Children’s Health: Future in Jeopardy

Introduction

The Constitution of India[1] defines ‘life’ as more than just the act of breathing. It does not imply a merely animal existence or a life of misery[2]. It encompasses a far broader range of rights, such as the right to live with dignity, the right to a livelihood, the right to health, the right to clean air, and so on.”

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”[3] In the Universal Declaration of Human Rights mentioned, “health as a part of the right to an adequate standard of living.”[4]

The right to life is vital to our basic existence; without it, we would not be able to survive as humans. It encompasses all elements of life that make a person’s life significant, full, and worthwhile. It is the only provision of the Constitution[5] that has been given the fullest interpretation feasible. Therefore, the core idea of the right to life, is the essentials, minimal and basic standards for a person.

Fundamental rights have been provided to citizens[6], which are essential in the development of an individual’s personality. Only by exercising such rights freely, we can live with dignity. Since there is a strong link between health and a person’s quality of life, the government has a duty to safeguard the health of the public.

The Healthcare system would be the most vital of all the rights to which we are entitled. Because of the importance of our human lives, we must safeguard this right as a public good. Universal health care is essential for the most marginalised members of any community to live with dignity.

Right to Health in India

When we talk about health rights it is not just limited to the health of an individual and accessible to health care institutions, health rights are inclusive of many rights and facilities some of which are as follows:

• Safe drinking water and adequate sanitation.
• Safe food;
• Functioning public health and health-care facilities, goods and services must be available in sufficient quantity within a State;
• Equal and timely access to basic health services;
• Adequate nutrition and housing;
• Healthy working and environmental conditions;
• Health-related education and information;
• Gender equality; etc.

In summary, when we talk about well-being, we frequently refer to health. Several variables impact good health that is outside the direct control of governments. States must, however, make all efforts feasible, within their means, to achieve the right to health and take immediate measures in that regard.

In India, we do not really enjoy the right to health. It is enshrined in Directive Principles of State Policy.[7] We do not really have a health care system, only a health insurance system.[8] Indian Constitution has not recognised the right to health under specific provisions but from time to time the ambit of Article 21 has been broadened by the Supreme Court. It has been held that the “right to live with human dignity also includes the protection of health.”[9] Cannot neglect the past situation in a covid pandemic when people died due to a lack of a properly functional health care system.

Despite numerous health plans and initiatives, the health of the population is deteriorating at an alarming rate. No one can deny the fact they have seen many times children on road or in metro cities begging for money or food. Have you ever wondered and thought about it that what were the necessities that forced them to do these? Despite the fact that the government has made a number of significant actions[10] to address children’s health issues, their impact has been inadequate.

Those rights which are given to them, are only related to safeguarding them but what about those rights which will provide them a better life? What about those children who do not have parents or anyone who can take care of them will they still be willing to go to school, get an education and have no place like home or nothing to eat? Is not it kind of providing them with a situation that forces them to work?

Therefore, child rights that have been provided by the Indian Constitution have become of no value in eyes of homeless children. We have recognised child labor laws and prohibit child labour below 14 years, but have we ever taken the pain of going into the root cause. “The world’s largest population of street children, estimated at nearly 18 million, lives in India.”[11]

Status of the Children in the Country

Nearly 30 million orphaned and abandoned children live in India[12] and it is continually growing. Only 75,824 have benefitted under Child Protection Scheme during 2019-20.[13]

There is no official data available for the death of a person owing to hunger.[14] Thinking about the children’s data owing to starvation and malnutrition death is a far cry.

Talking about the ground realities, while working under the NCPCR, the authors personally encountered a situation where a specific number of children were rescued from a hazardous workplace and after the commencement of the compensation process, they were handed over to their parents.

What was more shocking was that after some months it was found out that these same parents sent their children again in labour field. So, we cannot conclude that by passing a scheme, we have made progress in protecting children when at the time of drafting legislation, consideration of these ground realities is often seeming to be overlooked by lawmakers.

While focusing on increasing the number of Child Care Institutions (hereinafter will be referred to CCIs), progress in their facilities have been neglected. They are already not in adequate numbers to handle the child who are in dire need and protection.

The National Institute of Public Cooperation and Child Development in its report stated that there are 440 million children living in India, while 172 million of them are in need of care and protection and what is the most saddening part is that CCIs do not have the capacity to accommodate all these children for that reason only 4 lakh children are getting care and protection.[15] More than 9000 CCIs are functional in the country and funded under Child Protection Scheme but only 7889 child shelters are registered, surveys and reports reveal.

According to the report titled, ‘Mapping and Review Exercise of Child Care Institutions,’ “only 46.7 percent of CCIs had an adequate number of caregivers per child.”[16] Many of them are not working properly due to a lack of adequate facilities and inadequate supervision & regulation. Henceforth, relying on CCIs to take care of children is not less than tying a blindfold on the future of this child.

