Tuesday, March 28, 2017

On cattle protection and protein deprivation

While preparing for a larger survey this February in Sitapur, we were recording background information as well as the weights of all members of 20 families in Madhubana, an active sangathan village. Prakash, a senior Saathi, was in charge of this task. He came by later looking a bit upset – 'कोई मेहरूआ ४० किलो से ऊपर हो तो बताना' translating roughly to 'Do let me know if you find any woman weighing more than 40 kg?'.

We all know – anyone in this country who is willing to look into it knows - that the nutrition status of our people is grim. For those wading into nutrition research, the questions and debates are mind-boggling. Are people eating less today than 40 years ago because they have less or because they don't need as much (due to less physical activity)? Are the new demands on the food budget the cause for lower consumption? And what are these ideas and constructs of nutrition and height-weight charts anyway – aren't they just the legacy of colonial mindsets? And then are the lovers of technical solutions – wheat fortification is needed to reduce iron deficiencies, ready-to-use therapeutic foods are the answer and so on. One point almost everyone agrees with – the population as a whole is not getting enough proteins or micronutrients. More recent research is looking at diet diversity as a necessary factor for good nutrition - that is, the more types of foods you eat in each food group, the better your body can absorb essential nutrients. Another point that a small, but growing, group emphasizes is food security – there is a better chance of consuming certain foods if people grow rather than purchase them.

I have been hearing about the various grains, pulses, oilseeds and uncultivated greens that people used to eat in this region from elders ever since we started our millet-based mixed cropping initiative. In recent discussions, I realized that the landless labourers and marginal landholders had rarely eaten wheat or potatoes 40 years ago, and they were better off for it. Because most people practiced rainfed farming, there were a lot more pulses available – I heard about urad ki roti, moth ka sattu etc.

We are promoting pulses in our millet-based mixed cropping initiative, but the challenges of growing them are daunting. With the big farmers switching mostly to sugarcane, any grain or pulse is a magnet for animals. 3-4 years ago, we'd hear about the menace of nilgai (a wild deer) – how hordes of them would converge and reduce a standing crop to nothing in under an hour. We still do but in the last couple of years, an equal threat are अजर्रा (hordes of) or छुट्टा (loose) cattle. Last season, one of our farmers Tejram had a bumper crop of barnyard and foxtail millet in his three bigha (0.6 acres) plot. Early on, his crop had been raided by nilgai but the plants had recovered, and now he was guarding them day and night. But, one day in late September, he was not able to go look after his land. In a few hours, a horde of cattle had consumed the grain (which had been estimated at around 3 quintal) and stalks, leaving him with just 10 kg to harvest. He was in tears when I met him – 'मैं अगला साल ब्लेड वाला तार लगाऊँगा' - 'I will fence my field with blade wire next year,' he stated.

Blade wire is just that – wire with a sharp, blade-like edge. It is worse than barbed wire. There is a risk that it will hurt passersby or children. Around that time, we heard of an incident in another village where a cow had been cut by blade wire and died. The farmer who had used the wire was picked up by the police and later released, possibly after paying a bribe.

Fodder is expensive, the 2015 drought exacerbated the situation and common grazing lands are almost completely encroached. And of course, the near-disappearance of cattle traders in these parts means that cows past their milk producing stage are a liability. Now, with the crackdown on buffalo meat, even the buffalo trade will be wiped out. And perhaps buffaloes will join the roving hordes.

Many reports and articles are pointing out the protein squeeze people are facing with cheap buffalo meat no longer available, other meats too expensive and pulses also out of the reach of an average family. Growing pulses for home consumption was already fraught with difficulties and has been made worse due to abandoned cattle. But of course, gau mata and her cousin bhais mata will be saved from human cruelty.

I don't want to end this post on a bitter note. People on the margins, like our sangathan Saathis, are resilient and their cheer in the face of one adverse situation after another amazes me. Tejram will be planting millets and pulses again in the coming kharif season and has roped in two other sangathan Saathis to collectively farm with him. Other farmers are planning to grow moth and other pulses, and we have intensified our discussions about nutrition and its impact on health. It would be nice, however, if some government policy or programme would actually benefit these communities rather than become yet another adversity they have to weather.

Friday, March 24, 2017

Dreams and pragmatism in rural UP

I've been wondering what I can say about the Uttar Pradesh elections and YA's ascension. Given the amount of time I have spent there recently (almost 2 months during the election and results period), I should have some insights to share, right? Maybe I should just recount my experiences on one day in late February...

A colleague and I were at the bus stand, bound for a village about 40 km from Sitapur city. With the SP-introduced Lohia buses, services to villages had improved but there were very few buses available during the election period. So we were relieved to see a rickety bus headed to Mishrikh, an intermediate point. The bus was almost full when we were asked to step out so that it could be cleaned. Grumbling, we did. A man standing nearby started off - “When Modi comes to power in UP, such things won't happen. He will kick all the workers into shape – they will not be able to get away with this indiscipline.” The people around him nodded their heads or made sounds of agreement.

Later, in Pipri village, I saw another form of the boundless faith people seem to vest in their leaders. An old lady, who has been active in the sangathan, began chatting with me about the study we were conducting in her village. I explained that we were trying to understand what people were eating, whether it was connected to what they grew in their fields, whether it was sufficient for good health etc. “So you will come out with a report?” she verified. “What will you do with it?”. I said that we would share it with all concerned officials, politicians, activists, media. “If Behenji (Mayawati) comes to power, she will do something about it,” she said. “Will you report about the 32 people with pattas?”

