 survey involved formal interviews with the dalit communities of 531 villages in 30 districts in five states - Rajasthan, Uttar Pradesh, Bihar, Andhra Pradesh and Tamil Nadu. It found that as a five-state average, 17% of villages have PDS shops in dalit colonies, while 70% have PDS shops located in dominant caste localities, and 13% of villages have PDS shops located elsewhere. As a five-state average, 40% of respondent villages report discrimination in quantity-that is, dalits receive, for the same price, lesser quantities than the dominant castes from the PDS shopkeeper. Discrimination in price, where PDS dealers charge dalit customers extra for the same quantity of food that dominant castes purchase at a lower cost, is reported in 28% of respondent villages.

About 48% reported caste-based favouritism by the PDS dealer in distribution. In some places, PDS dealers service the dominant castes throughout the week, while only serving the dalit community on arbitrarily designated "dalit days" once or twice a week, often with reduced hours. A preferential order in service-when dalits are kept waiting and served last while dominant caste members are immediately served-is widely reported. In an average of 26% of the villages surveyed, PDS dealers practise 'untouchability' in the distribution of public goods to dalits. One such practice still in currency is the dominant castes dropping goods from above into cupped dalit hands below, so as to avoid the possibility of "polluting" contact. Other practices evidenced in the data include dominant caste PDS dealers in Bihar hanging cloth screens in front of their shops before dealing with Musahar dalits.

My own work with the survivors of the 2002 carnage in Gujarat, which took the lives of more than 2,000 Muslim men, women and children and rendered more than 200,000 homeless, highlights the intense food vulnerability of survivors of conflict and ethnic violence. Four years after the carnage, an estimated 70% of people have been unable to return to their original homes, blocked by threats, fear and economic boycott. Struggling without livelihoods in minimalist relief colonies, their physical survival and access to food remains intensely precarious.

The malaise of destitution

Whenever the media reports on 'starvation deaths', issues of food security and hunger surface briefly in public consciousness. The short-lived public outrage that follows such reports invariably leads to unseemly wrangles about whether it was indeed a starvation death. This is followed by angry denials by officials, and postmortems and other evidence being mustered to establish that there was some food available to the family and this was not death due to starvation.

The discourse on starvation must shift from people dying of starvation to those who are living with it as a way of life. This is closely linked to the equally neglected reality of destitution. It is usually not recognised that death by starvation is only the outcome of the much more chronic, invisible, malaise of destitution. A large number of forgotten people live at the edge of survival. Each day comes with the fresh danger of one push that will hurtle them into the precipice. The problem of starvation and hunger can be overcome only when people who live in constant peril of slipping into starvation are protected from destitution. Arguable the first duty of any welfare state is to ensure an end to destitution.

The discourse on starvation must shift from people dying of starvation to those who are living with it as a way of life. This is closely linked to the equally neglected reality of destitution. It is usually not recognised that death by starvation is only the outcome of the much more chronic, invisible, malaise of destitution. A large number of forgotten people live at the edge of survival. Each day comes with the fresh danger of one push that will hurtle them into the precipice. The problem of starvation and hunger can be overcome only when people who live in constant peril of slipping into starvation are protected from destitution. Arguable the first duty of any welfare state is to ensure an end to destitution.

Destitution lurks, sometimes visible, sometimes unseen, in every village and town. It is more endemic in certain social groups, such as women and girls, adivasis, people with disabilities, illnesses like leprosy, mental illness and HIV-AIDS, adults who are unable because of illness to earn a living, old people without care-givers, young children without adult protection, manual scavengers and bonded workers, among many others. A lot of empirical investigation is required into precisely which people, which social groups, in which circumstances, slip into destitution and why they reach this stage.

We have already commented on the inadequacy of state responses and schemes in preventing starvation. Apart from major leakage and corruption, the coverage of these schemes is meagre. They leave huge gaping holes in the social security net which large numbers of the most destitute slip through. Measures to prevent and reverse starvation or the persistence of absolute hunger are a duty not to the dead, but to the precariously living. It requires state action and public vigilance.

The right to food of all people cannot be met unless the government and people recognise the existence, scale and location of starvation and destitution and take the necessary measures. The state must introduce a sturdy universal security system for social groups that are most vulnerable to destitution and the consequent chronic hunger and starvation.

There may be many tangled questions about selection, distribution, corruption and monitoring, but our food resources are abundant. However, food security for all appears to be unlikely only because of the utter powerlessness, invisibility, political irrelevance and lack of organisation of the poorest and most deprived people of India. Social security in terms of food coverage for the most vulnerable social groups must not be left to the chance of executive discretion. It must be a legal entitlement, binding on every government. Only then will the enormous injustice, indignity and suffering associated with destitution be overcome.

(Harsh Mander, a former civil servant and ex-Country Director of ActionAid India, is a writer and social activist)

InfoChange News & Features, October 2006