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Will A Nobel For Outrage Make Us Feel It?

It was entirely fitting: that Amartya Sen heard about his Nobel Prize while he was in New York to give a lecture in memory of Mahbub-Ul-Haq. Fitting, because no two other men that I can think of have spoken as tirelessly and consistently as these have of things we in India must learn some day. For me, Sen's Nobel is a recognition of that voice. While Sen thoroughly deserves the Nobel, it is sad Haq is not here to know the world today honours his friend and their message.

Much has already been written about Sen. But perhaps the simplest expression of his theories is this: a nation's highest priority must be the development of its human potential. Haq, whom I wrote about here some weeks ago, spent years making much the same point. There is simply no other path to strength and prosperity. For India in particular, that means our country's continuing indifference to the situation of most Indians is precisely why they remain there. Couple that indifference to our preoccupation with frivolities like bombs and temples and you will know precisely why India remains a poor country beset with tangled problems.

As much as I was saddened by Haq's death, I am elated that Amartya Sen won the Nobel Prize. It is a sign that there is still a place in this world for humanity, for rationality, for sanity. But the award would mean a lot more to him, I'm sure, if India chose to consider and use his ideas. That would be, far and away, the best tribute to the man.

There are three points Sen's work makes that I find especially intriguing.

First, his assertion that famines happen only where there is an absence of democracy. This is particularly well known in India, because Sen makes his point with the example of the great famine in China between 1958 and 1961. That catastrophe killed 30 million people. (In contrast, the last big famine in India -- Bengal, 1943 -- killed three million).

The 30 million died not least because China had no opposition, no free press, no mechanism in place for people to hold the government accountable for its failures. As a result, the government did not feel any pressure to act to avert famine when the signs began appearing. Millions starved not because there was no food in China, but because the government was blind to even the existence of the disaster and took no steps to tackle it. During famines, it is the escalating price of food, not its physical scarcity, that condemns people to starvation. Yet during 1958-61, China made no move to give its starving poor the purchasing power to survive.

A disaster as enormous as China's famine is nearly inconceivable in India. Here, vocal opposition parties and alert newspapers stimulate public outrage, ensuring that governments act in time. "No government in India," Sen said at the Second Harvard Lecture in New Delhi in 1988, "can get away with ignoring threats of starvation and famine and failing to take counteracting measures. ... [W]hile food output has often fallen quite dramatically in post-Independence India, counteracting measures have been taken fast enough to recreate lost entitlements (mainly through employment schemes, often paying cash wages) to avoid open starvation and famine."

Thus India's greater success than China in averting large-scale famine. Quite naturally, this way in which we have outdone our northern neighbour has been widely discussed in India. Especially after Sen was awarded his Nobel.

But there is another facet to the comparison -- not quite as complimentary to India, so not as well-known here. That's the second intriguing point Sen makes. Except for the three years of the great famine, China has increased life expectancy and reduced mortality for its people far faster than India has managed. This has come from what Sen calls "the basic commitment of [China's] political leadership -- not unrelated to Marxist ideology - to eradicate hunger and deprivation."

If India had had the lower mortality rates that China has achieved, there would be nearly four million fewer deaths here every year -- every year! -- than we have today. The equation, then, is obvious enough. Here's how Sen put it: "[E]very eight years or so more people in addition die in India -- in comparison with Chinese mortality rates -- than the total number that died in the gigantic Chinese famine (even though it was the biggest famine in the world in this century)."

Puzzle: If democracy in India is a defence mechanism against major disasters like famines, why is it unable to protect against the steady killing caused by hunger and deprivation? Why is the press, the opposition, all of us, unmoved by the battles against the shadow of death that hundreds of millions of our fellow Indians must wage daily? If imminent famine and starvation are deservedly embarrassments for Indian governments, why is constant, widespread hunger not? Who in India is attempting answers to these questions?

Because of India's wobbly commitment to getting rid of undernourishment, to health care, to education, and most of all because these issues have caused so little public outrage, a numbing majority of Indians lives stunted, struggling lives. Sen explains that in normal times that are unblemished by famines, "the life of the average Chinese has tended to be much more secure than that of the average Indian."

That particular vision of security -- how secure average lives are - is the third intriguing point Sen makes. From the thrust of his ideas, it should already be clear: he was appalled by India's nuclear tests last May. Despite grandiose hosannas to security, nuclear-bomb style, that we heard from our leaders and their numberless cheerleaders, Sen knew the truth and spoke his mind: the bombs had little to do with making ordinary Indian lives more secure. They instead perpetuate the daily insecurity that so many Indians know.

"I think this was a serious mistake which was both ethically and politically wrong," he told Outlook magazine (August 31). "[T]he massive misdirection of resources away from economic needs and social priorities in the direction of the military costs India a lot even in the absence of nuclear programmes. The escalation of the nuclear confrontation may make eradication of deprivation and poverty that much more difficult. This is a major loss."

There will be arguments with that, rationalisations of our bomb adventure. "The bread vs bombs argument is flawed," a commodore announced expansively at a meeting I attended; others contend that "our front door must be locked" before we address such piffling side issues as poverty and illiteracy.

They are the main issues, Sen might say. For my part, I'll try to put all this in perspective by telling you about iron and folic acid (IFA) tablets. Pregnant women, like a French teacher I know, take these to avoid anaemia: they are available freely in Bombay. In more rural areas, the central government has a plan to supply them to pregnant women: 100 to normal women, 200 to anaemic ones. For two years now, the Centre has been unable to supply them to the states. This year, they have asked states to procure them and claim reimbursement, which some have done.

Not Orissa, though. Three paragraphs from a letter a doctor there wrote to me explain what is happening.

"Orissa is unable to [procure the tablets]: firstly they have few resources; secondly GOI [Government of India] already owes the state about Rs 1.7 million for health supplies bought a few years ago which GOI promised to reimburse and has not yet done. State Treasury is thus unwilling to advance [the Health & Family Welfare] Department any more funds for spending.

"[The] Department of H&FW approached UNICEF for assistance, which [it was] willing to extend. However, Secretary, H&FW in Delhi has refused to allow state Government to take UNICEF assistance -- they say the state has to find its own resources. A case of dog in the manger attitude -- GOI will not supply [the tablets], will not allow state to procure from donor.

"The bottom line is that women in Orissa (and MP, UP, etc.) continue to die of anaemia. ... Meanwhile, our district hospitals are full of anaemic women in heart failure giving birth to low birth-weight babies. The women die of anaemia if they cannot get blood at this late stage -- and as their husbands [and] relatives are anaemic too, the [district medical officer] is at his wits' end trying to find blood donors in an anaemic community."

"All this," the doctor writes, "makes me mad."

In a time when I am sure Amartya Sen is being flooded with congratulatory messages from various Indian government poobahs, there's this news that represents the very indifference towards deprivation he so mourns. Like other news before, it too will fade into obscurity without a whiff of public clamour. We are a nation that applauds the obscenity of nuclear bombs, but can find no outrage when women die for the lack of cheap tablets.

It makes me mad too. I imagine it must be devastating to the few Haqs and Sens we have among us.

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Dilip D'Souza