Wednesday 31 December 2014

Deconstructing Racism and Regionalism in India

Racial Thinking

The Hindu
India is a country with diverse regions, languages, castes, religions and races. As a nation, India has been in the forefront for propagating values like ‘unity in diversity’ and pride in multiculturalism, both in the national and international forums.  India’s contribution to the struggle against apartheid in South Africa can never be forgotten. But in practice, Indians have failed to accept and respect its heterogeneity resulting in the social exclusion of ‘others’. This social exclusion is often the result of discrimination based on race or differences based on physical attributes such as colour of the skin, facial structures etc.

Though racial discrimination is prohibited by law and may not be practised at the institutional level, but its effects in everyday life are regularly experienced by people from ‘other’ ethnic groups who live in a different geographical or social landscape. For example, there is an anti-Bihari sentiment across the country, a South Indian is called “Madrasi” and a person from North East is called ‘chinki’. These are just few of the many cases. There is also a never ending prejudice against black or dark-skin, always giving preference to a fair-skinned person, in India.

To exclude racism, various groups and experts have demanded the enforcement of an exclusive anti-racism law. However this demand is much in debate as the other side of the argument is that racism is a social problem that exists in the minds and attitudes which cannot be addressed unless the minds of the people are connected through integration and promotion of cultures of other ethnic groups.

Injustice inflicted by racism

Indians often see themselves as victims of racism, inflicted particularly by the West. However time and again, Indians have themselves been perpetrators of race based violence towards others whom they consider as inferior.

State of North Easterners in Metro Cities
Death of a 19 year old student Nido Tania; physical assault of an engineering student in Bangalore and attack on two youths by few locals in Gurgaon are still fresh in our memory. Though these are three different tragedies, what is common to all these incidences is the shameful fact that these are racist crimes committed against the North East people in mainland India.

According to a police record, the national capital has witnessed a rise in racial crimes against people from the North Eastern Region (NER). Out of 847 phone calls this year (till mid November), the police received 650 calls concerning racial discrimination against the people from NER.  The Bezbaruah Committee that was set up under the chairmanship of Mr. Bezbaruah to look into the racial issues faced by the North Easterners, highlights that over two lakh people have migrated to Delhi from North Eastern states between 2005 and 2013 and about 86% of them have faced some form of racial discrimination.

Anti-Bihari sentiment
There have been several racial attacks against people from Bihar who migrated to other parts of India mainly for employment. However they have been subjected to severe social exclusion in other states. Between 2000 and 2003, anti-Bihari violence led to the deaths of upto 200 people and created 10,000 internal refugees (MS Academic, 2012).

In February 2008, migrants from Uttar Pradesh and Bihar who settled in Mumbai for jobs were charged of being ‘infiltrators’ and accused of spoiling the Maharashtrian culture. Orchestrated riots and anti-migrant political campaigns routinely target migrants from other states and protest their presence in the city, even today.

Outsiders vs Tribals in North East
There have been series of massacres and bomb attacks on migrants from other states even in the North East. Discrimination and violence faced by ‘outsiders’ or ‘non-tribals’ in the North East have continued for a very long time, resulting in declining population of ‘non-tribals’ in Meghalaya, from 20% when the state was formed to below 10% (Tehelka).

An ‘outsider’ is called a ‘Dkhar’ in khasi, a pejorative term for people from other ethnic groups including Bengalis, Nepalis, and Biharis.


Targeting ‘Black’
African nationals are stereotyped as drug peddlers or sex workers in India. They are made victims of derogatory remarks like ‘negro’ or ‘kale’ (black), physically abused on the streets, and are also made victims of administrative (like police) apathy. The most recent demonstration of this is the brutal assault of African students in one of the metro stations of Delhi. These students protested being photographed by few local youths. In response, the African students were attacked by the locals and alleged of misbehaving with a woman, without any evidence. The victims sought police protection, but in vain.

Anti Racism Law in India: the debate

Need for an anti racism law
Article 15 of the Indian Constitution prohibits any race-based discrimination by the state. Such a fundamental right like Article 15 guarantees protection to victims of racial crimes committed by the state but fails to guarantee protection from private individuals. Additionally, anti-discrimination legislation also fails to acknowledge racism that is ‘invisible’ and executed through certain tone or gesture.

The Scheduled Castes and Scheduled Tribes (Prevention of Atrocities) Act is one of the foremost anti-discrimination legislations in India. Though the act protects significant number of persons from the North-East as majority belong to the Scheduled Tribes, it fails to protect non tribal from the region and other communities in India who are victims of xenophobia.

Recognising these gaps in the existing domestic laws, there have been demands for an anti-racism law from various groups and activists. However, the prospects of an anti racism law should be looked at holistically, such that it is able to tackle the issue and protect the interests of every vulnerable individual and group, both national and non-nationals, without being biased towards a particular group. One has to also see whether an exclusive law like this can eradicate every form of racism? Xenophobic exclusions and other forms of ethnicity-based discrimination are legally forbidden in the United States, yet it continues through indirect forms of expression, prevalent as ‘symbolic racism’ or reflected in socioeconomic inequalities like employment opportunities, homeownership, and income levels etc. For example, there is disparity in homeownership between African-Americans and the Whites, which is an indicator of the racial wealth gap, according to a recent study from Brandeis University.

The other side of the debate- need to strengthen existing legislations
Contrary to the advocates of anti-racism law in India, there are activists and groups who suggest correcting and strengthening existing legislations on anti discrimination. According to Mr. Bezbaruah, the chairperson of the Bezbaruah Committee, “We need a quicker solution because these crimes are increasing rapidly, when they should be decreasing.” In his views, the “introduction of fresh legislation would be lengthy; the government must consider swift reform of existing laws.”

