Report of Fact-finding Visit on â€œInfant Deaths due to outbreak of Japanese Encephalitis / Acute Encephalitis Syndromeâ€ in Malkangiri district, Odisha
The child causalities due to outbreak of Japanese Encephalitis in Malkangiri district were reported in 2011 and 2012. An estimated death of 36 children was reported by District administration inÂ Â 14 villages of the district within the period of September to 5th December 2012, but the actual scale of causalities was more than that.Â During that time, being shockedÂ over theÂ news, aÂ 3-member team ofÂ Right to Food Campaign, Odisha had Â Â visitedÂ Malkangiri districtÂ from 18th to 20thDec.12 on a fact-finding mission to find out the reasons behind causalities, steps taken by the District administration toÂ check child mortality Â Â and as to effectiveness inÂ implementation ofÂ food security programmes like MDM and ICDS, two flagship programmesÂ which aimÂ toÂ provideÂ nutritious foodÂ to theÂ childrenÂ and thereby check IMR and MMR Â in the country. TheÂ Fact-finding ReportÂ along withÂ host of recommendationsÂ highlightingÂ disastrous food insecurityÂ issues,Â failure of ICDS and MDM programme,Â chronic hunger among the childrenÂ and subsequent loss of immunity capacity of the childrenÂ was presentedÂ to Govt.Â to take steps forÂ increasing Â Â nutritional standard of the children through effective implementationÂ of Â Â Â Â Â Â Â ICDS programmeÂ and close Â monitoring of health and nutritional standard of the children by ICDS and health staff.
After gap of three years, the break out of same disease Japanese Encephalitis ( JE) Â has caused Â Â 60 child deathsÂ in different parts of the districts officiallyÂ Â during September and October 16 and many more unofficially. The child causalities highlighted by mass media exposed callous and insensitivity of the district administration and ineffectiveness and break down of healthÂ Â system of the district to deal this dreaded disease. After public reaction and outrage and protest by opposition political parties, the State Govt.Â took a lot of stepsÂ to check health hazard. ItÂ wasÂ thought of by Right to Food Campaign, OdishaÂ to sendÂ another Fact-finding TeamÂ to MalkangiriÂ toÂ find out the basic reasons of child causalities,Â whetherÂ any preparedness and preventive measures taken prior to outbreak of JE, nutritional standard of the children, statusÂ of implementation of various programme,Â intervention of the Govt.Â etc.Â Accordingly, a four-member Fact-finding Team had visited different parts of the district from Â 18th to 20thOctober 2016.
- Members of Fact-finding Team
- Pradip Pradhan
State Convener, Right to Food Campaign, Odisha
Member, Advisory Group of NHRC on Right to Food, M-9937843482
- Sri Ashok Patnaik
Advocate and RTI Activist, Malkangiri, M- 9437435399
- Sri Bikash Dandsena
Social Activist, Malkangiri, M-9437970303
- Sri Era Padiami
Tribal Activist, Malkangiri, M- 9437316380
- Objectives of the Visit
- ToÂ find outÂ the reasonsÂ ofÂ hugeÂ child deaths- whether it is due to outbreak ofÂ Japanese Encephalitis ( JE) or degradedÂ and ineffectiveÂ healthÂ service availableÂ in Govt. hospitals or any other reasons.
- To studyÂ Â and document the socio-economic condition of the family of child deaths reported by Govt.Â and condition of the children before their admission Â Â and death in hospitals collecting information from Anganwadi Centres andÂ the peopleÂ at large.
- To study the capacity and effectiveness of District Hospitals, CHCs to deal such dreaded disease on the pretext that preparedness measures,Â if any taken on the basis of learning fromÂ JE- related infant death hazardsÂ of 2012.
- To understand the effectiveness of ICDS programme to check malnutrition among children in Malkangiri.
- ToÂ Â make recommendations to State Govt., Central Govt.Â and other constitutional bodiesÂ about necessaryÂ stepsÂ required to be takenÂ to checkÂ this dreaded disease in the district in theÂ coming days.
