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Sunday, May 21, 2000

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Poor little billionth baby

SPARE a thought for poor little Aastha who has won the unasked for distinction of being India's billionth baby. No one gave her a choice as dozens of flash bulbs nearly burned her newborn skin. And few will note the irony that whereas a celebratory air surrounded Aastha's arrival as should the birth of any baby, on the same day, the Prime Minister spoke of the "grim" situation in the country with our population crossing one billion.

To tackle this "grim" situation, the Prime Minister has assembled a commission of no less than a 100 distinguished people who will pronounce their joint wisdom on what should be done about the country's burgeoning numbers. That the population explosion should be checked, first by reducing the number of such commissions and second, by reducing the numbers in such commissions has somehow not crossed the mind of either the Prime Minister or his advisers. If you have a problem, form a commission or set up a committee - the belief in this cure for all crises remains unshaken regardless of the colour of the government in power.

While the fuss was being made over Aastha, there were thousands of babies being born in other parts of India, away from the glare of the media attention being showered on this little baby. One newspaper carried the striking story of the birth of a girl in Anandpar village in Rajkot district, Gujarat. The mother, Neetaben, was taken to the health centre in a rickshaw when labour pains began. She had already moved out of her village to a relative's house in a neighbouring village because her village had neither a health centre, nor a doctor. But even her relative's village was ten km away from the nearest health centre. Because of the prevailing drought in Gujarat, this centre did not have clean drinking water. And, typical of such places, it had no medicines. Neetaben can thank her lucky stars, and not the country's health system, that she came through this delivery without complications.

Another equally worrying story was about the labour room in a big hospital in Calcutta where several women lay strapped up on tables ready to deliver while men and women in street clothes walked in and out of the room unchecked. The doctor on call was busy on the phone outside the labour room even as a woman was about to deliver.

So as the bloated Population Commission labours over the challenge of curbing India's population growth, it ought to spare a thought to the reality of our health system which has shown no signs of improvement despite the occasional noises made at international conferences. India was one of those that had committed itself to provide Health for All by the year 2000 at the meeting in Alma Ata in 1975. The year 2000 is here, but health for all still remains a distant dream.

One fears that increasingly, rhetoric and hype are replacing the reality in much of our policy and planning for the poor. While the reading public is offered columns of information about the ups and downs of Infotech shares on the NASDAQ, and how the richest men of India lost half of their wealth one night and found it again the next, we know nothing about whether anything is being done to improve the working of primary health centres and sub-centres in our rural areas, or of municipal hospitals and dispensaries in our cities. And as we congratulate ourselves in coming close to the top in the number of domain names registered, or in producing beauty queens, or churn out sentimental mush on Mother's Day whose origins are unknown to even those capitalising on this American concoction, we prefer not to remember these other, grim, realities of the situation in which the majority of Indians still find themselves.

It has been said in the past, and needs to be said again, that there is no short-cut to providing adequate health care to mothers and children if we want to reduce population growth. Too many women are dying in child birth. Too many children are dying before the age of one. Population growth has stabilised in those States where the health system is able to reach out to the majority of women.

At a time when every paisa that can be spared ought to be diverted towards giving people in this country the basic necessities of food, water, shelter, education and health care, our governments are busy finding ways to allocate more funds to elected officials and other busybodies. So the Population Commission will have a budget to cover the travel of all its 100 members to New Delhi, to pay for their lunches and dinners as they sit around and meditate on the immense problem before them, and to waste paper and ink on the recommendations that will pour forth after such deliberations.

At the end of the exercise, we will be richer by a few more obvious recommendations, but poorer by several lakh rupees that could have been better spent in improving facilities in even a dozen primary health centres.

Just as the drought has brought out the obvious solutions of rainwater harvesting, which requires very little investment, the billionth birth ought to make the Government realise that the "solution", if indeed we think of this as a problem, lies in simple, inexpensive steps that can be taken immediately, without elaborate government resolutions and diktats, to improve the health care system.

Tragically, it is precisely because these solutions cost nothing that governments are not interested. There is no money to be made, no power and glory. But there are millions of Neetabens whose gratitude awaits such simple steps. It is hard to believe that a country that wants to strut around on the world stage as a nuclear power, cannot find the will to ensure that our children, and their children, do not have to die because there is no doctor.


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