The Bezbaruah committee recommended adding sections to India’s Penal Code, including making a “word, gesture or act intended to insult a member of a particular group or of any race, punishable with a maximum of three year jail sentence and a fine.” The other recommendation from the committee includes setting up designated courts to deal with racial conflicts, making Police more responsible and increasing role of media, NGOs, private sector in addressing the issue together. Promotion of other cultures and spreading awareness amongst people about various social groups and culture is necessary to curb the problem.

In a survey poll carried out by the Morung Express, a Nagaland based newspaper, majority of the people said an anti racism law is unlikely to protect the people of North East from racial discrimination. “Racism is a social problem and it can only be solved at the societal level……………Only a paradigm shift in societal attitude will minimise racial discrimination.”
Racism is a social problem

Racism originates from intolerance towards other cultures to faulty prejudices against them. Since the ethnic minority or an individual belong to a different social landscape, their behaviour and lifestyle is absolutely unknown to others who develop wrong perceptions about them. There is an utmost need to address racism not just through legal discourse but also through sensitising people about other ethnic groups and cultures. It is essential to deconstruct faulty perception and half truth that have been passed on through incorrect narratives.  Role of universities, media, sports and tourism become crucial in creating awareness and integrating people (both national and non-nationals) of different background.

Racism is India has a very long history; however there has been lack of voice against such injustice. We all have to accept our share of the responsibility in supporting racism either by pretending that it does not exist or by preferring to stay silent on the issue. There has to be zero tolerance towards racial discrimination not because it is against ‘our’ people but because it is against human dignity. Academics, thinkers, artists, writers, activists, journalists, professionals and students must challenge any form of discrimination through debates, discussions, writings, complains and protests.

Strengthening law enforcement agencies and institutional support also becomes significant.  Attitude of the police, who are often charged of harassing victims of racial slurs, needs to change. As also recommended by the Bezbaruah Committee, concerned state and central government bodies like state bhawans, should play a more proactive role in providing support to migrants. Fast track courts should be set up in States, exclusively to handle crimes committed on grounds of race.

Time to put an end to ‘Racism’

India's contribution to the struggle against apartheid in South Africa has been highly acknowledged globally. Under the leadership of Mahatma Gandhi and Pt. Jawaharlal Nehru, as a national ideology, India has shown an uncompromising attitude towards any form of institutional racism. However this pride and India’s own freedom struggle becomes meaningless as long as racism exists, even if at an individual level.

Racism is a form of exploitation and it will continue to exist as long as we deal with the problem half heartedly. Resorting to legalistic means cannot be ignored, but complete eradication of this problem is only possible when people develop solidarity towards their countrymen and also non-nationals, by destroying artificial differences on the grounds of culture, language, physical features and colour.


 

Abhishikta Roy

Thursday 18 December 2014

Sahariyas and their Vulnerabilities

Source: Action Aid India
Madhya Pradesh and Rajasthan together have more than 2.45 crore tribal population divided into 46 and 12 groups respectively. Seven tribal groups in Madhya Pradesh and one in Rajasthan what is termed as Particularly Vulnerable Tribal groups or PVTGs (earlier called Primitive Tribal Groups or PTGs). Sahariya is one among these PVTGs inhabits   eight districts of Madhya Pradesh and few places in Rajasthan. According to Census 2011, Sahariya is the largest community in the list of 75 PTGs with a population of more than seven lakh. Around 85 per cent of Sahariyas live in Gwalior, Guna, Shipuri, Vidhisha, Datia, Bhind, Sagar and Tikamgarh districts of Madhya Pradesh. The government of India recognized the vulnerability of Sahariyas in 1975-76 by including them in PTGs but in the late end of the 20th Century, the enforcement of environmental laws, insensitive displacement, schemes for mainstreaming and ignorance of their vulnerabilities as PTG marginalized them further.

Livelihood of Sahariyas:

Traditionally Sahariyas are forest dwellers. They practiced shifting cultivation, hunting gathering, pastoralism, and a quiet nomadic life. Similar to many other PTGs, Sahariyas had also close link with forest and forest product for their livelihood. They practiced agriculture in mountains and during non-agricultural season, they collected forest products. According to a study conducted by Vikas Samvad, Bhopal in 2007, Sahariyas used to barter forest product like Gums and Chironji with that of cereals and also used to prepare baskets out of ‘Siari’ wood to store their half yearly requirement. Sahariya’s economy before the enforcing of environmental laws was self-sufficient and was in harmony with the local ecology.

After government took over the control of forest, Sahariyas lost their main source of livelihood. Vikas Samvad in its study of Madhya Pradesh argues that the government policy on forest wiped them from forest and forest products. According to the Census 2001 data, more than 70 per cent of Sahariyas are non-cultivators. Most of them are agricultural labourers. A study by the Centre for Tribal Development in 2002 reported that the annual per capita income among Sahariyas was Rs. 2,691, or about Rs 7 a day, less than one-third of the national poverty line figure of Rs. 26 a day in rural areas. Curtailing forest rights of Sahariyays, through environmental policies, what they were inheriting since ages destroyed their existence. On the other hands government’s un-planned, insensitive and shortsighted rehabilitation and development plan for Sahariyas pushed them to further deprivation.

Major Visible Vulnerabilities

Modern development initiatives in India in last few decades undermined socio-cultural diversities of PTGs such as Sahariya. Despite recognizing the vulnerabilities of PTGs in 1970s their voices remain unheard in developmental programs targeted to them. It seems that in last few decades their vulnerability increased instead of decreasing. Some of these vulnerabilities are discussed here in brief.

