Particularly vulnerable Adivasi speak of despair, hunger at tech “disruption” of social schemes

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Parhaiya Adivasi families arrived for a public hearing at Manika, Latehar

Jirua Parhaian and Dhaneshwar Parhaiya sat in front of the large crowd that had gathered to take stock of the effectiveness of public schemes in Jharkhand’s Manika block, under which which their village falls. They belong to the Parhaiya Adivasi community, which is classified as a “particularly vulnerable tribal group”. The elderly couple listened quietly while government officials acknowledged the problems that have prevented Parhaiya Adivasis from availing of government schemes meant for them.

Both were frail and walked with difficulty. But they had traveled to Manika, the block centre, 15 km from their village Uchvabal, to attend the meeting because they faced a dire predicament. “There is not enough food at home,” said Jirua Parhaian. She and her husband went to bed hungry at least a few nights every month. “Our ration card was cut without any explanation three years ago,” she said.

The couple had carried with them their Aadhaar card bearing the 12-digit unique identity number attached to their biometric data that the government wants all Indian residents to have. They submitted the number to a kiosk manned by government staff at the public hearing. “What more do we have to do to get our rations of rice started again?” asked Dhaneshwar Parhaiya.

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Jirua Parhaian and her husband Dhaneshwar Parhaiya whose ration cards have been cut off without any explanation, making it harder for them to afford all meals.

The government recognises Adivasis such as the Parhaiya and 70 other communities as particularly vulnerable tribal groups because of their precarious economic condition and dwindling populations.

These communities are also entitled to Antodaya ration cards meant for the “poorest of the poor”, which entitles them to 35 kg of rice at Re 1 per kg every month under the National Food Security Act. But they continue to face dire hunger and malnutrition.

In Jharkhand, which is going through a period of drought, these families are falling through the cracks in the absence of adequate social protection. A survey in November conducted among 324 Parhaiya households living in 15 villages in Latehar district found nearly 43% of the families had missed meals in the last three months because there was no food at home. The survey was carried out by National Rural Employment Guarantee Act Sahayata Kendras and Gram Swaraj Mazdor Sangh activists. The survey also showed that though the government has aggressively pushed Aadhaar as a way of streamlining welfare schemes and improving access to social security by providing everyone with an identity document, ground reality was different.

It found that Aadhaar, in fact, acted as a barrier to accessing social schemes. For instance, the survey found that 42% of Parhaiya families surveyed faced problems due to Aadhaar in the form of data entry errors, network glitches, biometric authentication failures or complications related to their failure to complete Know Your Customer norms for banks far removed from their hamlets.

Left out of social security
Traditionally, Parhaiya Adivasis survived by collecting forest produce such as honey and mahua flowers, roots such as gethia and kanda, and by making bamboo brooms, said Mahavir Parhaiya, an activist in Latehar district, which Manika block is part of. “But the dense forests are now gone,” he said. “The government made forests into plantations, handing them to contractors. Now our people struggle to find the jadi[roots] or saag[vegetables] that we survived on.”

This is one of the reasons why the community is dependent on government support to eat.

At the public hearing, several Adivasi families described corruption in schemes meant for them. Those who had ration cards said they frequently received less grain than they were entitled to despite having Aadhaar, which the government had introduced in the public distribution system in order to end pilferage.

Nearly a dozen Parhaiya women from Uchvabal and Pagar villages said they received only 30 kg or 31 kg of rice every month instead of their 35 kg entitlement. “After the surveyors came to the village, for the first time, yesterday the ration dealer Dinesh Rai gave [me] 35 kg rice,” Sugiya Devi told local officials at the hearing. She said the ration dealer had followed a “tin” system for years. “He fills two tins with ration and says we have got only this much,” she said. The tins were filled with grain and weighed at the meeting, while officials watched. They weighed only 31 kg.

The delivery of rations in tins also violates a system the Jharkhand government has put in place to ensure that families from particularly vulnerable tribal groups got their full entitlements, without any pilferage. Under the dakiya or post system, the ration dealer is required to deliver monthly food rations to such households at their doorsteps in sealed sacks clearly marked for such groups.

Read the full report here.

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Dasiya Kunwar Parhaian said the customer service center kiosk operator meant to connect the residents to government services online demanded a bribe of Rs 2,000 for her pension application.

In December 2017, several Adivasi and Dalit families living in the same district, Latehar, at a public hearing in Manika block had described the problem of how their subsidised food rations had been abruptly stopped. The government in Jharkhand, like in several other states, had in 2017 asked for all ration cards to be linked with Aadhaar and mandated that only card holders whose fingerprints are authenticated online from the Aadhaar database would get subsidised grain.