Pipri is a predominantly Dalit village and most of its residents were landless. Some of them received land titles in the 70s during Indira's reign and were able to take control of the land. In another round of redistribution, 32 people received land titles in the 90s. Most of this land belonged to a powerful family which has controlled the Pradhani of the panchayat for a very long time, and the land was never relinquished. The family was able to get a stay order against the transfer, and the 32 families tried to fight the case in court but lost.

“This matter should also go into the report, and Behenji will take it up,” the old lady said. I wondered how she could still have so much faith in Mayawati. Other friends that I had talked to had become more pragmatic about the BSP – they still voted for the elephant, but mostly because they were respected here and didn't have a place in other parties. Or maybe some had switched to the lotus, though they wouldn't admit to it.

In the evening, I was chatting with another older couple. The husband quietly brings us tea every time we have a meeting in Pipri. After a recent discussion about plastic, he has begun bringing us 'kulhads' (earthen cups). I realized that he was a beneficiary of land redistribution in the 70s and had received 5 bighas (one acre) of land. He mortgaged it, he told me, to pay for his son's wedding expenses. They need Rs. 20,000 to get it back but after a few months in Dehradun his sons had only been able to save Rs. 5,000. "बडा लडका पढा-लिखा है और गांव में उसके लिये कुछ नही है - the older boy is educated and there is nothing for him in the village”. So he and his younger brother had gone to Dehradun to work in a herbal medicine factory. By the way, 'educated' meant 8th standard pass, I later found out, but that is another story.

I struggled to not sound harsh in my reply. It is sad, I told him, that the precious land he had been given was mortgaged. It further reduces the connection with land. After a few minutes of silence, he told me that his sons were attached to the land. They didn't want to leave, but last year they had leased some land to grow wheat and had incurred a huge loss. Their pumpset had failed and they weren't able to irrigate properly. His younger son had stayed up many nights, he said, trying to irrigate from a neighbour when there was electricity but it was of no use.

Last year's wheat harvest was anyway below average, I knew, due to the 2015 drought and unseasonally warm winter that followed. In fact, after the 2014 rabi crop, there hasn't been a uniformly good agricultural season here. Few people would migrate from these parts, the upper Gangetic plains, a decade ago. Or if they did, it was for a few weeks to Lucknow or Kanpur. But now every family has a member in Haryana, Delhi or even Andhra and further away...

We like our elections, in this country and elsewhere. In the absence of robust local governments or fora for citizen engagement, elections become the do-all and end-all. But the marginalised, those who truly need government support to improve their lives, have given up hoping for it (except for a few dreamers). They are finding new ways to survive, further detaching themselves from the land, struggles and local issues. Maybe, like the NRIs who have funded the Sangh Parivar, these migrants now care more about the abstract, so-called cultural issues. Or maybe they just could not or chose not to return to vote...

Monday, August 29, 2016

'Left Out' - a short film on denial of health rights in Karnataka

Over the past few years, I've helped organize meetings and consultations, produced reports and participated in research studies which documented various forms of denial of health rights in India, mainly Karnataka. Recently, while documenting cases for a planned public hearing with the National Human Rights Commission (which was later cancelled), I had the opportunity to collaborate in a project to video-document some testimonies. Thanks to Dipti Desai's persistence, these testimonies have been compiled into a short film 'Left out', which is available on YouTube here.
The stories are from across Karnataka and reveal how hard it continues to be to access health care and to pay for it...

Monday, March 14, 2016

The Universal Health Coverage Numbers Game

Some years ago, during a sojourn in Sitapur, we began discussing Rashtriya Swasthya Bima Yojana (RSBY), the National Health Insurance Scheme which provides 'cashless care' for hospitalisation at 'empanelled' private hospitals. The RSBY coverage limit is Rs. 30,000 per year for a family of five. I was already involved in the research of government-supported insurance schemes in Karnataka, and knew that while they gave poor families 'access' to private hospitals (there are denials as well), the devil was in the out-of-pocket expenditure that followed.

Here the tale was different:
"हमने उनको भगा दिया", "किन को ?”  "अरे, कार्ड छापने वालों को!"
which roughly translates to: “We chased them away”, “Who?”, “The card printers!”
Every year, the RSBY card has to be re-issued, so Third Party Administrators (TPAs) go to these villages to enrol people in the scheme at a cost of Rs. 30. But my friends in SKMS (Sangtin Kisan Mazdoor Sangathan) were fed up of getting a useless card - “We go to Sitapur city with this card to all the private hospitals, but no one gives us free treatment”. So they refused to get enrolled and asked the TPA to leave. One year, the District Collector got involved – he went to some villages and requested the villagers to cooperate! But as far as I know, some are still holdouts.

Tuesday, March 08, 2016

Addressing health inequities through community-led advocacy in Bangalore – experiences, successes and challenges

For some reason, I have not written much about my work in Bangalore. Maybe because it was 'paid' work and I spent so much time writing reports, updates etc. in the style that the organization and funders required. Well, now that the project has wound up, here goes... Below is a paper I submitted for the Medico Friends Circle (MFC) annual meet in February - I modified it slightly for this post. It is a long write-up (almost 2500 words) and a bit technical. But I think there are interesting stories in there...