Starvation:
After losing control over production of grains and accessing food item through their traditional barter system in last few decades, Sahariyas are now facing starvation situation on every day basis. Due to scarcity of food, they rely on ‘tubers’ and ‘leaves’ collected from nearby forests. When drought hits and there is nothing to eat, Sahariyas depend on bread made of ‘Sama’ (a locally grown wild grass) and soup made from its seeds. Very often even this grass is not fit for consumption as it doesn’t ripen due to lack of water , which make them difficult to digest.

High Malnutrition:
Insufficient food has led to wide spread malnutrition amongst every age group of Sahariays. Action Aid India reported that the malnutrition level among Sahariya children under three is as high as 66.3%, which is much higher the national average of 47%. Many such other studies of Sahariyas revealed high level of undernourishment and hunger deaths. According to a paper inquiring status of women and children of Sahariyas of Madhya Pradesh published in Indian Medical Journal in 2013 found that Chronic Energy Deficiency (CED) affected 42.4 percent women whereas 90.1 percent women were anemic. In their study, Kapoor et al (2009) noted that CED amongst males was about 48.8 percent. As per World Health Organization a CED of 40 percent exhibits a critical health problem.

Poor Health:
Curative health care is not an option for most. In most cases, health centers are very far away from Sahariya villages. Moreover, many report being callously treated at the health centers by the staff. Many times Sahariyas are not aware about what they are being prescribed. Therefore, most times,’ quacks are preferred. Empirical studies have found that major causes of death include pneumonia, malaria, tuberculosis, gastric problems and diarrhea. Low standard of living, poor food habits, low socio-economic conditions, lack of portable water and unfavorable environment all contribute to poor health standards. 

Low Education and Child Labour:
Sahariyas do not have access to education; Census data reveals that only 2 per cent of Sahariyas have studied until the secondary level. The literacy rate of Saharia both in Rajasthan and in Madhya Pradesh is the lowest amongst all the tribes in these states. In Rajasthan the tribal literacy rate is 52.8 whereas Sahariya literacy rate is 48 percent. Similarly, Madhya Pradesh has a tribal literacy rate of 50.6 whereas the Sahariya literacy is recorded at 42.1 percent. Women literacy amongst the Sahariyas is much less with Madhya Pradesh at 32 and Rajasthan at 33.7 percent respectively.

Hindustan Times recently reported that children, instead of being sent to school are working to sustain their families. Increasing debt due to crop failure and food insecurity forces families to send their children  to work for wages ranging between INR 2000-6000. The children are employed to herd sheep and other animals in the jungles of Rajasthan and Madhya Pradesh.



Conclusion:

Even after being identified as a PTG group, policies dealing with Sahariyas have not kept in mind the features that make them an especially primitive group. However, continuous ignorance of their culture continuous to feature in the way government is formulating response to them. As mentioned earlier, they are frequently ill treated, which marginalizes them further. Moreover, when they access government services, the nourishment provided is not suited to their dietary practices. Children cannot digest or do not prefer panjeeri and soya buffs. The reason a special category of tribes was created was so that policies are customized to their lifestyle. Thus, the developmental approach of Saharaiyas must emphasize an effort to understand their social, cultural and economic conditions that make them a Primitive Tribal Group.



Jeet Singh and Shriyam Gupta 

Wednesday 3 December 2014

Women’s Autonomy and Demography: Women pay the price for population control

Prevelance of female sterilisation over male sterilisation

India is one of the first countries in the world to have formulated family planning programmes. Family planning programmes like mass sterilisation in India were introduced in response to the booming population . However it is female sterilisation (tubectomy) which has always been prevalent over male sterilisation (vasectomy) or other contraceptive methods.

Recently, in one of the worst medical disasters in India’s history, many women lost their lives in a mass sterilisation camp organised in Chhattisgarh. Family members of the victims have reported how women were pressurised to undergo sterilisation. Mahesh, brother-in-law of one casualty, told the Indian Express newspaper, “They [health workers] said nothing would happen, it was a minor operation. They herded them like cattle.”

However, this is not one of the rare cases where mass sterilisation camp has killed women. Between 2003 and 2012, as estimated by various reports, thousands of women died in sterilisation camps organised in various states including Uttar Pradesh, Tamil Nadu, Maharashtra, Karnataka and Andhra Pradesh.

Violating all medical guidelines, sterilisation camps like the one in Chhattisgarh and others are often found to have used contaminated medicines, rusted surgical equipments and unhygienic environment. Guidelines which set the maximum limit of surgeries to 30 a day, have often been ignored by doctors in sterilisation camps, were the operations outnumber the limit. The cause of such tragedies can be related to sheer medical negligence, apathy of doctors towards patients, poor state of health services in India and above all violation of women’s rights over their bodies.

The District Level Household and Facility Survey (DLHS)  in 2007–08 revealed that over 35 per cent of married women in  the the reproductive age group ( 15–49 years) had undergone tubectomy, as against 1 per cent of men who have undergone vasectomy. This is despite the fact that Tubectomy as an irreversible method of birth control is a more complex procedure than vasectomy.

In this light, it is important to comprehend the relationship between family planning in India and female sterilisation.

No choice for women: Social pressure, national targets

The DLHS data in 2012-13 have also indicated State Governments preference on female sterilisation over other contraceptive methods in India’s family planning programmes. For example, in Andhra Pradesh, during 2007-2008 and 2002-2013, 60 and 63 per cent women in the fertile age range had been operated respectively. However, during the same period, the number of men who underwent sterilisation, came down from 4 to 2 per cent. A similar trend was observed across many states in India.