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Jirmunya Parhaiyan, Sumati Kunwar, Dasiya Kunwar, all Parhaiya PTG Adivasi, from Rankikala and Sedhra who could not access rice rations after Aadhaar linking errors, at the right to food public hearing at Manika in December 2017.

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Radha Devi: Managing maladies in Bhuiantola

A path winding through paddy fields led to Bhuiantola, a hamlet where Bhuian Dalit families lived, on the outskirts of Tarwadih village in Jharkhand’s Latehar district.

That month, eight individuals in Tarwadih were on treatment for tuberculosis(TB), a serious bacterial infection that most commonly affects the lungs. Four of them lived in Bhuiantola.

The previous night, Radha Devi, the village sahiya or frontline health worker, an Accredited Social Health Activist(ASHA) had finished helping a woman delivery a baby in the hamlet. Now, walking down the paved path, she called out to Ramavtar Ram who was working in the fields. “Nine number” medicine is over for you. You will be on “CP” from now on,” she told Ram, a farmer in his 50s who was afflicted with TB, and had grown leaner from the infection.

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Devi did not train as a doctor or a nurse, and studied till only class IV. As one of over 1,325 health activist appointed under the National Health Mission’s community health programme in Latehar, she had supervised Ram’s TB treatment and infection control for the last six months. “I am not fully literate, but I can recognize the medicines as a number or an alphabet in the drug’s name,” said Devi, explaining how she had memorized the long, complicated names in english, an unfamiliar language, of 13 drugs used in TB treatment.

TB is fully curable by antibiotics taken for six months. Yet, India accounts for a quarter of new cases of TB infection, and a fifth of TB deaths worldwide. In Jharkhand, nearly 40 people die of TB every day.The government recognizes those living in remote tribal districts who get poor nutrition and face difficulty in accessing treatment as a priority group for reducing TB transmission.

Crucial infrastructure is absent in Jharkhand’s Adivasi villages. Dr Rajabau Yole a World Health Organization TB consultant in Jharkhand said that though every community health center was supposed to have a X-ray machine for radiological examinations and a courier system to transport sputum samples that needed to be tested for TB, this was missing in most districts.

There is also a major shortfall of doctors. Dr Raksh Dayal, Jharkhand’s state TB officer, said that the state had only 2,200 of the 3,400 doctors and about half of other contractual health staff it needed, and this affected the TB treatment programme. In Latehar, where Tarwadih lies, for instance, in the district TB hospital, 13 of 23 posts were vacant, including the post of a medical officer for TB, which had not been filled since five years.

In such a situation, health workers like Radha Devi filled a vital gap.
Latehar, where Bhuiantola lies, is one of the poorest Adivasi regions in Jharkhand. The families here are especially vulnerable also because they migrate to work in brick kilns in Varanasi in UP, and Aurangabad in Bihar when the paddy produce is exhausted in a few months. Working in kilns, they are exposed to smoke which damages the lungs, and reduces immunity to infections such as TB.

Sahiya Radha Devi counseling women in Tarwadih in Latehar (1)
“Many migrant workers hide it if they develop TB, and often they take medicines for only 3 to 4 months and do not complete the treatment,” said Ramesh Chaubey, Latehar’s district welfare officer.

Radha Devi, who was chosen as the sahiya in 2007 by the village’s residents while she was in her late 40s, had worked in brick kilns most of her life. The labour contractors offered sums of Rs 10,000-12,000 as “advances”, she said, and this was a big draw, but later did not pay regular wages. “At the kiln sites, away from towns, there are no health facilities,” said Devi. “Many workers develop alcoholism at the kilns. Some do not like the taste of the medicines, and some worry about adverse side effects. All these are the reasons why they do not complete treatment.”

Of the eight TB patients in Tarwadih, whom Devi was administering treatment to, Bartu Oraon, an Oraon Adivasi, was undergoing treatment for a relapsed infection. Mohan Bhuian, a brick kiln worker, had developed Multi Drug Resistant(MDR) TB, a more deadly form of TB infection, that develops if a patient gets incomplete or inadequate treatment. In MDR-TB, two of the most powerful TB drugs stop working. Those with MDR-TB can transmit this deadlier form infection to others in close contact through air droplets in the same way as regular TB. MDR-TB is treated with highly toxic drugs over a protracted two years period.

