Eerie Indicators

As per an NCERT survey, nearly a fifth of the 25 lakh- plus full-time primary school teachers are untrained.

A 2001 survey in Bengal's Purulia, Birbhum, West Midnapore districts showed only 7% of those who didn't take tuitions could write their names.

In Punjab, only 7% rural and 6% urban households use public health facilities for non-hospitalised illnesses.

A World Bank study reveals 39% doctors play truant in state-run institutions.

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• In East Singhbhum district of Jharkhand, the standard of education is so poor that students of classes five and six cannot comprehend two-digit additions.
  
• While the Uttar Pradesh health department claims 100 per cent immunisation, the Centre finds that the coverage is actually 30 per cent.
  
• In Bangalore, India's technology hub, two girls drown in a drain because their state-run school doesn't have a toilet and the girls were forced to go out.

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Extreme cases? No, this is the real state of the poor in India. As the Indian economy booms, and experts confidently predict double-digit growth rates in the near future, there is a large segment of society that seems to be untouched by it. For poverty-stricken households, survival itself is a question mark, even as policymakers talk about the coming of age of an Asian century, led by India and China.

The Outlook-GFK-Mode poll, conducted in one of India's poorest districts—Bolangir in Orissa—reveals the way the other half lives. Ninety-six per cent of the respondents had no toilet, over 50 per cent said the nearest primary healthcare centre was over 10 km away, and two-thirds of children dropped out of school at age 14. "There is a consistent gap between what the government reports tell you, and what independent surveys reveal," a senior economist, who works with a multilateral agency in Delhi, puts it bluntly.

Probably, the most glaring gaps lie in the field of education.

"One-fifth of India’s population suffers from chronic hunger. it should be a...matter of highest priority for India’s society and the world." Jeffrey D. Sachs Director, the Earth Institute, Columbia University

The two major issues confronting policymakers are to find ways to improve the quality of teaching in schools, and prevent children from dropping out. A recent survey by NCERT concluded that state-run schools impart a "questionable" quality of education. It found that nearly a fifth of the over 25 lakh full-time teachers in primary schools were untrained, and the figure was similar for the over 13 lakh teachers in upper primary schools.

For example, in West Bengal, education remains a neglected area. Explains Santosh Bhattacharyya, former vice-chancellor, Calcutta University, "Most school teachers belong to the CPI(M)-affiliated unions and don't feel the need to deliver. Teachers are highly paid and highly pampered. Thus, absenteeism is rife and when teachers take classes, they don't teach properly." A 2002 survey by the state government found that most of the primary and upper primary schools lacked infrastructure and they faced consistently low teacher attendance.

Children tend to drop out, either because parents find education useless, or expect them to augment household incomes. The Punjab's Economic Survey (2006) found that the dropout rate at the secondary level was over 48 per cent. In Bengal, the Pratichi Trust, founded by Amartya Sen, carried out a survey in Purulia, Birbhum and West Midnapore districts in 2001.

The silver lining: people are turning more demanding, using RTI to seek efficient delivery of basic services.

"We realised that 30 per cent of the students didn't attend classes," says Kumar Rana, senior research associate at the trust. "Only 7 per cent of those who didn't take private tuitions (since they couldn't afford to) could write their names. So, the poor continued to be excluded from education."

Exceptions exist. Like the World Bank-funded project in UP which has enrolled 50 lakh children in the past two years in the 30,000 new schools built in the state. To ensure accountability, teachers were recruited locally and, already, 1.5 lakh teachers have been hired at a monthly remuneration of Rs 3,500 each. "Since we have local teachers, it has come as a boon for the educated unemployed in the villages," says Radhey Lal, the head of Pooranpur village, which is under the Mohanlalganj subdivision of Lucknow. However, such examples are few and far between.

When it comes to the public health sector, the picture is as dismal as in education. Despite increasing budgetary allocations to health, states are unable to utilise funds. In 2005-06, 18 states were able to use just 50 per cent of the funds meant for improving healthcare delivery systems. Government studies themselves point out that the bulk of the money used is spent on infrastructure development, not on improving services. This perhaps accounts for the poor outcome of the countrywide immunisation programme.

"The faith in the healthcare infrastructure in rural areas isn't much," feels Deoki Nandan, director, National Institute of Health and Family Welfare.