This trend can be traced to the deep rooted social belief that the primary role of women is that of  reproduction and child rearing. Instead of looking at family planning as a responsibility of both men and women, family planning programmes in India have been directed at women by and large.  Added to this there is a tremendous social stigma attached to male sterilisation. Along with the fear of impotency, physical weakness, “it becomes a question of manhood”, says Rukmini, a District Reproductive and Child Health (RCH) Officer from Karnataka. “Unfortunately social stigma nearly always ensures the fairer sex is the subjugated lot…………….where women are more likely to go under the knife rather than men.”
(The Hindu)

In a patriarchal society, women usually have little autonomy within and outside the household; they also have limited control and no voice over their own reproductive and contraceptive choices. Hence they are always made easy targets of family planning programmes. For most women, sterilisation is not a choice, it is a diktat. Thus women are forced to undergo sterilisation, sometimes without their knowledge or opportunity to provide consent. According to the DHLS 2007-08, 40 per cent of women who got operated across India were illiterate. When women are poor and uneducated, they are more vulnerable, and are easily persuaded to accept the painful and irreversible contraceptive method through financial or other incentives. They are forced to undergo sterilisation either by authorities responsible for family planning programmes or by family members who are in need of monetary benefits. Women are convinced to undergo surgeries by luring them with cash incentives. “The husband of a Baiga tribe woman who died after undergoing tubectomy at a government-organised sterilisation camp in Bilaspur district alleged that health workers put pressure on them and also held out a promise of money for consenting to the operation.” (India Today) This is nothing but grave violation of women’s rights.

In 2012-13, the District Level Household and Facility Survey highlighted poor quality family planning services which were offered to women. Women were not informed about the side-effects of sterilisation or about other methods of contraception. Even where women were counseled, the staff strategically refrained from giving adequate and correct information. For example, in Maharashtra, only 17 per cent of the women were told about the side-effects, while in Punjab and Haryana only 14 per cent and 11 per cent women respectively were given any information related to other methods of contraception. Hence majority of these women could not have provided "informed consent" due to lack of awareness and knowledge.

“The government of India denies that there are targets but they’re clearly set and when it goes down to the district or village level that’s a real problem. Extreme pressure is the crux of the problem,” says Sona Sharma, joint director for advocacy at the New Delhi-based Population Foundation of India. Senior officials sometimes threaten health workers of reducing remuneration or suspending them from work. “Health workers who miss sterilisation targets because they give proper counseling and accurate information about contraception risk losing their jobs in many parts of the country,” said Aruna Kashyap, women’s rights researcher at Human Rights Watch.

To achieve the desired target, in some districts, more than the prescribed numbers of tubectomies are performed single handedly by a medical practitioner in unhygienic and inappropriate conditions. As a perk, compensation is given to service providers as well as acceptors of sterilisation. Unofficially material benefits are also given to health workers and agencies organising sterilisation camps.  In 2011, service providers in Rajasthan were reported to have been offered motorcycles, television sets, even Tata Nano cars.

Reproduction and contraception is for women: the social perception
In a study carried out in central India about the men’s perception of contraception, it was found out “Men viewed "family planning" as synonymous with female sterilization, whereas they saw "contraception" as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilized; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilized. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health.” (Male Perceptions on Female Sterilization: A Community-Based Study in Rural Central India by Arundhati Char, Minna Saavala and Teija Kulmala).

Female sterilisation being dominant, use of other spacing methods like Intrauterine Device (IUDs), condoms  are limited,  despite the fact that there is a high unmet need in spacing. According to DLHS III, all the spacing methods together account for just 25.5 per cent of the current contraceptive use, compared to female & male sterilisations which account to 75.5 per cent. Social and cultural acceptability of female contraceptives over male contraceptives have also set a high competitive bar on pharmaceutical industry and research that is prepared to invest more on the former than the latter. According to RH Reality Check (a daily publication providing news, commentary and analysis on sexual and reproductive health and justice issues) “research on male contraception is 50 years behind research on female contraception.”

Need to re-look at nation level population programmes from women’s perspective
It is a common perception shared by society that reproduction, and therefore contraception, is the responsibility of a woman. Despite all talks of empowering women and their reproductive autonomy, the right to choose whether to have children or not and the freedom to choose the methods of fertility management, based on access to proper information, has been largely denied to them. This gets translated in the family planning programmes and practices as well. It is sad that it is only by the death of several women in a botched up attempt at sterilisation that the whole issue has been bought to the fore.

It is time for the nation to understand that fundamental to the success of any family planning programme is the enhancement of women’s freedom and it should involve both men and women in its population stabilisation goal. More men should be involved in family planning programmes “not as targets for vasectomy but as partners within a gender-equality paradigm,” says Dr Abhijeet Das, Director of CHSJ and an assistant professor at the Department of Global Health, University of Washington.

The need of the hour is to look at India’s population programmes from the perspective of the women who are forced to suffer its consequences. In addition, there is an urgent need to improve public health services in India, make doctors and health agencies more accountable and eliminate coercive family planning porgrammes, to ensure that women in Chhattisgarh or any other place do not become victims of faulty sterilisation drive!



Abhishikta Roy

Thursday 13 November 2014

Concentration of Neonatal Deaths and Role of Community Newborn Care Practices

Neonatal Mortality and its Concentration in India

Every year about 0.76 million neonatal deaths (death within one month of the birth) occur in India, which accounts for 28 percent of such death in the world, the greatest for any country. About two-thirds of infant deaths and half of under-five child deaths are during the neonatal period.  India’s Neonatal Mortality Rate (NMR) stands at 29 deaths per 1000 live birth, and the states at high risk include Madhya Pradesh (39), Odhisa (39), Uttar Pradesh (37), Rajasthan (35) and Chhattisgarh (31).  Though the Neonatal Mortality Rate (NMR) has declined from 52 per 1000 live births in 1990 to 29 per 1000 live births in 2012 (SRS 2012) the declining rate has been very slow as compared to many other developing countries and emerging economic states.

