Amit Kumar, an Indian journalist based in the eastern state of Bihar, received a tip in 2009 from a village called Manan Bigha just two kilometers away from his home. There was a man there dying from starvation, he was told. The situation was urgent.
Mr. Kumar rushed off to visit the man, Kangresh Manjhi, and exhaustively documented his story. He learned how Mr. Manjhi, a lower-caste, landless laborer, was forced to stop working when he contracted tuberculosis in 2007; how his family was unfairly shut out of entitlements like food subsidies and free health care; how there was no food in their house.
Mr. Kumar’s article, which appeared in the newspaper Dainik Jagran in October 2009, provoked immediate action. Local officials visited the family and gave them 20 kilograms of wheat, 1,000 rupees ($20) and ordered the government’s food ration program to provide subsidized grains to the family monthly.
Last fall, I conducted field research on starvation in India along with my colleague Ankita Aggarwal from the New Delhi-based Centre for Equity Studies, a think tank. As we traveled across several states, hearing tale after tale of families battling chronic hunger to stay alive, it became clear to us that the media play a critical role in holding public officials accountable. A powerful news report can generate a wave of public outrage over starvation – and can result in government action.
In our travels, Mr. Kumar was the one journalist who stood out. Based in the Barachatti region of Bihar’s Gaya district – not far from Bodh Gaya, the place where the Buddha found enlightenment – the 31-year-old writes about people who are chronically ill and starving. He reports on their struggles and how the “right to food” the Supreme Court says they enjoy is violated in myriad ways.
“We have a team of reporters that are constantly going in and out of the villages,” Mr. Kumar said when we spoke with him during our visit to Barachatti in November. “When there is a case of someone suffering badly due to hunger or sickness…someone from the village will call me.”
Mr. Kumar, the son of a social worker, says he always had an interest in public service. He got interested in journalism in his first year studying political science at Magadh University in Bodh Gaya. “My family didn’t have money but we had the basic things,” he says. “I grew up with poverty in front of my face and had that constant feeling of: ‘what would it take to progress?’”
Nobel Prize-winning economist Amartya Sen argued long ago that independent India had successfully managed to prevent famine because of its democratic political structures. He was referring not just to electoral processes, but also the independent media that shines a light on government wrongdoing and galvanizes the public’s attention when starvation deaths happen.
“The government cannot afford to fail to take prompt action when large-scale starvation threatens. Newspapers play an important part in this, in making the facts known and forcing the challenge to be faced,” Mr. Sen wrote in a 1984 article in the journal Food and Nutrition.
Indeed, the catalyst for the “right to food” public interest litigation the Supreme Court has been hearing since 2001 was evidence of starvation deaths reported by several media outlets.
Mr. Manjhi came from the community of low-caste Bhuyias, landless laborers who work in stone quarries and brick kilns. In Gaya district of Bihar, the group has been hit hard by tuberculosis. According to India’s National Rural Health Mission, some 360 new cases are diagnosed each year in Barachatti, the region where Manan Bigha is located. Today at least 10 families in the village are struggling to earn enough to eat because the head of the household is too sick to work.
Mr. Kumar’s reporting documented the stress it put on Mr. Manjhi’s family when he had to stop working in 2007. Like other families in Manan Bigha, theirs didn’t have a ration card to get discounts from the government grain shop, even though the benefit is meant for poor families just like theirs.
Nandlal Choudhary, the “block development officer” who oversees local welfare programs, acknowledged that Mr. Manjhi’s family’s name had been mistakenly left off the list of families that should receive ration cards and said a public servant from the state agriculture department was suspended for the error in 2010. Mr. Choudhary said he submitted a request in April 2011 to get the family their card, but the family still hasn’t received it. Mr. Choudhary assured me the ration card will get processed soon.
The struggle to feed three children fell on Mr. Manjhi’s wife, Kari Devi. She worked on construction sites and in paddy fields in exchange for payment of about three kilograms of rice per month. It wasn’t nearly enough. When Mr. Manjhi was healthy the two managed to bring in 17 kilograms of rice per month. “Before my husband fell ill we had enough to eat,” Ms. Devi told us. “After he fell ill, three kilograms of rice wasn’t enough.”
Mr. Kumar also wrote about Mr. Manjhi’s struggle to get health care. According to his reports, Mr. Manjhi went to the local public health center a few kilometers away, one of the free clinics the government has set up in rural areas. First, his condition was misdiagnosed as a bad cough, Mr. Kumar’s report said. When cough medicine wasn’t helping him, he went back to the clinic and doctors took an X-ray.
“The doctor said his cough would get better,” Ms. Devi told us. “But when we came home I said, ‘Now where will I take him?’” She decided to pay for a private doctor in Gaya, the capital of the district with the same name. There, he was diagnosed with tuberculosis but the couple couldn’t afford the medicine. At home, Mr. Manjhi’s health continued to deteriorate.