Devi said to control the spread of infection, she had been trained by the staff at the TB hospital in Latehar to ask ask patients to spit in a pan and cover it with ash. “I ask them to take precautions, to use ash to cover their spit, or cough only into a gamcha and boil it in water to prevent further infection,” said Devi. “If they don’t like the aftertaste of the drugs, I even buy them small packets of namkeen with the drug,” she said, showing a small packet of snacks she had carried for a patient. She had also been counseling Neetu Devi, a young farm workers, who had recently delivered a boy, that while she had TB she had to cover her mouth while breastfeeding to prevent the infection from spreading to her baby.

Seeta Bhuian, whose husband Mohan Bhuian had the most serious infection in the village with MDR-TB, said Mohan had taking TB drugs irregularly for five years while migrating to work at the kilns and over time, he had got so sick that he could no longer stand. After he was diagnosed with MDR-TB last year, Bhuian had to take 13 medicines and an injection daily for six months and since the last three months, he had been on seven drugs daily.

“The sahiya came home to give him the medicines daily,” said Seeta Bhuian, Mohan’s wife. She added that Radha Devi had also traveled with Bhuian twice to Itki, 110 kilometers away. This is where the government ran a TB sanatorium, an indoor facility where Bhuian had been diagnosed with MDR-TB.

After nine months of treatment, Bhuian had recovered enough strength to walk, and had taken the cattle grazing that afternoon. But his family was anxious and concerned because one of the medicines, Kanamycin, had had a severe adverse effect on him making him lose his hearing four months into the treatment.

Radha Devi with Mohan Bhuian who is on treatment for Multi drug resistant TB in Tarwadih in Latehar (1)
Radha Devi had traveled with Bhuian to Itki while he was in the most infectious state, accompanied by his younger relatives. “At the sanatorium, the doctor told us the medicines were so toxic that they could make Mohan depressed, paralyzed, or deaf,” she said. “Sadly, I have seen Mohan go through all of these stages this year.”

After getting Mohan Bhuian admitted, Radha Devi had traveled over a 100 kilometers from her village to Itki a second time to act as his counselor when he started developing side effects. “Mohan called me on the phone and said he felt he was going to go mad,” she said. “I was scared I may get lost while traveling alone from our village, but somehow I managed to get to the city. I felt like he was my son and was worried.” For her travel costs, Mohan Bhuian had later reimbursed her Rs 400, after the government hospital staff did not pay her anything for the trip.

As a sahiya or ASHA worker, Devi is supposed to get Rs 100 as “incentive” for each TB case that she reported, but she said she had not received any payments till now.

Devi added that she had heard that the government had promised to double the honorarium of ASHA workers and other ground health and nutrition staff this year. “I have heard ASHA will get paid high amounts of honorarium totaling Rs 3,500-5,000 a month for the work we do,” said Devi. But in the past 16 months, there had been delays in sanctioning sahiya payments, said Suranjeen Pallipamula, a health activist in Ranchi.

“For more than a year now, I have not got paid anything,” said Devi.

An edited version of the story in The Hindu Sunday Magazine here.

All photographs by Manob Chowdhury.

Officials coerce in name of “community-led sanitation”

The rush to show that the Swachh Bharat deadlines have been met has left the most vulnerable low income Dalit households out. Officials have deployed various coercive measures in name of “community-led sanitation.

The panchayat officials in Rajasthan told farmers that if they did not have a red stamp saying “open-defecation free family” on ration cards, they would cut off the ration grains from the government. Those who still did not build by then were marked as households that lacked space to build latrines. This way, the target got reduced and local officials showed compliance.

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Many families that have built latrines don’t use them but government surveys do not reflect any of this. In places where open defecation has not ended, the ministry is relying on statistical tools to show it has.

Full report in HuffPost India here.

On India’s biometrics ID Aadhaar debate

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7-year old Abhishek Bairwa enrolling in Aadhaar in a shop in Bagru, Jaipur district after being asked by his school teachers to do so. photo AnumehaY

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Fact check: Will restricting Aadhaar now affect crores of welfare recipients?
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An audit of ration shops after the introduction of Aadhaar revealed that many genuine beneficiaries couldn’t collect food grain due to system glitches.
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How the government got the Supreme Court’s approval to link subsidy schemes with Aadhaar
India’s Unique Identity Dilemma isn’t about those who enrol in Aadhaar, but those who don’t
No benefits for beneficiaries

No Aadhaar, no scholarship

She returns empty-handed, this time too

To pass biometric identification, apply Vaseline or Boroplus on fingers overnight
Direct benefits transfer: Why direct transfer may not put money in people’s pockets

When public health schemes turn anaemic

Since 2010 when the central government discontinued the supply of medical kits containing Iron Folic Acid, vitamin A, zinc tablets and Oral Rehydration Solution packets under National Rural Health Mission (NRHM) to states, village anganwadis and health centers have turned anaemic pregnant women and adoloscent girls away.

