Bombay boom fails to feed India's forgotten children

The Indian state of Maharashtra is proud to boast as its capital the country's richest city. Bombay is the centre of the Bollywood film industry and the symbol of the country's economic boom. But sadly there is little evidence that its wealth has trickled out into the surrounding countryside.

The Indian state of Maharashtra is proud to boast as its capital the country's richest city. Bombay is the centre of the Bollywood film industry and the symbol of the country's economic boom. But sadly there is little evidence that its wealth has trickled out into the surrounding countryside.

In Maharashtra, more than 9,000 children under six have died because of malnutrition in the past year. Worse still, the rate of death has accelerated, with 1,000 children dying in the state in both April and May. Outside Bombay, 500 children a month are dying because they do not have enough food, according to Indian health activists.

In the rural interior of the state lies another India the economic miracle seems to have passed by, a desperately underdeveloped region of grinding poverty where people still live in tribal society. Unemployment is a serious problem.

Most child deaths are in this so-called "tribal belt". Months ago, a spate of malnutrition deaths were reported in tribal parts of West Bengal state, on the other side of India.

The Maharashtra state government has reacted to the mounting death toll with a shrug. This week, the state's Chief Minister, Sushilkumar Shinde, said the reports were "highly exaggerated", although the figures come from the state's official records. Mr Shinde said the high death rate is being caused by illnesses, including snake bite, high fevers, premature births, birth injuries and hypothermia.

But activists say malnutrition is a factor in a child's death even when another disease is involved, because children suffering from malnutrition have weakened immune systems and cannot fight infections. Dr Amar Jessani, a local activist, has accused the state government of trying to play down malnutrition to avoid a scandal. "It will become a huge political issue if the government accepts malnutrition is the reason," he said.

But the controversy has already shone an unwelcome light on the woeful shortcomings of Maharshtra's healthcare provisions in its 15 tribal districts. Indian newspapers have published photographs of tiny children, obviously severely undernourished, with horrifying accounts of the lack of medical facilities.

The Indian Express published the story of Sangeeta Padvi, a one-year-old orphan whose grandmother walked 25 miles with her to the nearest state hospital only to find there was no doctor, just a nurse.

The Bombay High Court has lashed out against the state government. "Where is the commitment of the state?" the acting chief justice, A P Shah asked in an anguished voice from the bench this week.

India has a bad record of caring for its tribal citizens. There is a tendency in Indian society to blame disasters such as these on the perceived backwardness of the tribal peoples.

And superstitious beliefs have in some cases exacerbated the suffering. The Hindu newspaper in Madras told of an 11-month-old boy who was admitted to hospital with malnutrition, and permanent blisters all over his chest. His mother had taken him to a local traditional healer who had tried to cure him by pressing the red-hot tip of a sickle into his chest repeatedly.

Activists say such superstitions persist because of the lack of adequate facilities. The hospital the baby was admitted to has no resident paediatrician; one flies in on 15-day tours of duty. Few doctors will work in tribal areas and the state government struggles to fill jobs at the hospitals it does provide.

This is not the first scandal over tribal child malnutrition the government has been embroiled in. In 2001, after a spate of malnutrition deaths in Maharashtra, political leaders rushed in and promised schemes to prevent deaths. But the scandal faded, and Maharashtra's forgotten children continue to die.