A latest report ‘State of India’s Newborn 2014’ released by Public Health Foundation of India (PHFI) reveals the health disparities among newborns of various communities in India. According to the report, health outcomes are shaped not just by biological factors but also by the social, economic, and cultural environment. Social hierarchies and inequitable distribution of resources produce significant inequalities in the health and well being of people.

Considering the health inequality and social inequality interface, the poorest and most disadvantaged have a higher risk for diseases. This includes the urban and rural poor, female children, specially-abled persons, and traditionally marginalized and excluded communities like Scheduled Tribes (STs), Scheduled Castes (SCs), and ethnic and religious minorities. They also have a higher probability of being excluded from the health services. The PHFI report states that the newborn in these populations are expected to be the most vulnerable to morbidity and mortality. It is evident from the empirical data on Indian neonatal and child mortality that mortality is high among children of these socially disadvantaged and economically deprived communities. The report by Public Health Foundation of India has also emphasized on identifying such communities. The report says that doing this will help in identifying entry points for action and setting priorities for long-term improvement in neonatal survival.

High Risk Communities

High Risk Communities
Status of Neonatal Deaths
Rural Population
In rural areas, neonates are at two times more risk of dying, as compared to their urban counterparts. Data has recorded Neonatal Mortality Rate as high as 33 deaths per 1000 live birth in rural India as compared to 16 for urban areas.
Source: SRS
Women
As children get older, probability of female mortality becomes higher than the males. Females have 36 percent higher mortality than males in the post neonatal period, but a 61 percent higher mortality than males at age 1-4 years.
Source: NFHS-3
Dalits and Adivasis
Child born in a SC family has 13 per cent higher risk of dying in the neonatal period and 18 percent higher risk of dying in the post-neonatal period, as compared to others. Similarly, a child born in a ST family has 19 per cent higher risk of dying in the neonatal period and 54 percent risk of dying in the post neonatal period. 
Source: UNICEF
Educationally Disadvantage Section
Children born to a mother with at least eight years of schooling have 32 percent lesser chance of dying in neonatal period and 52 per cent lesser chances in the postnatal period, as compared to illiterate mothers.
Source: UNICEF

Newborn Care Practices among High-risk Communities

Given the diversity of India, each community and region have their own local newborn care practices. Most of these practices are strong and legitimate, since they originate from local culture, environment and religion. Some of them are also based on traditional medical knowledge of the community regarding pregnancy and neonatal care. Traditional Birth Attendants (TBAs) are the key stakeholders in practicing and delivering traditional neonatal for the disadvantaged population in villages, slums, tribal areas etc. Various studies on this issue have identified many practices that are healthy for the survival and growth of the newborn. However, studies also identify a number of hazardous practices that leads to many prevalent causes of neonatal death such as sepsis, pneumonia, birth asphyxia, injuries, tetanus and diarrhea. The lack of institutional care system and prevalence of such harmful neonatal care practices are correlated to the higher concentration of neonatal death in villages, slums and traditional communities. Some of these practices are described here briefly to understand their impact.

Harmful Local Neonatal Care Practices
Health Consequences
Home Delivery by Untrained Individual
More than one third of deliveries in the rural areas are conducted outside health institutions. One in every four deliveries is conducted by untrained individual/person in the villages.
The unsafe places of deliveries and untrained person conducting deliveries cannot handle complicated cases. This increases probability of health complications in mother and neonatal care.
Thermal Care
Common practices in slums and rural areas identified by number of studies reveals that most of the newborn were given a bath immediately after birth.
Bathing immediately after birth causes hypothermia and may lead to death
Delay in Breastfeeding
According to the latest SRS data, during 2012-13 as high as 3.72 million newborns in India were not breastfed within one hour of the birth
The delay in breastfeeding and feeding baby with any liquid and solid food other than mother’s milk before the age of six month is a harmful practice for health and survival of the newborn.
Asphysia Care
To clean the airway of secretion, the newborn needs to be held upside down and the back slapped immediately after birth. Many studies found that there is a lack of knowledge about asphyxia in communities across the country and also amongst traditional birth attendants.
Asphyxia is one of the major causes of the neonatal death in India. Common community practices such as holding the baby upside down and patting or massaging it, blowing in the ears, sprinkling and dipping it in water and making loud noises are harmful for the newborn
Postpartum Hygiene
Umbilical cord care is a big issue in villages, tribal areas and in the slums.
Cord cutting and tying practices in rural India is one among high risk factors for neonatal infections. The blade is commonly used to cut off the umbilical cord in rural and geographically difficult areas but following the steps of clean cord care remain a problem. Most people lack knowledge about sterilization of the blade and after care.

Policy Responses and Way Forward

The entire cycle of reproduction and local cultural practices are intertwining. There are number of good neonatal care practices but we have also witnessed a number of harmful practices that fuel mortality of newborns. It shows us that the issue is not just medical but also has social dimensions. Indian Maternal and Child health policies have always addressed social aspect in various ways. In the last decade, National Rural Health Mission promoted community level interventions through ASHAs. However, TBAs remain the main source for delivering both good and bad community practices. The Indian policies never took TBAs seriously to involve them in health system other than providing them some skill trainings. There were no serious efforts to exchange knowledge between TBAs and modern medical professionals. Health system needs to accommodate TBAs and consider their community influence, traditional knowledge and skills along with knowledge gap to promote better neonatal care in the country.



