RABINDRA Thapa, 24, a community health worker associated with Save the Children (USA) is making his rounds through the communities of north Gorkha. At the village of Archalay in Lakury Bot Panchayat, a five-year-old boy is clearly in the last stages of terminal pneumonia. He was breathing fast, his nostrils flared, his pulse was racing at more than 50 per minute, and Thapa could see the suction in through the rib cage as the child struggled to breathe. The lips and finger-tips were already discoloured.
The father, who was hovering over the prostrate child with incense in his hands, said the jhankri (shaman) had just been in. His son was down with the "Nepali byatha", he said using the term used in that area to identify mysterious afflictions imported from Kathmandu (still "Nepal" to many villagers). Frustrated, and unable to convince the household that the child had to be taken to hospital in Gorkha, Thapa continued on his rounds. A month later, he met the father on the trail and was informed that "baccha khera gayo". The child had been "wasted".
At his moment of death, the child became part of the devastating child mortality statistics of Nepal, where more infants and children per thousand die than most other countries. But in a country jaded with development talk, numbers and charts, there is talk of the perishing children, but in a surreal atmosphere where the impact is not there. Perhaps this was what led James Grant, UNICEF's Executive Director, attempt to make the situation more graphic. Speaking to the press in Kathmandu last year, he said it was as if three Boeing 747s packed with Nepali children were crashing into the Himalaya every day during the height of the monsoon. There are 2.8 million children below five in the nation.
As for the statistics, the National Diarrhea Survey of 1985 estimated that 99,000 children die annually while UNICEF estimates the figure to be 137,000 so the truth is somewhere in between. Health Ministry officials say that every year, some 45,000 die of diarrhea alone. UNICEF stated in a report last October that children under five are the most endangered section of the Nepali population. The latest data from the Washington DC-based Population Reference Bureau show that 206 children under five out of every 1000 die. (For comparison, 329 in Afghanistan, 48 in Sri Lanka and eight in Sweden. In February, the Registrar General estimated that that India's child mortality rate was down from 104 per thousand in 1984 to 94 presently)