As the state with India’s highest rate of child undernutrition (50.09%), I continued my global health journey from central to northern India to Madhya Pradesh in its capital city of Bhopal. Despite the city’s ubiquitous conservative Muslim culture and resource-starved health facilities, I have read about or observed few cities in the United States that rival Bhopal’s impassioned, progressive grassroots health and human rights movement. I decided to continue my research project on child undernutrition and human rights in Bhopal through two leading non-profit organizations, the Sambhavna Trust Clinic and Right to Food Campaign. They are among the most successful models in holding the local and national Indian governments, as well as the international media and public spheres, accountable for the city’s health and associated human rights atrocities.
Sambhavna Trust Clinic
The Sambhavna Trust Clinic, a comprehensive health center founded by an eclectic cohort of renowned health professionals, scientists, writers, and social workers, is the clinical branch of the broad social justice coalition, the International Medical Commission on Bhopal. This campaign initiated the domestic and international environmental health justice campaign in 1994, which primarily advocates for the basic rights of the hundreds of thousands victims who lost their life or were disabled due to the American company’s Union Carbide gas leak in Bhopal in 1984. The mission of the Sambhavna Trust Clinic is to implement simple, safe, effective, ethical, and participatory ways of clinical treatment, monitoring, and research for the survivors of Bhopal. In addition to preventive and curative health care, the Sambhavna Clinic has initiated numerous local, national, and international human rights advocacy campaigns, protest demonstrations, court orders for the arrest of Union Carbide officials, and social media appeals. By keeping the Union Carbide tragedy fresh in the minds of government and corporate authorities a quarter century later, the Sambhavna Clinic has effectively delivered health care to tens of thousands of patients in slums in near proximity to the Union Carbide factory based on a model of social justice. In 1992, the Permanent Peoples’ Tribunal in Bhopal confirmed that the fundamental human rights of the Union Carbide victims had been grossly violated in terms of a series of articles in the various international declarations concerned with human rights. Although it was possible to sue with the International Tribunal for Human Rights in the Hague, it is often the case that transnational companies have more power than national governments, and as of now, none of these corporations have not signed any declarations on human rights.
Although Sambhavna does not focus on child undernutrition, I pursued my research specifically with the health center’s human rights activist and managing trustee Mr. Sathyu Sarangi, in order to understand Sambhavna’s methodology of approaching Bhopal’s health crisis through its world-reputed, successful rights-based approach, in which their tangible health outcomes are arguably India’s most well respected and cited. As a former engineer and now internationally recognized human rights activist, Mr. Sarangi has dedicated his life since the disaster in 1984 to seeking justice for the 25,000 individuals who have died since then, as well as 100,000 people who have suffered injuries. I have included below some of his inspiring thoughts on health and human rights below:
“Social activism among staff members is deeply ingrained into our daily work goals. Staff members participate in cycle rallies, poster exhibitions, and signature campaigns as part of their involvement with local and global social awareness and activism. More than half of its staff members are themselves survivors of the environmental disaster, and so they are social activists who are committed personally to the cause. I have suffered numerous death threats, I have received many beatings, as well as three prison sentences. But I refuse to allow these physical ailments from distracting me from my campaign. This is how deeply we are all committed to the human rights campaign we started. Along with raising issues of Bhopal and specific demands against Dow and the Indian government, the campaign has raised issues of corporate accountability, penalizing corporate crime, public access to information on industrial actions, inherently unsafe technologies and products, and the regulation of corporate activities.
However, community-driven activism is what drives most of our local and global human rights advocacy work. For instance, in 1994, about 350 women from the communities affected by groundwater contamination occupied the director’s Bhopal Gas Tragedy Relief & Rehabilitation Office for three-and-a-half hours, demanding the supply of safe water. The protestors left only after the director gave them a written statement promising immediate action on the matter. Each of the communities has a group of women representing it. These women keep track of the quantity and quality of water supplied every day. This facilitates prompt response. The data collected by them is used to nail government’s lies in the Supreme Court. All decisions are taken at open meetings, in which representatives from different communities participate. Over 2,000 people, mostly women, are expected to travel to New Delhi to protest against the delay in distribution of compensation. Community leaders have mobilized people for this campaign, visiting the communities and speaking to people. Local supporters carried out house-to-house visits. In terms of a recent example, there will actually be a rally taking place on August 5, 2009, which marks this year’s Hindu celebration of Rakhi [a day in which sisters tie rakhis, or decorated string, around their brothers’ wrists as a sign of sibling affection and appreciation of their protection and love]. The Sambhavna Trust Clinic will transform an ancient religious ritual that is deeply ingrained in the hearts and minds of Indian families throughout the Indian subcontinent into a day of addressing the health and human rights of this community. The Sambhavna Clinic staff will march alongside 100 women up to the Madhya Pradesh government offices with rakhis on their wrists, and demand that the government officials, or their “brothers,” live up to their duty, or dharma, by protecting their communities from further political and financial neglect. In another example, health education by Sambhavna’s community health workers led to collective action by residents of the communities affected by groundwater contamination.”
Some of the most prevalent human rights issues in our community are:
a) Child undernutrition: The breast milk of local women has been found to be toxic and children born to exposed parents of the 1984 gas leak are also affected by poison leaked into the air, soil, and water by the Union Carbide Corporation, all which influence their nutritional status.
b) Inequality in the populations affected: The poorest, who lived closest to the chemical plant, were hit the hardest. In addition, the shortest in stature [children] inhaled the most fumes since they were closest to the ground where the gas mostly resided.
c) Poor governance: The Government of India retains the exclusive right, according to the Act of Parliament, to represent the survivors of Union Carbide. The government must be the people’s own lawyer, but since they are not playing this role, the people have to fight for their ‘natural lawyer’ [the Government of India].”