- Malkangiri District- An overview
Malkangiri is one of the most backward districts of Odisha and infamous for significant presence of malnourished children and highest number of child causalities in the country. Looking at the history of its development, the district is named after its headquarters town Malkangiri. During the formation of Orissa Province in 1936 Malkangiri was a “Taluk” of Nabrangpur sub-division of Koraput District in Orissa. In 1962 it was upgraded to a subdivision of Koraput District. The present Malkangiri comprising an area of 5,791 sq.kms. got its identity as an independent district with effect from 2nd October 1992 following the reorganization of districts of Orissa as per notification dated 1st October,1992. .Oriya is the main spoken language.Â Â The district is divided into two distinct physical divisions. The eastern part is covered with hilly terrain of Ghats, Plateaus and Valleys sparsely inhabited by primitive tribes notable among who are Bondas, Koyas, Porajas and Didayis. The rest of the district is comparatively flat plain broken by a number of rocky wooded hills. Almost the whole of the district is covered with vast stretches of dense forest. Â Â Â Â
Â Map of Malkangiri district
The district has seven administrative Blocks i.e., Kalimela, Khairput, Korukonda, Kudumuluguma, Malkangiri, Mathili, Padia and two NACs i.e., Malkangiri and Balimela. It consists of 108 GPs and 928 villages. Literacy rate in the district is 31. 26%. Â Infant Mortality rate is 55 per 1000 child births in the district.Â Children suffering from malnutrition are a common phenomenon in the district.
Tribals constitute the dominant community in the district with a presence of 59.21% of the total population.Â Â Most of the tribal people are poor and live in abject poverty. As per Govt. report, 81.88% of the rural people live under Below Poverty Line.Â Â The whole district is affected by Naxal violence. Almost all development projects and programme like PDS, ICDS, MDM, NREGA, Integrated Action Plan (IAP), ITDA, OTELP, Banda Development Authority and Didayi Development Authority are being implemented by Govt. to ensure livelihood and provide food security to the people in the district.Â To curb naxal violenceÂ in the district, both Central and State Govt.Â have also undertaken special development projects for socio economic development of the people in the district byÂ spending crores of rupees.
- Japanese Encephalitis (JE)- What it is ?
Japanese Encephalitis (JE) is a mosquito borne zoonotic viral disease. The virus is maintained in animals, birds, pigs, particularly the birds belonging to family Ardeidae (eg. Cattle egrets, pond herons etc) Â which act as the natural hosts. Pigs & wild birds are reservoirs of infection and are called as amplifier hosts in the transmission cycle, while man and horse are â€˜dead end hosts. The virus does not cause any disease among its natural hosts and transmission continues through mosquitoes primarily belonging to vishnui group culex. Vector mosquito is able to transmit JE virus to a healthy person after biting an infected host with an incubation period ranging from 5 to 14 days. The disease affects the Central Nervous System and can cause severe complications, seizures and even death. The Case Fatality Rate (CFR) of this disease is very high and those who survive may suffer from various degrees of neurological sequeale. (An estimated 25% of the affected children die, and among those who survive, about 30-40% suffers from physical & mental impairment). The children suffer the highest attack rate because of lack of cumulative immunity due to natural infections. Acute Encephalitis Syndrome (AES) is a general description of the clinical presentation of a disease characterized by high fever altered consciousness etc mostly in children below 15 years of age. Acute Encephalitis Syndrome (AES) has a very complex aetiology and JE virus is only one of the many causative agents of Encephalitis. Further it is also
- DetailsÂ ofÂ visit of the Team
The Team members visited three JE- affected blocks i.e. Malkangiri, Korkunda and KalimelaÂ and 10Â villages Â and interactedÂ withÂ Â cross section of the people,Â parents of deceasedÂ children,Â Medical Officers of CHCs,Â Panchayat representatives,Â Anganwadi Workers, Supervisors,Â theÂ villagersÂ to find out the reasonsÂ ofÂ death ofÂ childrenÂ and outbreak ofÂ JE. The TeamÂ membersÂ alsoÂ visitedÂ CommunityÂ Health Centres at Kalimela and KorkundaÂ Â Â andÂ inspectedÂ the WardsÂ to understandÂ theÂ healthÂ condition of theÂ childrenÂ beingÂ treated.Â The doctors were very cooperative and explaining details and responding the query. Â Most of the children admitted in the hospital were visibly malnourished and suffered from fever. The doctors have taken themÂ as suspectedÂ AESÂ Â Â and keptÂ Â them under observation.