Jeet Singh and Shriyam Gupta

Tuesday 4 November 2014

Creating Social Change to End Manual Scavenging


Source: UN Women
Manual Scavenging-The dirty truth
“Hundreds of thousands of impoverished "low caste" Indians are being forced to clean human excreta from dry toilets and open drains, despite a ban on the discriminatory and undignified practice”, reports Human Rights Watch (HRW) in its recent publication in August 2014. It is a shameful truth that reflects the discrimination practised by society and the state towards one of the most vulnerable sections of the population, the Dalits.

Manual Scavenging is not only dehumanising but also dangerous. According to the Tata Institute of Social Sciences, 80 per cent of the manual scavengers die before they turn 60 because of health problems and accidents. In the last decade, 98 manual scavengers have died in Gujarat. This figure was gathered by Safai Kamdar Vikas Nigam, in reply to an RTI query and was published by the Times Of India in April 2014.

Despite legislations prohibiting employment of manual scavengers and demolition of dry toilets, the 'Houselisting and Housing Census 2011' data in March, 2012 shows a bleak picture. Its estimation of insanitary or dry latrines in the country is close to 26 lakhs. Though there is no credible data on the exact count of manual scavengers in the country, various surveys and sources have suggested that there are approximately 11 lakhs manual scavengers in India.  

Legislations banning the practice alone cannot change the social realities. There are number of legislations to eliminate manual scavenging like The Civil Rights Act, 1955; the Construction of Dry Latrines and Employment of Manual Scavengers (Prohibition) Act, 1993 and the recently enacted Prohibition of Employment as Manual Scavengers and their Rehabilitation Act, 2013. However, the twin evils of insanitary latrines and manual scavenging persist.

Our society has to challenge and break free from the internalised caste hierarchy, empower the minds of the manual scavengers and change the attitude of the state.

Attitude of the society
Manual scavenging is a manifestation of the rigid caste system in India. Manual scavengers belong to one of the Dalit sub-castes and are considered lowest in the caste hierarchy. The society, time and again has treated Dalits as untouchables and reserved the humiliating job of cleaning excreta only for them thus reinforcing the idea of untouchability based on occupation. A child born into a family of manual scavengers is denied the basic rights guaranteed under the constitution. Manual scavenging as an occupation is passed on from one generation to another.
 In the rare occasion when a manual scavenger challenges the social structure and his position in it; s/he is threatened by members of higher castes, and ostracized to the extent that s/he is denied food entry to communal land to feed their livestock, and other facilities necessary for his survival. The community in which the manual scavenger lives does not allow them to break free from their caste based roles.

Lack of political will of the State
Government institutions like municipal corporations, village councils, railways and defence are the largest violators of the law and perpetuate the problem by continuing to recruit manual scavengers and failing to demolish dry toilets.

Indian Railways
Approximately 43,000 railway coaches are engaged in the passenger service, and there are about 1, 72,000 insanitary toilets which discharge the human excreta on the railway tracks that require the services of manual scavengers. Intrigued, the high court ordered an inspection of bio-toilets led by a team of senior advocates P S Narasimha and Rajiv Nanda. In their status report to the court, the advocates described work on bio-toilet installation as being extremely slow and criticised the Ministry of Railway’s timid target of installing only 500 bio-toilets.

Municipal Corporations
A recent survey report by Manav Garima, a community based organisation fighting against dry toilets and practice of manual scavenging have brought to light the existence of dysfunctional toilets under the aegis of Ahmedabad Municipal Corporation (AMC). Located in slums, these toilets do not have proper sewerage system, water facility etc.  Also, not every household has a separate toilet. People are forced to defecate in the open. The survey which looked at few sample areas found out that there were 126 areas where manual scavenging was practised and there were 188 dry latrines. To make the situation worse, AMC built 30 new dry toilets in the Nagorivad area of Ahmedabad.

A survey conducted in a few villages of Dhule in Maharashtra, by the Rashtriya Garima Abhiyan showed that 162 women and 90 men were hired by panchayats and municipal corporations to manually clean toilets and open defecation areas.

Challenges faced by people and breaking the silence
People who continue cleaning human excreta do it involuntarily under great social pressure, poverty, illiteracy and often because of the extreme atrocities they experience when they seek alternative job opportunities.

As reported in the Human Rights Watch publication, the manual scavengers face resistance not only from the members of higher castes but often from local officials like Pradhans who refuse to give manual scavengers any in

formation or assistance in getting a job card. As a result, manual scavengers are deprived of work opportunities provided by MNREGA.

The fear of demanding a new life and accepting the humiliation as fate is the greatest challenge. There are many schemes and legislations to provide education, alternative job opportunities, trainings to manual scavengers, but these benefits and opportunities alone cannot change their situation unless every single manual scavenger refuses to clean other’s excreta. Until then, when a manuals scavenger denies cleaning the dirt, there is another manual scavenger ready to do his work.  Hence, it is crucial to make manual scavengers aware that such dehumanising work is illegal and by mobilising them their voice can be made to be heard not as an individual but as a group.

Role of Social Movements towards defending the right’s of manual scavengers
In contrast to constitutional safeguards, some civil society movements have been able to bring to the forefront the massive discrimination faced by manual scavengers in India.

Safai Karamchari Andolan
Safai Karmachari Andolan (SKA) is a national movement working towards eradicating manual scavenging, by organising and mobilising the community around the issues of dignity and rights, accompanied by strategic advocacy and legal interventions. SKA’s efforts helped to uncover the fact that government departments including Railways, Defence, Judiciary and Education are violators of the Manual Scavenging Prohibition Act. A Public Interest Litigation (PIL) was filed in the Supreme Court by SKA and 18 other civil society organisations in 2003. As a result, the Supreme Court gave strict orders to all the states and central ministries to address the issue of manual scavenging. In 2010, for the first time 23 hearings were conducted in the state of Haryana and the act was enforced and 16 members were taken into custody for violating the law and employing manual scavengers.