*For further information about the Sambhavna Clinic & Union Carbide disaster,
please refer to:
1) Bhopal Express (Bollywood movie, 1999)
2) Bhopal Medical Appeal/ Sambhavna Trust Clinic website:
The Madhya Pradesh Media for Rights/ Right to Food Campaign, or Vikas Samvad, is a state partner of the national Right to Food Campaign and its headquarters are located in Bhopal. Its campaign is grounded in the belief that the main responsibility for guaranteeing the basic entitlement to food lies with the state, and the national Right to Food campaign focuses on the following food security issues: the national Employment Guarantee Act, the universal Mid-day Meal Programme in all primary schools, universalization of the Integrated Child Development Services (ICDS) for children under the age of six, effective implementation of all nutrition-related schemes, revival of the public distribution system, and equitable land and forest rights. On the state level, the Right to Food Campaign’s mission is to engage in research and advocacy initiatives in order to address the following human rights issues in India: poverty, food security, livelihood, disability, women’s rights, globalization, health, social exclusion, education, child rights, environment, and right to information and governance.
I pursued my research project specifically under its child undernutrition and human rights campaign, which engages in multiple local and national activities, including public hearings, rallies, conventions, action-oriented research, policy recommendation reports, media advocacy, and lobbying of Members of Parliament. I was fortunate to interview the lead investigator and director of the Right to Food Campaign, Mr. Sachin Jain, who was one of the most insightful and experienced public health leaders I have ever had the pleasure of interacting with. Excerpts of my interview with him are included below:
“Child undernutrition is only an outcome, not the process that breeds inequality and injustice. We must create linkages with this issue to other fields, such as law and human rights and education. The Indian health departments can only play a small role in this multifaceted issue. When a child is brought to a health facility, we see more and more how the role of public health in addressing the root causes and cures is very limited. We must focus on how the issue of child undernutrition evolves- that is the important question, not on the outcomes…Child undernutrition is an issue of household food security and of livelihood and of a control over natural resources and of drought and unemployment. There are too many macro-issues to name.
But first and foremost, we must examine the public health and biological issues associated with child undernutrition. We witnessed that child undernutrition was a direct and indirect cause of child death in Bhopal, and this is the reason why we have the highest double burden of child deaths and child undernutrition in the country. The irony of the situation is that the period of growth between 6 and 24 months is the most crucial period of physical and mental development for a child, and since this period falls after the exclusive breastfeeding period of 0 to 6 months, the highest number of undernourished children lie within this age range in India.
Second, there is no specialized national or local food program that exists for children suffering from tuberculosis, HIV/AIDS, leprosy, and other physically taxing diseases. Because these children are already stigmatized by their disease, they face a double burden of exclusion since the absence of a tailored food program for them leaves them vulnerable to child undernourishment as well. Most disabling, however, has been the public health community’s narrow purview of child undernutrition and neglect of the social determinants of the condition. Public health professionals have focused too much on which macro- and micro-nutrients are lacking among children, as well as hygiene quality of the meals served in schools. But right now, the priority is fighting for the mere survival of government schemes and political will, and not on the quality of food delivered. If we cannot even allocate even the most basic food rations to all children in India, how can we even focus on these smaller issues? I have realized that we cannot fight all these issues from all different angles at one time. We must unite as a public health community and fight an organized, streamlined campaign to garner the attention of the Indian government and navigate the already chaotic political environment efficiently.
Third, we must understand how international food policy influences our domestic right to food policy decisions. By opening our country’s issue of child undernutrition to a worldwide audience, we are able to contextualize how our undernutrition rates compare with that of other developing countries. When the Indian government and society hears that Madhya Pradesh possesses a child undernutrition rate similar to that of Ethiopia and Chad, they can gain a better picture of the gravity of our situation. We cannot approach our problem in isolation, and international food policies allow us to study what worked for other countries and what failed.
Finally, governance is of utmost importance when looking at the issue macroscopically. Governance must provide a basic environment for the right to basic survival, and this is the most basic indicator of good governance. So what else can we expect from the government than their assurance to the basic amenities of food, water, shelter, health, and education? But good governance in India is stifled by development politics, especially since India is the second fastest growing economy in the world and possesses the largest number of consumers. Thus, the root problem is that the Indian government places all their resources and attention on approaching the country’s development through economic growth indicators, rather than on human development indicators. We have damaged our health care delivery system for the last 60 years, and it will only take the humility of the Indian government to accept this fact and take action. We must implement a strong monitoring system, and genuinely engage the community to get involved in these health and human rights issues. Good governance means creating a decentralized system of leadership for service systems such as health. In addition, the government must have the humility and integrity to admit to the severity of the problem. Nine children died in duration of a week in three villages of the Satna district of Madhya Pradesh. The issue came to light when someone got wind of it. The health department issued a report that the deaths were owing to undernutrition. However, the Women and Child Development Department immediately denied the report, implicating that the children had succumbed to various other diseases, and so the department was not responsible for the deaths. No responsible officer visited Satna and the WCD Department managed to alter the report mentioning that the children were above six years of age and thus outside the purview of the government’s care.”
*For further information about the Right to Food Campaign, please visit: