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 Post subject: Lanka's masked realities
 Post Posted: Tue Mar 07, 2006 1:40 am 
Lanka's masked realities

COLOMBO DIARY | PK Balachandran
@ HT / March 6, 2006

For a poor country Sri Lanka has indeed taken impressive strides in social development. The Infant Mortality Rate (IMR) is lower, and life expectancy and literacy are higher in comparison with other South Asian countries.

But this is a façade, which hides a grim reality, points out Dr ST Hettige, Professor of Sociology at the University of Colombo.

"By giving all the necessary shots to the child, it can be made to survive. But what kind of life is this child going to lead in the coming years? We don't seem to give much thought to this question," he told Hindustan Times.

In his paper Social Development and Public Policy in Sri Lanka (Social Policy Analysis and Research Centre, Colombo, 2005) Prof Hettige points out that there is widespread malnutrition, both among children and adults; the quality of life of the elderly is poor; and the school drop out rate is high.

"If a large proportion of surviving children are stunted or wasted or both, their future prospects are naturally compromised due to poor intellectual growth, deficient physical development etc."

"When they reach adulthood, their own children are going to be affected by their nutritional condition," he says.

Prof Hettige contends that social development cannot be measured only in quantitative terms. There has to be a qualitative appraisal also. In fact, social development should focus on the "quality of life", whether in the case of children or adults, he argues.

"The neglect of these issues has had significant implications for social and economic development. There is an urgent need to shift the focus from extensive development to intensive social planning to address a wide range of social development issues that remain largely neglected," he says.

Brighter side

Let's see the brighter side of the Sri Lankan situation first. In her report entitled Repositioning Nutrition (World Bank, Washington DC, 2006) Senior Consultant Nutritionist Meera Shekar gives comparative figures for the countries of South Asia including Afghanistan, which show that Sri Lanka has something to be proud of.

In terms of Under5 Mortality Rate (which is the number of children under five years of age dying per 1000 live births), Afghanistan is the worst with 257 deaths. In Pakistan it is 101 and in India, 90. But in Sri Lanka, it is 19. According to another estimate it is even lower, at 15.

In India, 46.7 per cent of kids below five are underweight. In Pakistan it is 38.2 per cent and in Sri Lanka, 32.9 per cent. Quoting figures put out by the World Bank in 2005, Prof Hettige puts it at 29 per cent.

Darker side

According to figures provided by Meera Shekar, in 2001, anaemia affected 30 per cent of pre-school children and 32 per cent of women of child bearing age.

Chandani Jayatilleke quotes a study by the Colombo-based Medical Research Institute (MRI) to say that 20 per cent of the school children are anaemic. The study, done by Dr Renuka Jayatissa, found that 29.6 per cent were under weight and 17.8 per cent were stunted (Daily News March 28, 2004).

In 2000, one fifth of school going children were affected by goitre because of iodine deficiency. Iodine deficiency has increased since the 1980s, when it was 14.4 per cent.

Vitamin A deficiency among children under six, is also high, at 35.3 per cent.

Sri Lankan adults suffer from both from malnutrition and obesity. 21.8 per cent of married women are undernourished and 24 per cent are over weight.

Undernourishment among women is the highest among the workers in the plantations sector, who are mostly Tamils of Indian origin. Undernourishment is 50.4 per cent among them. But among the women of Colombo, the capital city, it is 9.7 per cent.

However, 43 per cent of women in Colombo are over weight. Among the plantation women, the figure is 4.5 per cent.

Diet and obesity related Non Communicable Diseases (NCDs) are quickly emerging in Sri Lanka. For example, the number of cases of diabetes had tripled between 1980 and 2002. This trend is likely to get further aggravated by the anticipated changes in lifestyles and an increasingly ageing population (Source Meera Shekar, World Bank, Washington).

According to the MRI study cited earlier, 10 per cent of school children come to school without breakfast. Nearly a quarter of those surveyed had not eaten any greens or vegetables for a whole week.

