-- Karamyog Website, Maharashtra, May 2005
 
STORY OF PARU

EIGHT-MONTH-OLD PARU was at the age when she should have been able to crawl. But when we met Paru and her mother in Keli village, Amravti district, Maharashtra, the infant could barely raise her hand. Extremely weak and undernourished, she had been falling ill repeatedly. "She always has fever or diarrhoea. It's difficult to keep taking her to hospital. It's too far (11 km) and the doctor's medicines don't seem to work," and very little attention is given by them said her mother.
 
Besides, Paru had two other elder siblings looking after her when her mother went to work in others farms for daily wages; she had to work every day. Her husband had gone to Akola in search of work. Furthermore, the local Anganwadi (child care centre), which is supposed to provide food for the infants every day, has failed to do so. "They don't give the children anything. What's the point of taking them there?" said her mother. Five days after this, when we met Paru¡¦s mother, her daughter Paru died.
 
PARU'S DEATH IN WIDER PERSPECTIVE
 
Every hour in Maharashtra, there is an avoidable death of one tribal infant.  There would be 9,717 fewer deaths of tribal infants every year if the infant mortality rate among tribal children in Maharashtra was to improve and become the same as that among children in the high standard of living index population. According to the National Sample Survey Organisation (1997), more than half the families in Maharashtra do not get enough to eat. We are still food insecure in spite of all the claims made by the government. India spends more on arms and ammunition than on national food security.
 
TRIBAL VICTIMS OF NEGLECT
 
A survey carried out this year by the Maharashtra State Tribal Research Institute highlights the alarming levels of hunger and deprivation in the State. It found that three out of four infants in the predominantly tribal district of  Amravati were malnourished. The survey also exposed the State's failure to record 57 per cent of the malnutrition-related infant deaths in tribal hamlets. A Tribal Research Institute study, confirmed by a two-year survey conducted, found that around 70 per cent of infant deaths in Maharashtra are unrecorded. These findings expose the state of public health services. But, more important, they reveal the extent of poverty and deprivation that exist in what is considered one of India's most developed and prosperous States.
 
PRIMARY HEALTH CENTRES IN A SORRY STATE
 
The high death rate in the tribal areas reflects the lack of availability of health services. Health centres are far from the remote hamlets. Where they do exist, most primary health centres (PHCs) are not properly equipped with either medicines or trained personnel. For example, the remote Hathru primary health centre in Chikaldara block is operated from the government doctor's house itself. "There are no proper facilities for deliveries here. There is neither a bed nor a delivery table and there are no sterilization facilities," says a local worker. Each village is supposed to have an Auxiliary Nurse Mid-wife (ANM) to help in deliveries and dispense basic medication, but very few ANMs live in these remote areas.