These are essential for reducing anaemia and birth defects which affect 69.5 percent women and girls between 15 and 49 and over 70 percent of all children below five in Jharkhand – the highest levels of anaemia according to National Family Health Survey 2 and 3 done in 1999 and 2006.

“There are eight pregnant women and several adolescent girls in the village but we do not have any stocks of tablets,” says Rukmini Devi, the anganwadi sevika in Bhandara. Photo by Manob Chowdhury

“There are eight pregnant women and several adolescent girls in the village but we do not have any stocks of tablets,” says Rukmini Devi, the anganwadi sevika in Bhandara. Photo by Manob Chowdhury

Over six lakhs, or nearly 12 percent, of children below six years of age in Jharkhand suffer from severe malnutrition. Children born underweight due to anaemia among women is a significant factor. Under a central scheme, 100 IFA tablets are to be given all pregnant women and weekly IFA supplements are to be provided to all adolescent girls between 16 and 19 years of age. Recently, adolescent boys have also been included in the scheme.

“District civil surgeons were asked to procure this but some bought expensive non-generic IFA tablets and exhausted funds. A month back the tender process was completed and now those will soon be supplied to all districts,” said Dr Praveen Chandra, Director NRHM in Ranchi. In 2011, former health minister Bhanu Pratap Shahi, former health secretary Pradeep Kumar and other department officers were named as accused in a Rs 130-crore NRHM scam related to purchase of medicines. The CBI is now investigating the case.

The state Social Welfare, Women and Child Development (SWWCD) website shows a budget of Rs 2.53 crores for purchase of “medicine kits” but officials in Ranchi say this meant only for purchase of first-aid. The department launched the Rs 70 crores Jeevan Asha program last month with focus on reducing malnutrition but this too does not have a component especially for IFA tablets.

At Khunti

More than two years after she gave birth to her youngest daughter, Shanti Oraon, an adivasi farmer in Bhandara village in Khunti district has been unable to resume working in the fields. “She has breathing trouble, and could not start walking even after she turned two and a half years old. I must stay at home with her all the time,” she says of her infant daughter lying wrapped in a bedsheet on the floor. Across the road from Shanti Oraon’s house, Pooja Devi watches her one-year-old play with a plastic bangle in her mouth. “She weighed less than three kgs when she was born. She falls ill often even now,” she says.

Bhandara lies a little over 30 kms from Ranchi, the state capital, and is on the outskirts of Khunti’s district center and market. Despite good connectivity with roads and easy accessibility, Bhandara and the adjoining villages Belahatu and Chikor have not received supplies of IFA since 2009.

Shanti Oraon recounts that during her four pregnancies she received IFA tablets, each costs less than 20 paise, only before the birth of her second child more than four years ago but none before the birth of three of her children. “There are eight pregnant women and several adolescent girls in the village but we do not have any stocks of tablets to give them,” said Rukmini Devi, the anganwadi sevika in Bhandara as she prepared a meal of rice and soyabean nuggets for the seven children below six years of age who turned up for lunch that afternoon from among the 89 enrolled as per the anganwadi charts.

“Over 3/4thd of girls between 15 and 19 are not in schools so there must be focus on how to reach them. In our surveys we have found that even when pregnant women get IFA tablets there are beliefs that these tablets can make your child darker – because the iron tablets can make the stool darker. Encouraging women to take tablets will require regular counseling,” said Job Zachariah, Head UNICEF Jharkhand.

Read the full story in The Hindu here.

Away from home

MVI 1856 from Anumeha Yadav on Vimeo.

Families from Chattisgarh and UP say they have been working in bonded debt in kilns in Sundarbani in Jammu and on outskirts of Srinagar since 15 to 20 years. They work in kilns in Jammu for 7-8 months and then are bought by kiln owners in Srinagar for the rest of the year when work closes in Jammu kilns. Naveen Kumar who is working in a kiln at Bhakar near Sundarbani is worked in the kilns in JK many years in is bonded debt of over Rs 1 lakh.

My previous reports on forced labour in Rajasthan, here and here.