Two years old child Prem lost his life in Madhya Pradesh state capital city Bhopal in June’2009. The verbal autopsy for Prem’s death reveals that the poor position of existing ICDS & health services are responsible such incidence of malnutrition deaths in slum rehabilitated after urban displacement.

Prem was severely malnourished since last one year before his death. Though his condition was degrading day by day, he was not enrolled as malnourished child in Aaganwadi center nor was he being referred to Nutritional Rehabilitation Center (NRC). In lack of required medical services & nutritional supplement, ultimately Prem has taken his last breathe on 12 June’09.

Prem was not only the child who is malnourished in Sukhi Savania. Two more children, Jahid s/o Mohd Sabir (6 years) & Karan s/o Ramesh (3 months) are severely malnourished & are in poor health condition in lack of proper functioning of ICDS services in the area. Sukhi Savenia Aaganwadi was not functional since last six month after retirement of the previous Aaganwadi worker.

Only after the media intervention at Sukhi Savania, the ICDS officials & staff at Sukhi Savenia come into action and a new Aaganwadi worker is placed in position on the very next day.

Again Prem’s mother Sharda is the typical example to the worst suffers of deficient health facilities that are available to pregnant women & lactating mothers. Sharda, Prem’s mother had given birth to baby at home delivery within two hours Prem sad demise. She was not even registered in Aaganwadi center till seven month of pregnancy. Ante natal checkups services are at halt continuously from many months at Sukhi Savania.

Similarly, Laxmi w/o Sonu (20 years) was also forced to have home delivery due to lack of support from service providers. When she refused to consume IFA tablets of expiry date, the Aaganwadi center had not supplied new IFA tablets to Laxmi. Recently Janani Sahyogi Yojana has been put to halt without making any alternative arrangements to ensure institutional & safe deliveries. As a result Aaganwadi helper Kamla Bai of Sukhi Savenia slum had denied providing referral support to pregnant women to take them to hospitals reasoning that now they will not get benefits under Janani Surksha Yojana & even these network hospitals refused to provide services under JSY, when approached.

Displacement is a traumatic experience for everyone undergoing it. Even after 5 years of displacement from Railway station, Bhopal; the 300 families rehabilitated to are still devoid of basic facilities that ensure even the right to survival. New settlement at Sukhi Savania is 15 kms away from their working place. As a result a large amount of their income has been spent to travel expenses to reach out to their work. It is also very difficult to meet out their daily needs of livelihood, food, health, education & medical aid in lack of proper infrastructure & services in Sukhi Savenia.

This exclusionary condition is visible not only in Sukhi Savania. Similar deteriorating living conditions are rampant in other slums of Bhopal, especially in slums thrown out to remote areas in the name of rehabilitation. Maternal & child health condition is nastiest in displaced slums. Most of the Aaganwadi centers are deficient to suppIy IFA (Iron Folic Acid) tablets to pregnant women. Ehasan Nagar slum at Karod with 75 families of Paradhi community even do not have Aaganwadi center.

In such pitiable conditions of health services consequences into poor maternal & child health especially for underprivileged population of the displaced slum. It has a worst impact on the health of the poor vulnerable children’s under five years. Ensuring maternal & child health is still a big challenge in urban slums displaced to other places in Madhya Pradesh. But in spite of that it is dazzling fact that the only Nutritional Rehabilitation Center (NRC) at Hamidia Hospital in Bhopal has been closed down. It is result of the insensitive attitude of the service provider that result into 8 maternal death & 41 infants deaths in the period of just 3 months from April’09 to June’09 out of which most of death occurred in urban slum or rural areas of Bhopal.

To come out of incidence of maternal & child deaths it is must to give proper attention to strategic rehabilitation planning before actual displacement. Such planning should include provisions of basic infrastructure & facilities of health, education and livelihood.

- Seema Jain