Some serious measures should be implemented by the government in regard to CCIs. Firstly, the focus should not be on increasing the numbers, instead, the focus should be on working properly and efficiently of existing CCIs. After that, considering the future of these children, adequate facilities and measures should be provided to them.

In a country where the right to live with dignity is a part of a fundamental right, people should not be dying due to a lack of healthcare. The right to life includes the right to health, although it is limited.

Way Forward & Conclusion

Adoption of the Right to Health for Children under special provisions will be critical in ensuring that all children receive proper health care. Although the right to health is a facet of human rights that extends for everybody, children are the most neglected population, having been denied access to adequate health care.

Furthermore, children are completely reliant on adults for all their needs. They have extraordinarily little discretion over health issues, proper nutrition, hygiene, and their surroundings. When there is no parental care, the state must become responsible for fulfilling the child’s healthcare needs. The Supreme Court has held that employees’ health is a fundamental right.[17] However, children’s health has garnered little emphasis.

Thousands of children are still dying due to the lack of healthcare. In the recent time in pandemic, panicked calls for oxygen, hospital wards, and medications, and even facing trouble in finding a place to bury their loved ones exposed our inability to provide dignity in both life and death. Healthcare has become a privilege afforded by a few due to decades of underdevelopment in public health.

Not only have children been denied their health rights, but the existence of child labour has exacerbated the problem of their healthcare system. India’s overall number of child and adolescent labourers is thirty-three million. And after the covid it is likely to see a sharp rise in the labourers’ statistics.

The implementation of numerous government initiatives and the programme has been proved to be inadequate. Macroeconomic frameworks have failed, as healthcare provision, and there is a lack of accountability and supervision.

Investing should be done in evidence-based policies that promote healthy development for all children, which is at the core of children’s rights, and to help every kid reach their highest potential. The true conundrum is how health is treated as a commodity.

A constitutional amendment, similarly, to the Education Right, should be proposed for the Right to Health. Health rights need to acknowledge as a positive fundamental right that cannot be dependent on the financial ability of the state. If health is recognised as a fundamental right under a special provision, the whole health ecosystem will be strengthened, physicians and healthcare workers will be empowered, and responsiveness, fairness, and accountability will be ensured and in the end the future of the country will be secured.

The Rajya Sabha had a discussion over The Right to Health Bill, 2021 moved by a private member. Right to Health as Fundamental Right is what this bill seeks to establish. If this bill gets passed and becomes an act, many obstacles in achieving national health will be appropriately addressed and will further aid in improving the situation of medical poverty status in India.

Thus, attention will shift to these homeless children as well and they too are covered under this act per se. However, the fact that only 14 private member bills have become legislation since the first Lok Sabha in 1952, and none in nearly five decades, implies that all these aspirations will remain a dream again.

End notes

[1] Article 21, Constitution of India 1950

[2] Francis Coralie Mullin v The Administrator, Union Territory of Delhi AIR [1981] 786

[3] Constitution of World Health Organisation, 1948

[4] Article 25, Universal Declaration of Human Rights 1948

[5] Article 21, Constitution of India 1950

[6] Part III, Constitution of India 1950

[7] Article 38, 39(e), 41, 42, 47, 48(a), Constitution of India 1950

[8] Team Acko, ‘17 Types of Government Health Insurance Schemes in India’ (Acko, 20 May 2022) <https://www.acko.com/government-health-insurance-schemes-in-india/>

[9] Bandhua Mukti Morcha v. Union of India AIR [1984] SC 802

[10] Rashmi Shetty, ‘Child Protection Laws in India’ (ActionAid India, 22 January 2021) <https://www.actionaidindia.org/blog/child-protection-laws-in-india/>

[11] Abhinav Singh & Bharathi Purohit, ‘Street Children as a Public Health Fiasco’ (2011) 23 Peace Review 102,109.

[12] Vrinda Shukla, ‘Ties that bind: Why India must expand foster care’ (Indian-Express, 8 June 2021) <https://indianexpress.com/article/opinion/columns/india-foster-care-children-death-covid-second-wave-7348473/>

[13] Ministry of Women and Child Development, ‘Welfare Schemes for Orphan Children’ (PIB Delhi, 7 Feb 2020)

[14] Krishnadas Rajgopal, ‘No State has reported starvation deaths, Centre tells Supreme Court’ (The Hindu, 12 May 2022) <https://www.thehindu.com/news/national/no-state-has-reported-starvation-deaths-centre-tells-sc/article65009990.ece>

[15] 101 Reporters, ‘Number of Children Living in Shelter Homes in India’ (Make a Difference, 2017)

[16] ‘Over 1000% increase in registered child care institutions in India since 2015’ (Business Standard, 16 June 2019) <https://www.business-standard.com/article/news-ians/over-1000-increase-in-registered-child-care-institutions-in-india-since-2015-119061600221_1.html>

[17] Consumer Education and Research Centre and Ors. v. Union of India and Ors. AIR [1995] SC 922

The article has been contributed by Sumit Kumar and Avismrita Shyamali Mishra, students at National Law University Odisha.