"The ratio of the poor to the overall population in India has declined dramatically over the period 1987-2000, in both rural and urban areas." Jagdish N. Bhagwati Economics Professor, Columbia University

Adds R.N. Gupta, who was formerly with the Indian Council for Medical Research, "The political system is responsible for many things, including healthcare, going wrong." Low payscales, poor amenities, lack of connectivity and power shortages make doctors reluctant to take up jobs in rural areas. Even if they do, they mostly don't report for work. A World Bank study showed that 39 per cent of doctors and 44 per cent of other medical personnel are absent from their work in state-run health institutions.

In Punjab, says A.K. Nanda, senior fellow, Centre for Research in Rural and Industrial Development, "the tertiary healthcare has collapsed as the Punjab Health Systems Corporation, which was set up to oversee it, has become virtually defunct". At the policy level, the focus seems to have shifted towards diseases that afflict the affluent, rather than killer ones like TB. Faced with rampant corruption and nepotism, only seven per cent of the rural households and six per cent of the urban ones use public health facilities for non-hospitalised illnesses in the state.

The urban poor fare no better. The government has estimated that 23 per cent of the urban population are slum-dwellers, and most of them below the poverty line. In most cities and towns, around 20-30 per cent of the population are slum-dwellers, while the number is 30 per cent in the case of Delhi.

"The difference (in India and China’s economies) has not so much to do with democracy, but (in India’s) failure to invest in education and health." Joseph E. Stiglitz Nobel-winning economist

Recognising the need for a more planned approach to city development, the ministry of urban development and ministry of housing and urban poverty alleviation are in the midst of finalising a new policy. One proposal is to adopt the model being planned to transform Mumbai's Dharavi, Asia's biggest slum.

The silver lining—and it shouldn't be taken lightly—is that people are becoming more demanding. "There are signs that the electorate is beginning to demand better service delivery," says Vikram K. Chand, who works for the World Bank. Agrees Rema Nanavaty of SEWA, "Awareness among rural people is definitely on the rise, but programme implementation is slow. If you see progress in some areas, it's because of the initiatives of local communities and civil societies." SEWA itself has built an association of 9,63,000 women, who are fast becoming the agents of change in rural areas, especially in Gujarat.

Veena Jha, India's programme coordinator at the United Nations Conference on Trade and Development, contends that NGOs "have had a big role to play in Bihar, especially north Bihar, where they are partnering with locals to open new schools. What is noticeable is that people are hungry for education." In Rajasthan, says social activist Aruna Roy, "the state government is lackadaisical, but people's pressure is forcing it to act". Across the country, individuals have found voices, and are using the right to information to seek efficient delivery of basic amenities and services.

Even the Centre and state governments are waking up to the new realities. At the central level, the finance ministry is designing a computerised model that will make the system transparent and enable the public to access records. The ministry for health and family welfare has engaged the United Nations Population Fund to assess the quality of services and the performance of accredited social health activists in 18 states for mid-course corrections. In the first phase, the performance in three states—Rajasthan, MP and Orissa—is being evaluated.

The combined attempts are making a change in the rural hinterland—albeit very slowly. But still, let's conclude with the good news, hoping that such models will be replicated in lakhs of other villages. Here's a story about the transformation of Raj Samadhiyala, a village 20 km from Rajkot in the drought-prone Saurashtra region of Gujarat. From being a poverty-stricken hamlet, its 2,000-odd dwellers today harvest three crops, including 20 varieties of vegetables. The personal annual incomes range between Rs 50,000 and Rs 12 lakh. The primary healthcare centre works to full attendance, each house has a toilet, water connection and drainage system, there's full enrolment in the local primary school, and the village is safe and secure with no reported thefts.

The credit goes to Hardevsinh, a post-graduate who chose to stay back to change the village. "I bridged the gap between the panchayat and the people by setting up village community leaders. These leaders were accountable for results from their respective communities," says Jadeja. Thus, the village was able to introduce water harvesting, build 45 checkdams, create a network of farm ponds and percolation tanks that raised the water table over the years.

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By Lola Nayar with Jaideep Mazumdar, Chander Suta Dogra, R.K. Mishra and Sharat Pradhan