Last week, at a meeting without publicity and far from the headlines and hungry, aggressive media, a senior Assam health department official spoke wonderfully and evocatively in Assamese to a group of assembled doctors, health workers, organizers, activists and researchers, sharing his concerns and difficulties. The All-India National Family Welfare Survey (NFWS), released last year, was being discussed and in it, as we know, Assam is right at the bottom in terms of human development indices, especially in the health sector: 390 is the Maternal Mortality Ratio, the worst in the country. Uttar Pradesh, Bihar and Madhya Pradesh as well as Jharkhand are at 302.
The goal had been to bring down Assam’s MMR from the staggering 480 (per one lakh live births) to 200 by the time the 12th Five Year Plan starts (i.e. this year). The figure has improved somewhat, to 381, from the NFWS data. But the aim, the health official said, must be to reduce it to 100, infant mortality (children between zero to six months dying soon after birth) from 58 to 30 (in 1,000 live births) and the Total Fertility Rate (TRF or reproductive replacement rate among married women) from 2.6 to 1.1.
Another disturbing trend is being noticed – a fall in the sex ratio among children i.e. in simple terms, this means that more males are being born than female, a statistic that brings to mind the horrific sex discrimination and pre-birth selection and killings of female children in Northern India. The question that arises here is: are we following this trend? In Assam, the figure per 1,000 male children is now 956, a drop from 967: this is in the 0-4 year group.
Yet, in Assam, there is good news too – our Infant Mortality Rate has fallen, among the highest in the country, from 68 to 58 in the past decade. The significant improvements in the health sector are due to a dynamic leader and a team of committed officials and health workers at different levels, with a special push through the National Rural Health Mission and its innovations. It cannot be allowed to slacken. Thus though there is improvement in the IMR, Assam’s data on that count is still the worst for the North-east, followed closely by surprisingly, of all states, Meghalaya, which boasts of a matrilineal system and gender equity in not balance in favour of the female as far as social traditions are concerned.
And there are some figures which don’t add up and which were presented by Assam’s UNICEF head, Jeroo Master, last week to the same group that listened to the Assam official. Thus, while Sikkim had a skewed sex ratio overall of 889 women among every 1,000 men, this dramatically grew to 944 among children. Nagaland rose from 931 overall to 944 for children while Manipur, buffeted by every kind of human disaster that one could think of, intimidation, violence, state oppression, venal armed groups, food shortages and paucity of other essential requirements, scored a top of 987 in the general sex ratio. Yet this dropped by over 50 points to 934 among children.
How are these statistics to be explained? For they require extensive and intensive research, analysis and probing. This cannot be done by academics alone and scientists. The media must pay a full and clear role in the matter. The media, and I am speaking especially of the North-east, has not exactly covered itself in glory tyhese past years in its coverage of real issues.
It needs to go above the petty politicking and a pathetic record of hysterical reporting aided by shouting anchors on issues that deserve cursory treatment (e.g. a grenade is tossed in Guwahati, two people are injured and the media goes ballistic – while the rest of 3 crores and 26 other districts as well as every other street and locality of the sprawling capital where the grenade exploded are safe and peaceful, this little incident is blown up literally, giving those behind the event maximum publicity for minimum effort: the media played into the hands of those who wish to see Assam and the NE insecure and troubled).
The fact of the matter is that we should be aware that more people are dying as victims of basic diseases and even in road accidents than are being killed by either State violence or attacks by rebel groups. So isn’t it time to change our priorities and for newspapers and news channels as well as radio stations to appoint full time health reporters who can assess the crisis in this sector – not just in Assam but across the region?
For example, take the issue of Infant Mortality. It has been proven across India and the world that exclusive breast feeding is a definite way of reducing infant mortality. Yet this is not a priority in some states. In Meghalaya we have the disturbing trend of the highest number of young children who are underweight and the lowest for exclusive breast feeding. Is this linked to higher rates of mortality?
As important as political issues are, as important as demands for ethnic representation are, as critical as questions of public mobilization, the right to information and environmental protection, what can be greater than the right to life itself?
This could be the difference between life and death for tens of million of children and young women, who are barely in their teens when married off.
There are positive developments also: the Planning Commission has come up with a Health programme for the next Five year plan (2012-17). It is not a long document and is accessible on the net. It has grown through the work of members of a National Steering Committee headed by Dr. Sayeda Hameed, the Commission’s member.
As a member of that committee, I am happy that it has accepted several critical recommendations including that mental health and psychiatric counseling should be made available to victims of and in areas which have seen sustained conflict. There are many other positive recommendations which will now become part of national policy, get funding and be implemented. But to me, as the person who developed this proposal on networks of counsellors in areas of conflict like the NER, it is satisfying sometimes to note that Governments do, sometimes, listen. Those who were victims of trauma and violence will have access to healing and conversation, letting their old ghosts and demons go.
The media and public hype about the state elections will begin to subside later this week; but we need to recognize that some of the issues flagged above are the news we need to understand, the information we need to collate and disseminate, the work that we need to undertake. Universities must get out of textual knowledge and move into this realm with activists, health workers and professionals. And here too is a chance for the media to play a positive role and to redeem itself, if not wholly, at least substantially — because not to provide in-depth coverage of such issues would amount to criminal neglect.
By Sanjoy Hazarika / By the Brahmaputra