On 18.10.16, the Team members also met Dr. U.C.Mishra, Chief District Medical Officer, Malkangiri Â and discussed with him about the reason of outbreak of Japanese Encephalitis (JE).Â HeÂ explainedÂ in detailsÂ aboutÂ how virusÂ is transmittedÂ fromÂ pigs to manÂ throughÂ mosquitoes.Â This disease has broken outÂ dueÂ to bad sanitation condition, pigs. HeÂ alsoÂ saidÂ thatÂ dueÂ to malnutrition , manyÂ of theÂ tribal childrenÂ haveÂ lost theirÂ immune capacity for whichÂ their bodyÂ could not resistÂ this dreaded disease.Â Â He admitted that as large number of JE affectedÂ Â children got admitted, they could not handle it and many of them died.Â Referring these patients to BerhampurÂ Â became problem for the administration. Because many of them also died on the way. Â Now theyÂ have taken a lot of stepsÂ includingÂ mobilisingÂ doctors, staff nurseÂ fromÂ differentÂ districts, Sishu BhawanÂ and engagingÂ themÂ forÂ treatment. Pigs have been kept in enclosures around 3 kms away from human habitation.Â Fogging and restoration work has been startedÂ Â in affected villages. Dr. S.B.Mohapatra, ADMO carried with him the team members and facilitated their visit to different Wards, ICU, Nutritional Rehabilitation Centre (NRC)Â Â where the affected children are treated.Â It was observed that most of the children admitted in hospital and under treatment are malnourished.
Places visitedÂ and persons / officials interviewedÂ by the Team and their response .
|Name of Block||Name ofÂ villages/ offices||Person/ officials interviewed||Content of InterviewÂ and queryÂ madeÂ by the team|
|Kalimela||KoimetlaÂ village ( Koimetla GP)||Muka Madhi||HisÂ Â Â daughter Manjun Madhi , one yearÂ and eight months Â gotÂ sufferedÂ from fever. He carried herÂ toÂ Kalimela CHC. The doctor referred her to District Hospital.Â No proper treatment was made. He brought back her daughter to home on 6.10.16.Â She got serious next day.Â While carrying herÂ toÂ District Hospital, SheÂ Â died on the way Â on 7.10.16 Â ( itÂ has not been reportedÂ inÂ Govt. list)|
|Kasa Padiami||He admitted his son Bikram Padiami, 3 years old in District Hospital.Â The Doctors could not treat his son properly. He was toldÂ Â his son to be referred to Berhampur. The doctor asked him to wait. He waited for one day and hisÂ son ultimatelyÂ died in Hospital on 10.9.16.|
|Sukra Padiami||His son Bapi Padiami, 3 years and 9 months old died on 11.9.16 in M.K.C.G. Hospital, Berhampur. Â He could not avail Hospital Ambulance to bring backÂ hisÂ son. Finally he hired private vehicleÂ Â @ Rs. 22,000.00 to carry his dead son toÂ Â home.|
|Jaga Madhi||His daughter Ananya Madhi, 3 years old died on 22.9.16.|
|MV-68 Anganwadi Centre||Shyamali Halda, Anganwadi Worker||She reportedÂ about 3 malnourishedÂ childrenÂ Â identifiedÂ in the centre|
|KalimelaÂ Community Health Centre||Dr. Muktikanta Mallik , In-Charge of CHC||He reported that total of 74 children suspected AES (Acute Encephalitis Syndrome) were admitted within two months Sept and Oct. 16. 40 patients referred to District Hospitals and 34 treated and got cure.|