Poverty is the main cause

With over a third of the Sri Lankan population of 20 million living below the poverty line, poverty is clearly the main cause of malnutrition and its attendant conditions.

Conventional theory is that the biggest chunk of expenditure for a poor family is food. But in reality, this is not so. According to Prof Hettige, poor families are forced to stint on food and spend heavily on other necessities like health, clothing, fuel, transport and education. This is because these other necessities are so expensive.

When public transport deteriorates, people have to use the more expensive private transport like three-wheelers. When the public health system deteriorates, people have to resort to the more expensive private medicare, he points out.

To meet the additional cost of living, poor people naturally turn to cheaper food like white bread and avoid expensive but nutritious items like fish, meat, milk and fruits, Dr Hettige says.

People in the rural areas have better access to good food than those in the urban areas. But more and more people are leaving the rural areas for urban employment to earn cash, because of the downgrading of agriculture and the deterioration of the rural economy.

Rising costs of labour and other inputs have made farming unprofitable and farms are being abandoned, leading to unemployment and poverty in the rural areas.

Lack of social support system

Poverty is not simply a matter of an individual's income. It has to be seen in the light of his familial and social responsibilities. In a non-industrial society like Sri Lanka, an earning member is expected to support a large family and poor relations. This results in the "sharing of poverty" says Dr Hettige.

Poverty has to be shared because of the absence of a social security net, he points out.

Problem of the aged

Due to the reduction of the mortality rate, Sri Lanka today has a substantial section of senior citizens. But this has not been an unmixed blessing.

As Prof Hettige points out, living is becoming a problem for the aged because of a lack of an independent income. 68 per cent of those who have crossed the retirement age have no pension or any kind of social security.

60 per cent of the retired persons are dependent on their children. 42 per cent of the old in the plantation sector do not have adequate food.

Many of the old have serious health problems requiring expensive medicare and social support. But with the deterioration of public hospitals, they have to go to expensive private hospitals, which they cannot afford because their families cannot afford it, Prof Hettige says.

The paucity of income could lead to the old and the infirm being ignored or ill-treated. This could generate family tensions. Some non-earning old persons may have no option but to resort to begging to keep body and soul together.

Therefore, even as Sri Lanka gloats over its high life expectancy, its aged are groaning,

"It is a serious situation," as Prof Hettige puts it.

Lack of quality education

Literacy (which is ability to read, write and count) is very high in Sri Lanka by South Asian standards. But its school system leaves much to be desired in terms of quality, Prof Hettige says.

There are about 10,000 government-funded schools with over 4 million students. This is adequate as far as numbers go. But quality is very uneven. Only a minority of urban schools have the facilities to do what they are expected to do.

Good private schools have come up to ease the situation, but these levy fees, which the poor majority cannot afford.

Tamil medium schools are worse than Sinhala medium schools in many ways, mainly because of long years of neglect in the plantation areas and disturbed conditions in the North Eastern Province.

According to Ministry of Education figures released in 2003, about 14 per cent of children between 5 and 14 years of age did not attend school. The drop out rate was minimal among both Sinhala and Tamil medium students till about Grade 5. But from then on, it began to increase.

The drop out rate was higher among Tamil medium students than among Sinhala medium students, especially in Grade 10, where the figures were 10.17 per cent and 4.7 per cent respectively.

School dropouts join the ranks of the illiterate and semi literate workers in the informal sector and are subjected to the same conditions of poverty, observes Prof Hettige.

He urges the Sri Lankan government to increase the nutritional levels of the majority of the people; improve the school system at the small town and village levels; and devise schemes to meet the basic needs of the growing population of the aged.

The sociologist strongly recommends that the public health and transport systems be improved so that the cost of health and travel come down. This would enable the poor majority to spend more on food and nutrition and make Sri Lanka's social development more meaningful than it is now.

(PK Balachandran is Special Correspondent of Hindustan Times in Sri Lanka)

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