The Government of India has recently released a fact sheet of the Wealth index and its status among Scheduled and Scheduled Tribes of India. This Fact sheet must be recognized as a document for self realization for all of us. Data mentioned in the fact sheet shows that 46.6 percent of tribal women are undernourished while the national average is 33 percent. In case of pregnant women situation is also not enjoyable, 73.9 percent pregnant women are anemic although the national average is 57.9 percent. But in case of Children, future of the society is not bright, 85.1 percent children in Tribal communities and 82.3 percent children in Scheduled Caste communities are anemic in India.  High status of Maternal Mortality is big challenge for both, State and the society but it needs to be analyzed in the context of Social exclusion and marginalization processes. If tribal communities are weakening it simply means that the livelihood and household food insecurity is playing a crucial role in it. On the one side it can clearly be mentioned here that issues of Women and child health have never been defined as political issues, but on the other hand every thing in democracy is defined and decided through the political processes. It means things are not moving politically in favor of women and children. The latest National Family Health Survey (III) has come out with new challenges, and in fact it must be internalized as alarm for the policy makers and other stake holders of the social development. We have been raising voices on the issue of high infant and maternal mortality, but we can not forget that more then 40 percent women are undernourished and more then 57 percent pregnant women are anemic. Most shocking phenomena is that the ration of malnutrition and anemia has increased by 5 and 8 percent after 1998-99. On the same side anemia among children and malnutrition also has been on increase, anemia increased by 11.3 and malnutrition by 6.8 percent. And very recently Asian headquarter of MDGs has come to Madhya Pradesh and delivered a certificate of appreciation to the State Government for their remarkable performance and efforts in achieving Millennium Development Goals (MDGs).

In the past decades there has been a reduction in the number of maternal deaths but in spite of this the number of maternal deaths is 7700 per year in the state. Nearly one maternal death is taking place every hour. The average number of maternal deaths in Madhya Pradesh ten years ago was 498 per lakh, which has come down to just 379 per thousand at present, and the process of change in the situation can be considered very slow. According to the National Family Health Survey-3 the number of women who underwent the three necessary examinations prior to delivery during heir last pregnancy is 42.2%, the number of women who deliver under the care of some doctor, nurse, ANM, LHW or some trained health worker is 37.1 %, the number of institutional births is 29.7% and the number of pregnant women suffering from anemia (15-49years) is 57.9%. Status of breast feeding in MP is alarming, only 14.9% children are receiving mother’s milk (colostrum) within one hour of birth, although it is a guaranteed element for safe and healthy life for a human being.

Fighting fatal diseases such as HIV/AIDS, malaria and others has been declared as one of the millennium development goals. Till April 2007, 2201 HIV positive cases were found in M.P., out of which 86% cases were found to be between the ages of 11 to 45 years. On an average the number of HIV positive cases has been rising by 200 cases per year since 1998.  If we look at the situation of malaria in the state, we can see that the contribution of Madhya Pradesh to the total number of cases in the country is 24%. 40% of the cases of Plasmodium Falciparuim (one of the most dangerous kinds of malaria) are recorded in M.P. Out of the total number of deaths due to malaria 20 % are recorded only in M.P. (Madhya Pradesh Draft Health Sector Reform Srategy-pp9, 10) In the year 2006,when the blood of the 97 lakhs 32 thousand 662 patients suffering from fever, was tested 96 thousand and 42 of the patients were found to be malaria positive, out of those 28 thousand 900 cases were of Falciparuim malaria. In M.P. the level of T.B. is also dangerous. According to the Medium Term Health Sector Strategy (2006) in 2005, 85 persons per lakh were found to be affected by T.B. 111 patients per lakh have been identified by the statistics of the Health Department. Between January and March 2007 the status was that 104 per lakh patients had been identified as being T.B. patients.

Protecting the environment is the most difficult of the goals from the millennium development goals. The multinational companies, which have been invited by the state government according to the policy of the state, have ruined the national resources. Those factories, which are located on the banks of rivers, are discharging their untreated effluents into the rivers, which in turn are destroying the fertility of the surrounding farms and also polluting the rivers and the ground water. The multinational companies are being given unlimited rights to draw out underground water and privatization of water is being done. There are often reports of violence because of fights over water. In many parts of the state the level of underground water has fallen very low. The level of nitrate in the underground water has risen because of the discharge of untreated effluents and chemicals by factories. The number of people suffering from fluorosis has increased. In the third part of the goals it is the aim at the national level to improve the standard of living of the total number of people living in slums by the year 2020. But by destroying the means of livelihood, displacing people living and depending on jungles, inviting multinational companies in agriculture and thereby rendering farm labour and farmers landless and as a result of that having increasing pressure on cities and urban areas and allowing illegal colonies from springing up- how can these goals be achieved? It is difficult to say. Various experiences prove that if a violation is found, the lower class will be punished, as they are nor protected neither by the state nor by the Market. They are just used. Cases of corruption in Medicine supply or in procurement of Supplementary nutrition for children have been becoming the headlines of media quite frequently, but if you ask who got punished? The answer is a Ward boy, ANM, Nurse or any Anganwadi worker. We all see that the matter of human rights directly affects the interests of Market and profitable institutions. Still unaccountability and the lack of political will is big threat to all kinds of efforts to inclusive development in Madhya Pradesh. So can we decide there are miles to go before, we receive any certificate of appreciation.

Sachin Kumar Jain