It is early morning in Kushinagar District of Uttar Pradesh when we arrive at the small village of Puraina. Driving through lush green fields of wheat, maize and sugarcane, the area has a definite feeling of prosperity. As we enter Puraina and make our way down streets of thatched houses, small children line up curiously, to see who the outsiders are. Only then do we notice that their bellies are swollen, that they have rough, blond hair and gummy eyes – all telltale signs of malnourishment.
Sheila Musahar cradles her youngest child, Gaeni, who has had a high temperature for the past six days. Sheila is 25 but looks at least ten years older. Gaeni is two, but looks like a six-month-old. Falling ill in Puraina forces reconciliation to disease, as modern medicines are not just rare, but absent. "There isn't enough money to get food; how can we get medicine?" asks Sheila, as she observes her fevered child. Indeed, the nearest health centre is three kilometres away, and for those who do make the trip, money is invariably the next hurdle. Government clinics are supposed to hand out free drugs, but that is just a myth as far as the people of Puraina are concerned.
While the national economy is booming, the health indicators of India's poorest communities have not been keeping pace, and not just in extremely poor communities such as Puraina. Even as Indian foreign-exchange reserves have rocketed from less than USD 6 billion in 1991 to over USD 150 billion in 2007, hunger is currently stalking more than a third of all Indian children. The proportion of children in India under three who are too thin for their height has actually risen, from 16 to 19 percent over the past seven years. In Uttar Pradesh, the latest National Family Health Survey shows that the numbers of anaemic children under three years of age have increased from 73 to 85 percent over the same period. The central government spends less than one percent of its national GDP on health.
Half-chapatti, chilli, rock salt
But it is not just macroeconomics that is holding back Puraina, it is also generations of discrimination – India's very own apartheid. Puraina's 76 families all come from the low-caste Musahar community, and their situation bears witness to the fact that India's outlawed caste-based discrimination is still very much alive and kicking.