Mr. Kumar’s story appeared on October 5, 2009 with a Hindi headline that translates as “Plagued with TB Kangresh Forced to Beg.” S.S. Badhan, a high-level bureaucrat responsible for administering development programs in Barachatti at the time, and Ajay Sharma, a member of the local village council, visited the family. They gave them wheat, some cash and ordered that they be added to the ration program so they could get discounts on food from government shops. The story also prompted the government health center to provide care for Mr. Manjhi’s TB.
M.E. Haque was a new physician at the center and treated Mr. Manjhi free of charge, prescribing a rotation of four oral medications. “When he was very sick and many people knew about his case I was informed,” Dr. Haque said. “I did what was possible for him.”
Unfortunately, two months after the story ran, the family stopped receiving its monthly grain rations again. “When the issue went cold, their situation went back to normal,” Mr. Kumar says. The dealer refused to sell subsidized grains to Ms. Devi.
By April 2010, the family had gone four months without subsidized grains. “I was working, but we never had enough to eat,” Ms. Devi told us. Mr. Manjhi, chronically hungry and battling illness, was bed-ridden and struggling to stay alive. Ms. Devi’s brother-in-law was able to give the family two kilograms of rice a few times. Neighbors said they didn’t have enough food to feed their own households so they couldn’t help Ms. Devi when she needed it most.
Matters worsened when a dog bit Ms. Devi on the foot in the first week of April 2010. Her foot got infected. She does not know the name of the infection but said her foot swelled and was painful and she was unable to work.
Ms. Devi faced a difficult decision. If she stayed home to care for her husband and children, the infection might spread and get worse. But if she left home to get treatment – which would require going about 35 kilometers to a private hospital in Gaya, likely a multiple-day trip – who would care for her husband and children in the meantime? Plus, the household could scarcely afford to spend more money on medical care.
Ms. Devi decided to treat her infected foot and return to her family as soon as possible. Her sister borrowed 600 rupees ($12) from a moneylender, which financed her commute and the medication she received at Gaya Medical College.
When Ms. Devi returned home, the situation was critical. For five days in April, there was no food in the house. To keep Mr. Manjhi alive, Babita, his youngest daughter, would get kichidi, a simple Indian meal of rice and lentils, once daily from the village health worker.
On April 13, 2010, Kangresh Manjhi died.
Mr. Kumar and other journalists followed up on the story after the death. Mr. Kumar wrote about the failure of government programs such as the food distribution system. He asked why the supply of subsidized grains to the family, which started after his initial report, stopped only two months later. He asked why the villages in the area didn’t have emergency stocks of food in case a person was starving.
These questions and reports prompted further official visits. Among the visitors: a state legislator and several village elders from the region. They all dispensed some amount of money.
There were some downsides to the barrage of media coverage. The debate was narrowed down in some quarters to the superficial question, “Did Kangresh Manjhi die from hunger or tuberculosis?” Local officials were quick to attribute the death to TB and only TB.
Sanjay Kumar Singh, then-District Magistrate of Gaya, the highest-level bureaucrat in the area, ordered a post mortem in response to the controversy. Officials exhumed Mr. Manjhi’s body and took it to Gaya Medical College for the examination.
Local officials, including the village council president at the time, told us that the official conclusion was that Mr. Manjhi died of tuberculosis. But Mr. Kumar says this was never announced publicly. The publicly available report from Gaya Medical College is inconclusive on the cause of death.
Hunger is a politically charged issue. Dr. Haque told us that tuberculosis is curable if patients take their medication regularly, are not afflicted by malnutrition, and do not drink. Some 10 patients are diagnosed with TB at his public health center every month, he says, and the cure rate is 75%. But we found it difficult to have a straightforward conversation with him about what role hunger could have played in accelerating Mr. Manjhi’s decline.
We pressed him: Didn’t Mr. Manjhi’s inability to obtain enough nutrient-sufficient food on a regular basis play a role in his death?
“With any disease,” if there is malnutrition, the patient’s immunity will suffer, Dr. Haque said. He suggested Mr. Manjhi may not have followed his TB medicine regimen, which could have been another factor. “There are multiple causes. But it’s impossible to say that the exact cause (of death) is hunger or starvation.”
Dr. Haque said there were plenty of good samaritans willing to feed people in need. Looking out the window of his office he saw a poor elderly woman standing alone by a tree. “See, there is a beggar outside and if she is starving, then someone from the hospital will give her at least something to eat,” he said.
Starvation is a brutal but little-discussed reality in India. The Wall Street Journal’s India Real Time is publishing a six-part series on starvation, showcasing the findings of an investigation by the Centre for Equity Studies, a New Delhi think tank that is researching hunger and advocating reforms of India’s food policies. The series of essays documents the stories of starvation victims, explores the primary causes of their deaths, and argues fiercely that India must overhaul its broken food security system. We welcome your comments and feedback.