|Korkunda||Palakonda village (Â Sikhpali GP)||Marsha Kabadi||His sonÂ Rama Kabadi, 3 years oldÂ diedÂ Â in District HospitalÂ on 29.9.16|
|Bira Kabadi||His son Deba Kabadi, 4 years old was admitted in district hospital. The doctors neglected in treatment and did not prescribe any medicine. His sonÂ Â diedÂ in HospitalÂ on 21.9.16|
|Nande Madhi||His daughterÂ Debika Madhi, 2 years oldÂ died on 21.9.16|
|Deba Kabasi||HisÂ sonÂ Rame Kabasi, 2 years and 7 monthsÂ diedÂ on 15.9.16Â in M.K.C.G. Hospital, Berhampur|
|IrmeÂ Madakami, Anganwadi Worker, Palakonda||SheÂ gaveÂ the listÂ of 3 malnourishedÂ children and explainedÂ in detailsÂ aboutÂ stepsÂ taken to refer malnourishedÂ children to theÂ District hospital.|
|Jhunurani Mohapatra, ANM||She explained about provision of two meals provided in Anganwadi Centre to all pregnant and lactating women and children upto 6 years of age from 10.10.16 and mass sensitisation programme undertaken by them to maintain proper sanitation in the area.|
|MV-19 , Primary Health Centre ( new)||Dr. Chandan Soren, Medical In-Charge||22 suspected AES cases referred to District Head Quarter Hospital within last two months.Â On queryÂ aboutÂ reason forÂ death ofÂ onlyÂ tribalÂ children, heÂ saidÂ thatÂ the tribals areÂ not healthÂ conscious and do notÂ maintainÂ proper sanitationÂ around them.|
|Patrel village||Ajay Madkami||His sonÂ Aditya Madkami , 3 years and 10 months old Â isÂ 8 kg suffering from Malnutrition|
|DO||Binod Bihari Takri||His daughter Jhansi Takri, 4 years old died on 29.9.16.Â She was suffering from malnutrition.|
|DO||Sukanti Karasta, Anganwadi Worker||She provided list of 3 malnourished children identified and necessary steps takenÂ Â for their recovery.|
|MV-53||Pinku Biswas, Anganwadi Worker,||She was seen managing the centre well.|
|Â Puspali ( Tarlakota GP)||Puspali Anganwadi Centre||Immunisation programme was going on in the presence of Mathamai rath, Supervisor and Minati Panda, Anganwadi Worker. She provided list of 3 malnourished children.|
|Mahulput||Shyamali Biswas, ANW||She was appraised about non-distribution of egg to pregnant and lactating woman of Jamuguda village. AfterÂ complaint, she agreed toÂ provide food and eggÂ Â to them|
|Sangita Panigrahi, Supervisor||During visit,Â the team spotted herÂ supervising provision of cookedÂ mealÂ to pregnant and lactating woman in the centre.|
|Siraguda||Bipasa Mandal, ANW||Many beneficiaries have not receivedÂ money under Mamata Yojana for years together|
|Korkunda CHC||Dr. Tanmaya Acharya||He saidÂ that total no. of 73 JE suspectedÂ children were admitted within two months. Out of it 28 referred to District Hospital.|
|Malkangiri||Tamasa||Muka Madkami||HisÂ son Bidesh Madkami , 6 months oldÂ diedÂ on 7.10.16Â in hospital.|
|Padia Kabasi||His daughter Puja Kabasi , 4 years old died inÂ home.|
( MV 68- MalkagiriÂ village 64 -Â habitation of refuse BengalisÂ rehabilitatedÂ by Govt.)
- List of MalnourishedÂ children collectedÂ from Anganwadi CentresÂ and Â identified by the team during visit Â
|Sl.No||Name of Block||Name of village||Name of malnourished children with age|
|1||Kalimela||Koimetla||Rasmita Padiami, 1 yearÂ and 8 months old|
|2||DO||DO||Radhika Madi, 3 years andÂ 7 months old|
|3||DO||DO||Bimala Madi, two yearsÂ and 11 months|
|4||DO||Palakonda||Tami Padiami, 2 years old daughter of Aite Padiami|
|5||DO||DO||Santu Kabasi, 2 years and 10 months old|
|6||DO||DO||Surya Kabasi, 11 months , Father- Bimal Kabasi|
|7||Korkunda||PotrelÂ Village||Mangul Madi, 2 years And 3 months ,Â son of Sama Madi|
|8||DO||DO||Sabar Padiami,Â 1 year and 3 months , son of Dabe Padiami|
|9||DO||DO||Ganga Padiami, one year and 3 months|
Jamuna Padiami, one yearÂ andÂ 3 months, twin of Munda Padiami
( Tarlakata GP)
|Kasa Beti , 1 year andÂ 8 months|
|11||DO||DO||Rita Madkami,Â 2 years and 2 months|
|12||DO||DO||Jangi Kuasi, 2 years andÂ 7 months|
- Analysis of the problems aggravatingÂ healthÂ hazards and JE epidemicÂ Â
- Child death is not new phenomena inÂ Malkangiri district. Every year thousands of children died of fever, malaria and other small ailments.Â The information obtainedÂ under RTI from the office of CDMO, Malkangiri on 3.11.12Â Â has exposedÂ thatÂ from 2007-08Â to 2011-12, around 7400 childrenÂ have died due to contraction ofÂ various diseases likeÂ Epilepsy, ATI, LBW, Diarrhea, Ashthma, Fits, Burning, UND, Septicemia, Birth Asphyxia, Fever related ailments and Boll cancer etc. it meansÂ in normalÂ period,Â thousands of childrenÂ mostlyÂ tribalÂ childrenÂ diedÂ of minorÂ ailments, Â The death due to outbreak of Japanese Encephalitis in 2012 and 2016 has only aggravated the situationÂ Â exposing the ineffectiveness of health system of the state.
- WhileÂ visitingÂ theÂ Anganwadi Centres, CHCs, District hospitals andÂ interactingÂ withÂ AnganwadiÂ workers,Â itÂ was observedÂ thatÂ Â mostÂ of theÂ children who have diedÂ orÂ under treatmentÂ areÂ malnourished.Â More than 95% of JE-affected children are tribals and all of themÂ Â areÂ Â malnourished. It is interesting to be noted here that among the affected tribal children, most of them are girl children. Due to chronic hunger and lack of food, the tribal children have suffered from malnutrition.Â A malnourishedÂ Â child is easily susceptible Â Â to any disease. Because, their immune capacity gets lost.Â As a result, they have succumbed to dreaded disease like Japanese Encephalitis.Â As reported by health experts, the children are highly vulnerable to this disease. MalnutritionÂ amongÂ the tribal childrenÂ can be attributedÂ toÂ extreme poverty, lackÂ ofÂ employmentÂ opportunity orÂ lessÂ accessibility to food andÂ ineffectiveness of Govt.Â programme.Â During interaction with the villagers,Â Â they were asked about daily consumption.Â All of the replied that they consume rice and jungle leaves (forest leaves) as their staple food and sometimes rice and dal.Â It shows horrible food insecurity situation among the tribals.Â As they could not get any work, they could not earn to feed their children.Â The employment generation programme implemented by district administration has failed to provide employment to the tribals.Â During interaction with theÂ villagersÂ ofÂ KoimetlaÂ village,Â itÂ wasÂ found that theÂ NREGAÂ labourers have notÂ been paidÂ theirÂ wagesÂ sinceÂ 7 months.
- It was observed that ICDS programme is badly implemented in Malkangiri district.Â ForÂ example,Â theÂ beneficiariesÂ ofÂ JamugudaÂ villageÂ under Tarlakota GPÂ have notÂ beenÂ gettingÂ egg and food forÂ years togetherÂ becauseÂ of 2 km distanceÂ fromÂ Â Anganwadi Centre.Â The Anganwadi Worker has not taken any proactive step or extra initiativeÂ Â to ensure food/ THR to them. The Team alsoÂ Â came across a lot of complaints relating to distribution of substandard Chhatua.Â Many beneficiaries are not consuming it and using it for food of pigs. Under Mamata Yojana,Â Â the beneficiaries like lactating woman have not been paid money for years together across the district. Either ICDS programmeÂ Â Â have miserably failedÂ to ensureÂ nutritiousÂ foodÂ to theÂ children and P & L woman Â orÂ has itÂ been ineffectiveÂ to addressÂ malnutritionÂ amongÂ the childrenÂ whichÂ requiresÂ furtherÂ studyÂ or review of the project in Malkangiri.
- ThoughÂ aÂ number of childrenÂ diedÂ dueÂ to Â Japanese Encephalitis (JE)Â duringÂ 2011 and 2012,Â theÂ administrationÂ could not learn anythingÂ andÂ remainedÂ callousÂ and indifferentÂ toÂ Â takeÂ stepsÂ Â for preventionÂ andÂ controlÂ of theÂ disease inÂ the district.Â It is worth to mention here thatÂ Â Â Â Â Â Ministry of Health and Family Welfare, Govt. of India decidedÂ Â in 2011 to implement National Programme for Prevention and Control of Japanese Encephalitis/Acute Encephalitis Syndrome in the country.Â This programme is implemented with cent percent Central Govt. support in 171 JE-prone districts of 19 states.Â Though Malkangiri has been affected from 2011, the year of beginning of National programme, the State Govt.Â has precariouslyÂ failedÂ toÂ influenceÂ the Central Govt.Â to be part of the National programme. ItÂ isÂ also fact thatÂ the StateÂ Govt.Â has notÂ evenÂ triedÂ toÂ be linkedÂ with NationalÂ ProgrammeÂ to combat this dreadedÂ disease,Â despiteÂ of itsÂ ineffectiveness and incapacitiesÂ to dealÂ it. It has happened due toÂ Â Â Â ineptÂ Â political leadership andÂ Â insensitivity bureaucracy of our Govt.
- Malkangiri district is extremely backward and poverty-stricken district in the country which has drawn attention of the policy makers several times.Â Â Thatâ€™s why a good number of development projects and special tribal welfare programme is undertaken for improvement ofÂ socio-economic condition of the people.Â Crores of rupees are sanctioned for implementation of various project.Â On the other hand,Â the District Hospital andÂ CHCs and PHCsÂ areÂ seen ill-equippedÂ withÂ lack ofÂ infrastructure,Â vacant ofÂ post of Doctors, ANMs and Para-medical staffÂ forÂ yearsÂ together. If proper treatment had been offered to the patients in a coordinated way, life of many innocent children could have been saved. Whatever staff and para-medical staff are available in the district, they are not working properly.Â Â ANM, male and female health workers hardly visit the field.Â There is no monitoring of health programme and activities ofÂ Â medical staff by the higher authorities.Â Â Â The patients are not provided proper treatment in Hospitals rather got neglected and died.
- The insensitivity of the district administration to deal critical health hazard situationÂ Â Â Â and lack of preparedness has aggravated the problems resulting in huge child causalities.Â After hue and cry in mass media,Â the districtÂ administrationÂ took a number of preventive measuresÂ at village levelÂ toÂ counterÂ spread of disease byÂ putting para-medical staffÂ in different locations, conducting massive awareness programme among the people, fogging, keeping pigs in enclosuresÂ at distance place from human habitations and offeredÂ fantastic treatmentÂ in hospitalsÂ toÂ checkÂ child causalities. Â IfÂ this kind of arrangementÂ had been taken earlier,Â theÂ magnitude ofÂ childÂ causalitiesÂ could have been avoided.
In view of the above problems, the team endorsed the following recommendations to Â make MalkagiriÂ Â a district of zeroÂ Â child causalities.
- The State Govt.Â shouldÂ constituteÂ a JudicialÂ CommissionÂ headedÂ by a retiredÂ HighÂ Court judgeÂ alongÂ withÂ medical expertÂ asÂ Â membersÂ to make a thoroughÂ investigationÂ intoÂ magnitudeÂ ofÂ causalities ofÂ onlyÂ tribalÂ childrenÂ due toÂ outbreak ofÂ Japanese Encephalitis, factors responsibleÂ for it,Â reason of susceptibility of tribal children to this dreaded disease.Â The recommendation of the Commission should be carried in letter and spirit.