Rashtriya Garima Abhiyan
Launched by Jan Sahas Development Society, the “Rashtriya Garima Abhiyan” is a national campaign for dignity and elimination of manual scavenging. The Abhiyan has liberated 11,000 manual scavengers in Madhya Pradesh. By organising sanghatans or community-based organisations, it has mobilised manual scavengers and empowered them to oppose all kinds of discrimination. Liberated and empowered, manual scavengers have taken the lead in putting an end to this practice. The campaign has been taken to other villages and states. In December 2012, the Rashtriya Garima Abhiyan, also organised a two-month long march ‘The Maila Mukti Yatra’ across 18 Indian states that liberated thousands of manual scavengers.

Similar success stories have been showcased by other national and local level movements which have successfully spread awareness and empowered manual scavengers and helped them fight against their own fears and challenge the rigid social structure and government institutions that are responsible for depriving them of their rights to live in dignity.

Journey towards changing mindsets
Manual scavenging is “shame of the nation” said Mahatma Gandhi.  The fight to end manual scavenging is more than one individual’s struggle; it is a struggle of the nation. Social movements have shown positive change by bringing people together. For a change to happen at a large scale, it is important for all the segments of the society, including civil society organisations and the state, to join hands and fight against the violation of human dignity.

Legislations and schemes prohibiting manual scavenging, as modernising India’s sanitation, are important. But for effective implementation of these, mindsets of people, society and state needs to undergo change. Synergised efforts towards challenging the caste structure, changing the mindsets of people involved in scavenging and people employing them as scavengers can make a significant positive difference.


By Abhishikta Roy 

Thursday 30 October 2014

Is Abrogating Article 370 a Mistake?


Source: rediff.com
India is a country which embraced Federalism at the time of independence from Colonial rule with many nations existing within its ambit. A noteworthy instance in acknowledging the Federal polity in India is that of Jammu and Kashmir and Article 370 of the constitution which grants the state an autonomous status. Since the BJP-led government assumed office at the Centre in May 2014, the idea of abrogation of this article has been gaining steam. However, this move may jeopardize India’s already fragile relations with the state of Jammu and Kashmir and may lead to a forced Balkanisation of the state and defeat the idea of Cooperative Federalism with which article 370 was enacted.

On July 11, 2014, the Supreme Court of India dismissed a petition challenging the constitutional validity of Article 370. A bench of Chief Justice RM Lodha, Justice Pinaki Chandra Ghose and Justice Rohinton Fali Nariman dismissed the plea by Kumari Vijayalakshmi Jha, who argued that the article was a temporary provision that lapsed with the dissolution of the state's constituent assembly in 1957.

However, the impact that this proposed move would have on the Indian Federal structure are lost in the din of political rhetoric. Why has this article been the most debated one among all the provisions of the Indian constitution? What is the BJP’s interest in abrogating it and what impact would this action have on not only the people of Jammu and Kashmir, but also India as a whole? These are some of the aspects explored in this essay.


Brief History
At the time of independence, J&K was a Muslim majority state with a Hindu ruler, Raja Hari Singh. The state was a bone of contention between then newly formed Pakistan and India. Being a Muslim state, Pakistan demanded that the state be a part of that country while upholding the ideals of secularism, India staked claim at it.

There was no provision in the British approved partition plan which stated upfront that the Hindu Princely state must accede to India and the Muslim states to Pakistan. The accession of Junagadh was an example of the ambiguity consequent to this. Jinnah accepted the accession of Junagadh to Pakistan in 1947 despite it being predominantly a Hindu province and later a people’s movement revoked that decision and Junagadh became a part of India.

Article 370 was a result of a refusal by the Hindu King Raja Hari Singh of Jammu and Kashmir to join either India or Pakistan after partition. In order to retain sovereignty of the state, despite Pakistan’s claim over it owing to a Muslim majority in line with the two-nation theory, led to the state’s monarch siding with the Indian side under special circumstances.  All the other princely states had chosen sides among the two countries, however, owing to a political movement under the leadership of Sheikh Abdullah (Father of Farooque Abdullah; later formed the National Conference), who was opposed to merging with Pakistan, J&K was granted a special status. In 1947, coming under attack from NWFP tribes, an Instrument of Accession was signed between Hari Singh and India which agreed upon maintaining the state’s sovereignty unlike other princely states. What this meant in effect was that other than specific matters including defence, communications and foreign policy, the Indian Parliament would have to seek permission from J&K State Assembly before implementing any laws in the state. The article was accepted in the Constituent Assembly in 1947 and was adopted in the Constitution in October 1949.

In 1949, PM Nehru asked Abdullah, who was appointed as the PM of J&K to prepare a draft of the article (then called Draft Article 306-A) to be appended to the Constitution in consultation with Dr. Ambedkar.  The then Law Minister Dr. Ambedkar had refused to draft the article on the grounds that while Abdullah wanted India to defend and develop Kashmir and that Kashmiris have equal rights all over India, the same rights must not apply to citizens from other parts of the country in Kashmir. He felt that it was a betrayal of the national interest. On his refusal, the article was eventually drafted by Gopalaswami Ayengar who was a minister without a portfolio in the first Cabinet of India and a former Diwan of Hari Singh. After being introduced in the Constituent Assembly, the draft Article 306-A faced extensive opposition, with only Mualana Azad standing in its favour. However, with Pandit Nehru’s backing, it was adopted and implemented, initially as a temporary arrangement, with hopes of a full integration in time to come.

The idea of a Plebiscite in J&K to uphold the people’s voice of the state in framing the state’s constitution was taken up briefly in the beginning, being discarded eventually in 1949. The Constituent Assembly of J&K which was to be consulted for any Central Law to be implemented in the state was constituted in 1951 and dissolved in 1957 and in the absence of such a body, abrogation of the article 370 is simply unconstitutional.

