PHM-Exch> Two million slum children die every year as India booms

[Claudio Schuftan]

From: Kamayani kamayni at gmail.com



India <http://www.guardian.co.uk/world/india>'s growing status as an
economic superpower is masking a failure to stem a shocking rate of infant
deaths among its poorest people.

Nearly two million children under five die every year in India – one every
15 seconds – the highest number anywhere in the world. More than half die in
the month after birth and 400,000 in their first 24 hours.

A devastating report by Save the Children, due out on Monday, reveals that
the poor are disproportionately affected and the charity accuses the country
of failing to provide adequate healthcare for the impoverished majority of
its one billion people. While the World Bank predicts that India's economy
will be the fastest-growing by next year and the country is an influential
force within the G20, World Health Organisation figures show it ranks 171st
out of 175 countries for public health spending.

Malnutrition, neonatal diseases, diarrhoea and pneumonia are the major
causes of death. Poor rural states are particularly affected by a dearth of
health resources. But even in the capital, Delhi, where an estimated 20% of
people live in slums, the infant mortality rate is reported to have doubled
in a year, though city authorities dispute this.

In the Bhagwanpura slum on the north-west fringes of the capital, numerous
mothers have lost one or more infants in their first years of life through
want of basic medical attention.

Akila Anees's son, Mohammed Armann, who was almost three, died in her arms
three weeks ago. A torrential downpour had flooded the slum, rainwater
mixing with the raw sewage which fills the ink-black drains bisecting the
narrow lanes. It rose to a depth of 2ft. Within days, Armann had fallen ill
and died soon afterwards.

Save the Children says millions of mothers and their babies are simply not
getting the skilled medical care they need, and the poor, in particular,
have been left behind. "For many poor parents and their children, seeking
medical help is a luxury and health services are often too far away," said
Shireen Miller, its head of policy and advocacy in India.

India's state healthcare system is supposed to be open to all, offering
access to government-run hospitals. The reality is that, while government
hospitals often offer high standards of care, they can be overcrowded, and
if they are short of the required medicines patients are asked to pay for
them themselves. In the meantime, private health care has surged and now
accounts for the majority of India's medical provision, giving access to
world-class facilities for those who can pay or who can afford private
insurance premiums.

According to the UK India Business Council, about 50 million middle-class
Indians can afford private healthcare – a growing number but still a tiny
fraction of the overall population – while the country still lags behind
other developed countries, with only 0.7 hospital beds per 1,000 people
compared with a global average of 4.

According to the report, the national mortality rate for under-fives in the
poorest fifth of the population is 92 in 1,000 compared with 33 for the
highest fifth. The national average is 72.

Delhi's health minister, Kiran Walia, has blamed migration into the city for
its problems, but many poorer families simply feel that they are shut out by
the system. .

The Save the Children report says nearly nine million children die worldwide
every year before the age of five. India has the highest number of deaths,
with China fifth. Afghanistan has the dubious distinction of featuring in
the top 10 of total child deaths and of child deaths per head of population,
a list topped by Sierra Leone.

The charity accuses the world's leaders of a scandalous failure to meet the
Millennium Development Goals, agreed in 2000, to cut child mortality by two-
thirds between 1990 and 2015 and calls for a sharp increase in health
spending.

http://www.guardian.co.uk/world/2009/oct/04/india-slums-children-death-rate
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