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INDIA: Four-year-old boy died from malnutrition in Uttar Pradesh
Khusbuddin died of malnutrition on 6 February 2008. Khusbuddin was four years old and the son of late Mr. Mohammad Matin. Khusbuddin was suffering from Grade IV malnutrition.

ASIAN HUMAN RIGHTS COMMISSION – HUNGER ALERT PROGRAMME

Hunger Alert Case: AHRC-HAC-003-2008



25 February 2008
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INDIA: Four-year-old boy died from malnutrition in Uttar Pradesh

ISSUES: Right to food; failure of government health service; corruption; criminal neglect
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Dear friends,

The Asian Human Rights Commission (AHRC) has received information regarding the case of four-year-old boy, Khusbuddin, who died of acute malnutrition in Harpalpur village of Kashi Vidyapith Block, Varanasi district in Uttar Pradesh state. The AHRC has been informed by the People's Vigilance Committee on Human Rights (PVCHR), a local human rights organisation working in Uttar Pradesh state that Khusbuddin was suffering from Grade IV malnutrition which resulted in his death.

CASE DETAILS:

Khusbuddin died of malnutrition on 6 February 2008. Khusbuddin was four years old and the son of late Mr. Mohammad Matin. Khusbuddin was suffering from Grade IV malnutrition.

Khusbuddin was living with his father Mohammad Matin, mother Jaharun Nisha and elder sister in Mirzapur district. After his father's death, Khusbuddin's family moved to his maternal grand parents' home in Harpalpur village, Kashi Vidyapith Block, Varanasi district.

Khusbuddin was identified to be suffering from Grade IV malnutrition, weighing 6.5 kilogram at the St. Mary's hospital in Kourata. Khusbuddin's mother Jaharun was too poor to get Khusbuddin treated at the private hospital. On 5 December 2007, Jaharun took Khusbuddin to the Primary Health Centre (PHC) of Kanai Sarai in Kashi Vidyapith Block which is about 12 kilometers away from Khusbuddin's house. Jaharun had to walk to the PHC since she could not manage the bus fare.

However, the officer at the PHC did not provide any medical attention for malnourished Khusbuddin saying that there was no medicine at the centre at that time. Neither did Khusbuddin receive any food at the PHC. Jaharun could only give Khusbuddin some water and sugar on that day.

After Khusbuddin's death, Dr. A.K. Sahaye of the PHC and Mr. Manish Srivastava, Block Officer in charge of UNICEF programme visited Khusbuddin's house and tried to obtain Jaharun's signature forcibly on a paper certifying that Khusbuddin did not die of malnutrition and was not ill-treated at the PHC. Since they failed to obtain Jaharun's signature, they asked her neighbour to write her name on the blank paper.

It was reported that the Auxiliary Nursing Mother (ANM) of Anganwadi Centre (child care centre) of Harpalpur village who is supposed to be responsible for the health care of the children has never visited Khusbuddin's house and has denied any support to the family so far. It was also reported that after Khusbuddin's death, the village head Mr. Salim delivered 1000 Indian Rupees (USD 25) to the victim's family under the order by Chief Secretary of Uttar Pradesh. This is the only support Khusbuddin's family has received from the government so far.

BACKGROUND INFORMATION:

Harpalpur village is 9 kilometers away from Varanasi city. The village is predominantly occupied by Muslim handloom weavers. Like other weavers' communities in Uttar Pradesh, many weavers in Harpalpur village also had to leave their profession due to the decline of handloom weaving industry. As of now many of such weaver families are suffering from starvation.

Khusbuddin's father Mohammad was also a weaver. After Mohammad death, Khusbuddin's mother Jaharun has been doing embroidery on dupattas (long scarf). This would earn her about 20 Rupees (USD 0.5) in two day's time. Jaharun finds it difficult to manage the daily food for the family with this income. Khusbuddin's elder sister however is provided mid-day-meal from the primary school where she attends.

Despite the extremely poor living condition of Khusbuddin's family, the red ration card (Antyodaya Anna Yojana Card) was never issued to this family. Khusbuddin did not get any support in order to escape from hunger. The Anganwadi centre, which is the key in delivering the Integrated Child Development Services (ICDS) is neglecting their work in Harpalpur village. The ICDS targets children aged six years or below.

The health workers of the Anganwadi centre have important and direct roles to prevent the poor children and women from starvation and ailments related to starvation and malnutrition at the village level. All the ICDS services are provided through the Anganwadi workers in an integrated manner to enhance its impact on child care.

Under the ICDS, the Anganwadi workers should visit the village regularly to carryout health check-up for the children. Once they identify a malnourished child, the child has to be registered at the Anganwadi centre in order to provide nutrition and health care for the child until the child's condition is safe. However, like the case of Khusbuddin, the negligence of the Anganwadi staff at Harpalpur village is one of the main reasons that result in starvation deaths in India.

The case of Khusbuddin explains that the negligence of the medical officers at the PHC accelerates not only infant mortality in India but also facilitates corrupt practices to hide data regarding infant mortality. In addition, it is a common practice in India to conceal deaths from starvation as was sought to be done both by the doctor at the PHC and the Block Officer. This fact is noted in the most recent report of the UN Special Rapporteur on the Right to Food. This report was prepared by the Rapporteur immediately after his visit to India.