Government’s interest in revoking article 370
The BJP has indicated in the past that once in power, it would work on abrogating Article 370. Now that they have a government at the Centre, this seems like an impending reality. A junior Minister in the Prime Minister’s Office, Jitendra Singh recently said in a statement “We are in the process of repealing Article 370 and are in talks with the stakeholders,” starting fresh speculations on the issue. Also veteran BJP leader L K Advani, in his blog, called for the same in order to facilitate Kashmir’s further integration into the country.  This blog was a tribute to the founder of Jan Sangh, Shyama Prasad Mukherjee who died in a jail in J&K in 1953 while leading agitation against the article.

The reason for BJP to want the article gone is rooted in the history of how it came about. Being a Right-wing Hindu Nationalist Party, the BJP maintains that after the implementation of Article 370 in J&K, Sheikh Abdullah was appointed the Prime Minister of the state. He brought about reforms in the state, especially pertaining to land which adversely affected the Kashmiri Hindus (especially the upper caste Pandits) and led to them being relegated in their social standing. The land-owning Hindu community, as a consequence to the law limiting maximum land individual holding of 22.75 acres, lost their land during the redistribution process where any surplus land holdings was distributed among the peasants who worked on it, mostly Kashmiri Muslims. This led to the idea of land redistribution mistaken for communalism.

Moreover, since 1950, on several occasions, various provisions of Article 370 have been overruled by Constitutional orders. As it stands now, out of 395 total articles in the Indian Constitution, 135 are alm0st identical to that of the J&K Constitution and 260 articles have been applied to J&K making the article virtually irrelevant. Although, officially, J&K still enjoys an autonomous status, in reality, the state is farther away from autonomy now than it was at the time of independence. 

Unfortunately, the larger implications of scrapping this legislation would impact India’s relations with J&K, a state which agreed to be a part of the country on the sole condition of retaining its autonomy. Any attempts at abrogating this article, would therefore, fuel the already-existent mass resentment against the Centre. The article, as it is, hasn’t been followed through in entirety, however, scrapping it completely would lead to a further trust deficit in the people of the sate towards the Union. For the BJP too, to move past the labels of being a majority-appeasing, radical Hindu party, it is important to drop this issue. Moreover, PM Modi, in his Republic Day message this year as the Chief Minister of Gujarat had emphasized on the critical importance of a vibrant and functional federal structure in India as the Centre may not always be able to do justice to the potential and needs of various states. Repealing article 370 wouldn’t uphold the same vibrant and functional federal structure he spoke about.   

Abrogating the article a mistake
There is a widespread opposition in the state against speculations of the Centre abrogating article 370 with the current government being politically opposed by both, the separatists and the NC.

Article 370 grants the state of J&K special provisions with regards to its political structure. This article, according to the constitution, can only be abrogated or modified by the President with the nod from the state government and an approval by the state’s constituent assembly. By this definition, constitutionally, the article cannot be abrogated because J&K’s constituent assembly was dissolved in 1957 after the accession of the state was deemed complete and ceases to exist now.

Since 1956, when the Indian constitution was amended at Bakshi Ghulam Mohammad’s insistence, J&K has slowly but steadily been losing the powers it was guaranteed under section 370. In 1957, the Delhi Amendment was applied to the state, abolishing the Sadr-e-Riyasat and PM position in J&K, replacing them with Governor and CM. There started the complete dilution of autonomy.

The provisions of the article have time and again been ignored by respective central governments in India and consequently, it has already been diluted to an extent of only remaining as a symbolic right to the people of J&K. However, abrogating it completely would send out a message to the Kashmiri population that the Centre has failed to recognize the state’s autonomy which was the essential condition at the time of accession. In an environment of an already high level of distrust in Kashmiris towards the Indian state, this move could be seen as an attempt to completely disregard their voice in the constitutional process, that they have no right over their own political fate.

Essentially, the problem is in the perception of how the article is seen by the central government and the state. The state sees it as a constitutional right to autonomy and self governance while the Centre sees it as an extended temporary provision which has run its course.

In 1949, India had taken the matter to the UN and thereafter, several resolutions were passed relating to it, most of which concluded that bilateral negotiations between India and Pakistan would be the only way to solve this conundrum. Despite that, there hasn’t been much said about the issue by either of the countries openly in the recent times, although, tensions remain on the surface.

There have been attempts within India to solve the tensions between the Centre and the state leadership, Beg-Parthasarthy Accord of 1975 being one of them. In 2010 also, a special group headed by Justice Saghir was sent by then Prime Minister Manmohan Singh to negotiate the terms of article 370 with the state. However, none of the efforts by any of the governments has yielded any concrete positive results.

If this article is abrogated, the next step would be the Balkanisation of the state into Jammu, Kashmir and Ladakh regions at the behest of the Centre. History proves that such a move can have only a detrimental impact on the people of such states. States emerging from erstwhile Yugoslavia serve as a reminder to this grim reality.

Conclusion
The call for abrogation is also indicative of a complete misunderstanding of Indian federalism which is founded in the theory of unequal federalism. The constitution has abundant provisions providing special status to various other states too. Then there are the Fifth and the Sixth Schedule for the Tribal and Northeastern states. Would these be revoked too in time to come?  How then would the centre protect the rights of those who have neither sufficient representation nor, adequate opportunities for progress? This unequal but special provision guarantee these protections to the most marginalized and neglected communities in India, revoking their rights would result in a sure descent into a similar undemocratic structure which our founding fathers opposed and fought against. 
 

Medha Chaturvedi