Muzaffarpur deaths: poverty, not nature, took away the children
The disease that killed the Muzaffarpur children is caused by a thought process that is now ruling us: that the fittest alone shall survive.
John Steinbeck’s classic Grapes of Wrath uses lots of slang signifying more than what they ordinarily mean. Skitters, an old Scottish word for diarrhoea, is used repeatedly by Steinbeck whenever ten-year-old Winfield Joad -- the youngest in the family of the Joads, one of the families forced to abandon their farms and go South to make a living -- ends up working on farms plucking peaches for a pittance.
Winfield Joad and his elder sister Ruthie -- whose daily diet during the travails is anything but frugal and lacking in variety and nutrition -- end up eating too many peaches while plucking them for a living. And they end up suffering bouts of diarrhoea -- a syndrome that Steinbeck conveys to his readers using the slang ‘skitters’.
Skitters here is not just slang; nor does it mean the same as diarrhoea in the sense of a disease. It is a symptom. It is the tendency in children, forced into work at a tender age and whose daily diet lacks variety and nutrition, to eat whatever they lay their hands on -- peaches in the case of Winfield and Ruthie Joad (10 and 12 years of age). These they pluck for a measly wage, and end up sick with diarrhoea.
This is true about encephalopathy, also called acute encephalitis syndrome and substantially different from encephalitis. One ought to acknowledge Dr. Jacob John, among those medical professionals who refuse to be drawn into the vortex of commerce afflicting the profession, for enlightening us with this important distinction between the syndrome that left more than 100 children dead in Muzaffarpur, Bihar, and the disease called encephalitis.
True to his calling and the Oath of Hippocrates that everyone qualified to practice medicine takes, Dr. Jacob John has also informed us about the cause of the disease that killed those children in Muzaffarpur. Their parents are poor, pluck litchis in the orchards for a living, and these children eat the fallen fruits on empty stomach and end up having low blood sugar. They then die due to that. The doctor, true to the oath, has identified the cause of this syndrome. In ways more than one, there is a similarity between what John Steinbeck narrates in his account of America during the economic depression and our own land now.
Muzaffarpur and encephalopathy, then, are as much a metaphor as was skitters in Steinbeck’s novel. And they are as much a critique of our society as of the society and the administration in the US during the depression. The depression was preceded by the destruction of farming and the brutal self-centred behavior of those who remained rich.
The point is that these children died because they consumed the raw litchis that had dropped around the camps after those that their parents plucked were loaded on trucks to be carried and sold in markets far away.
That Muzaffarpur litchis fetch a lot of money and are also exported is as true as the fact that peaches were sold to make wine, in Steinbeck’s narrative, and hence fetched a lot of money to those who owned the farms. It must be conventional wisdom that litchis are eaten when ripe, preferably after a meal, and this is how those who buy them consume. None of those has died due to eating them ripe. Our blood sugar levels have not dipped either.
It is conventional wisdom, one must presume, that litchis are not consumed on empty stomach and certainly not when they are still raw. They are harvested before they are ripe and become a succulent fruit by the time they reach the market. In other words, it must be known that consuming them when raw will lead to death due to low blood sugar. As much as Winfield and Ruth Joad must have known that eating too many peaches will make them sick.
But as Steinbeck narrates, the kids ended up eating the forbidden peaches because they were not blessed with variety in their daily diet and hence suffered malnutrition. And in such a state, it is only normal to eat what they find edible. Just like the poor in some parts of India eat limestone and infected mango kernel to survive and end up dying due to the infection. Poverty got these children pick up fallen litchis around the camps where they lived, unaware that litchis, when not ripe, will cause hypoglycaemia. And their parents, even if they know that the child’s blood sugar level has fallen, are so poor that they will not stack sugar in their kitchens as many of us do in our homes.
Hippocrates, the Greek philosopher, who proposed that every disease had a natural cause, is called the father of modern medicine. Those trained in the system of medicine take their oath in his name even today. The cause for encephalopathy, as we know by now, is poverty. And the syndrome that has taken away more than a hundred children in just a few days does not require super-specialty hospitals for treatment. Dr. Jacob John has told us this. Let us take it as a fact until proved otherwise.
All that is needed is a system that ensures that the poor who are forced to work on fields and end up taking their children to live with them in camps -- such as in the litchi farms during the harvest season -- are assured of schools where their children can be admitted and where they are fed adequately. This, one presumes, is what is provided for in the law governing the Right to Education for all children between age six and 14 (and child care centers below age six).
It is no use blaming one political party or another. Muzaffarpur is not merely about a government’s failure. I repeat it is not merely that and stress that it is also that. The disease, indeed, is caused by a thought process that is now ruling us: that the fittest alone shall survive. Steinbeck’s novel, penned in 1937, would become a classic because of its message that the trouble was not the depression but the policies that led to the depression. And the making of a society where collateral damages were considered inevitable for progress!
Muzaffarpur and encephalopathy convey a similar message.