The AHRC has issued similar cases in the past from India concerning the failure of the public health system. The poor condition of the PHC in Kashi Vidyapith Block also was exposed in previous Hunger Alert HA-012-2007. For more information, please refer to HA-014-2007, HA-015-2007, and UG-006-2007.

SUGGESTED ACTION:
Please write to the authorities mentioned below expressing your concern in this case. Please urge the authorities in India to investigate the facts concerning this case. The facts that led to Khusbuddin's death have to be brought to light and the people responsible for the death must be punished. Such a letter of concern might prevent further starvation deaths in Uttar Pradesh.

The AHRC is also writing a separate letter to the UN Special rapporteur on the Right to Food calling for an intervention in this case.

To support this appeal, please click here:

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SAMPLE LETTER:

Dear __________,

INDIA: Those responsible for the death of four-year-old Khusbuddin must be punished

Name of victim: Khusbuddin, aged four years, son of late Mr. Mohammad Matin, resident of Harpalpur village, Kashi Vidyapith Administrative Block, Varanasi district, Uttar Pradesh state
Date of incident: 6 February 2008
Place of incident: Harpalpur village, Kashi Vidyapith Administrative Block, Varanasi district, Uttar Pradesh state

I am writing to express my concern regarding the case of Khusbuddin who died from starvation and malnutrition on 6 February 2008. Khusbuddin was suffering from Grade IV malnutrition immediately prior to his death.

I am informed that Khusbuddin was identified to be suffering from Grade IV malnutrition at the St. Mary's hospital, a private hospital in Kourata. I am informed that as Khusbuddin's mother Jaharun Nisha was too poor to manage Khusbuddin's treatment at a private hospital. I am aware that Jaharun tried taking Khusbuddin to the Primary Health Centre (PHC) in Kashi Vidyapith Block on 5 December 2008. However I am concerned to know that Khusbuddin was denied any treatment at the PHC.

I am aware that the PHC is about 12 kilometers away from Khusbuddin's house and Jaharun had to walk that distance to reach the PHC since she could not manage the bus fare. At the PHC Khusbuddin was refused any treatment on the ground that there was no medicine at the centre.

I am also informed that even though Khusbuddin was diagnosed as suffering from Grade IV malnutrition two months prior to his death, until he died Khusbuddin never received any assistance. Both the PHC and the Anganwadi centre at Harpalpur village neglected Khusbuddin. It is a shame that the PHC and the Anganwadi, the two government centers that are mandated to provide all necessary assistance for the poor, particularly the health care of the children of six years or below, neglected Khusbuddin till he died. The neglect of the staff at these centres has resulted in Khusbuddin's death.

I am also informed that after Khusbuddin's death was reported in the local media, Dr. A.K. Sahaye of the PHC and Mr. Manish Srivastava, Block Officer in charge of the UNICEF programme visited Khusbuddin's house. I am concerned to know that instead of assisting the family, the officers tried to forcibly obtain Khusbuddin's mother's signature on a paper certifying that Khusbuddin did not die from malnutrition and was not ill-treated at the PHC. However Jaharun refused to sign. I am informed that the officers obtained the signature of a neighbour in the paper.

I am also aware that Khusbuddin was living with his mother and elder sister and his maternal grandmother after Khusbuddin's father's death. I am informed that Jaharun can only earn about 20 Rupees in about two days which is not sufficient for the family to survive. In spite of this the family is denied a red ration card.

I therefore urge you to immediately investigate this case and to punish those who neglected the condition of Khusbuddin's health that resulted in his death. I also urge you to enquire into the allegation of cover-up of the case by the officials attached to the PHC and the Block Office. I hope that your prompt and sensible actions would help to root-out corruption in the public health services in Uttar Pradesh, which might also help in preventing other deaths from starvation and malnutrition in the state.

Yours sincerely,


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PLEASE SEND YOUR LETTERS TO:

1. The Director
Department of Women Welfare & Child Development,
Government of Uttar Pradesh,
Jawahar Bhawan, Ashok Marg,
Lucknow, Uttar Pradesh
INDIA
Fax: +91 522 228 6140

2. Ms. Mayawati
Chief Minister
Chief Minister's Secretariat
Lucknow, Uttar Pradesh
INDIA
Fax: + 91 522 223 0002 / 223 9234
E-mail: csup@up.nic.in

3. Secretary to the Government
Uttar Pradesh State Government
5th Floor – Lal Bahadur Sastri Bhavan
Lucknow, Uttar Pradesh
INDIA

4. The Secretariat
The Right to Food Campaign – India
C/o, PHRN,
5 A, Jungi House
Shahpur Jat, New Delhi-110049
INDIA
E-mail: righttofood@gmail.com

5. The Regional Director
World Food Programme
Unit No. 2, 7th Floor, Wave Place Building
55 Wireless Road
Lumpini, Patumwan, Bangkok 10330
THAILAND
Fax: +66 2 655 4413

6. The Country Director
World Food Programme
2 Poorvi Marg, Vasant Vihar,
New Delhi 110057
INDIA
Fax: +91 112 615 0019
E-mail: wfp.newdelhi@wfp.org

Thank you.

Urgent Appeals Programme
Asian Human Rights Commission (ua@ahrchk.org)