- The Team is of the view that the malnourished children have been susceptible to this disease.Â There is high malnutrition among the tribal children in every villageÂ Â across the district.Â theÂ childrenÂ who have diedÂ or under treatmentÂ inspectedÂ by the TeamÂ areÂ seenÂ and examinedÂ as malnourished. So to save the precious life of the tribal children requires intervetion of theÂ Govt.Â to checkÂ malnutrition among the children. The food insecurity and extreme hungerÂ hasÂ resultedÂ in childrenÂ sufferingÂ fromÂ malnutrition. ICDS programmeÂ whichÂ has mandateÂ toÂ increase nutritional standardÂ of theÂ childrenÂ has precariouslyÂ failedÂ dueÂ to itsÂ bad implementation, hugeÂ corruptionÂ and irregularitiesÂ in distribution ofÂ Chhatua ( Take Home Ration).Â The team feltÂ that the provision of Rs. 6.00Â forÂ food per head per dayÂ Â Â in AnganwadiÂ centreÂ is notÂ at allÂ sufficientÂ to meetÂ nutritionalÂ need of the tribalÂ children. secondly, thoughÂ it is notÂ sufficient,Â butÂ whatever is givenÂ isÂ againÂ misappropriatedÂ byÂ Anganwadi workersÂ andÂ otherÂ ICDS officials. There is a chainÂ of misappropriationÂ of ICDSÂ fundÂ from top toÂ bottom.Â Â Â So,Â itÂ is recommendedÂ that ICDS programme needsÂ to be revamped with allocation of required fundÂ Â in contextÂ ofÂ MalkangiriÂ district along with independent monitoring teamÂ to be put in place to moitor its implementation.
- As the outbreakÂ of Japanese Encephalitis has assumedÂ alarming proportionÂ in Malkangiri,Â there is urgent needÂ to coverÂ this districtÂ underÂ National programmeÂ launchedÂ by Govt. of IndiaÂ Â for Prevention and Control of Japanese Encephalitis/Acute Encephalitis Syndrome . So thatÂ with cent percentÂ support from Central Govt.,Â Japanese Encephalitis disease can be controlled. So, the State Govt. should be engagedÂ inÂ dialogue with Central Govt. forÂ coverage of MalkangiriÂ districtÂ under the said programme.
- A number ofÂ Â tribal welfare programme under various schemes, tribal sub-plan schemes supported by Central Govt. and State Govt.Â Â with allocation of huge fundÂ is implemented Â in Malkangiri. DespiteÂ huge funding,Â why the Primitive Tribal GroupsÂ likeÂ Didiya, Bonda Â are suffering. TimeÂ has comeÂ to examineÂ whyÂ these programmeÂ have failedÂ toÂ bringÂ any changesÂ in life and livelihoodÂ of tribals.Â Why their socio-economic condition is still disastrous.Â Â Â WhetherÂ the programme areÂ itselfÂ defectiveÂ or it is badly implementedÂ by Â Â unscrupulousÂ officials.Â It needsÂ to be studiedÂ by expertsÂ in context ofÂ Malkangiri andÂ their recommendationsÂ should be carried outÂ in letter and spirit.
- The medical system of MalkangiriÂ Â shouldÂ be revampedÂ and well-equippedÂ withÂ appointment of doctors, para-medical staffÂ making it effectiveÂ to provide freeÂ health service to the patients.
- There must be independent grievance redressal and monitoring mechanismÂ in place to monitorÂ the implementationÂ ofÂ various welfare programme meant for tribals. TheÂ report of the monitoringÂ should be taken into consideration by the higher authority.Â Time-bound grievance redressal system should be put in place and massive sensitisation programme to be conducted among the tribals across the district.
- The Japanese Encephalitis epidemic is just like disaster. It requires trained personnel to deal this disaster situation. The team recommended that the officials should be trained on disaster management to take preventive measures to counter any epidemic in the district.
- GovernanceÂ systemÂ withÂ transparency and accountabilityÂ in implementation ofÂ various programmeÂ should be enforcedÂ at every administrative level ensuringÂ participation of the beneficiaries.
Pradip Pradhan Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Sri Ashok Patnaik
State Convener, Right to Food Campaign, Odisha Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Advocate and RTI Activist, Malkangiri
Member, Advisory Group of NHRC on Right to FoodÂ Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â M- 9437435399
Sri Bikash Dandsena Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Sri Era Padiami
Social Activist, Malkangiri,Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Tribal Activist, Malkangiri,9437979303 Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â M- 9437316380