“The tyranny of a prince in an oligarchy is not so dangerous to the public welfare as the apathy of a citizen in a democracy.”
– Charles-Louis Montesquieu (The Spirit of the Laws, 1748).
It is almost two months since the Gorakhpur tragedy in which over 60 children died in a hospital allegedly due to lack of oxygen supply. But the tragedy has already receded in public memory and media discussions. So much so, when it emerged on September 4 that 49 children died in another Uttar Pradesh (UP) hospital in Farrukhabad, allegedly again due to lack of oxygen, it did not evoke any response.
This is unexceptional, not because India is a large nation with complex and recurring problems (as the Elphinstone Road Station stampede deaths demonstrate), but because this is the weightage and seriousness that is attributed to tragedies such as that of Gorakhpur.
Unsurprisingly, India, after seventy years of freedom, is ranked 131 (out of 188 countries) in the Human Development Index. It shows the catastrophic failures in ensuring basic health, education and sustenance for all.
Let us go back to examine the response to Gorakhpur from the state, the media and the citizenry at large to understand how it is emblematic of the nation’s attitude to tragedies. As the story broke on August 11, television anchors and panellists stated that while the tragedy is sensitive, “we are debating about an issue that is also equally sensitive, i.e. [the singing of] Vande Mataram…” and which is also the “real issue”! On another television channel, Vande Mataram was similarly the prominent story.
The president of the ruling party, Amit Shah, had said: “In a big country like India, there have been many such incidents in the past. This is not the first time.” This was followed by various obfuscations and deflections on the part of the UP Government to deny any responsibility for the tragedy. It denied that lack of oxygen supply was the cause of the tragedy.
But the most shocking of the responses, ironically, was the lack of a response from the prime minister for three whole days. Here, it is worth asking – when was the last time an Indian prime minister remained completely silent in the face of deaths of young children including newborns? This silence becomes even more glaring when one considers that the present prime minister responds via social media to every tragic event in the world almost instantaneously, from forest fires in Portugal to the crashing of a military plane in Myanmar.
The Gorakhpur tragedy, instead of being forgotten, should be a critical landmark in the history of India as a nation. Not because such tragedies stemming from negligence have not happened before. But because the response to it plumbed new depths of banal apathy. Further, it takes to extreme levels the politicization in partisan ways of human lives, especially of children.
But our normally apathetic public sphere is also Janus-faced. It can be roused into action on certain issues and not others. Gorakhpur is the result of India’s pathological focus on emotive and symbolic issues, especially of a religious or nationalist kind, at the expense of basic material well-being. Thus religion/nationalism becomes a panacea for all social problems.
The worst manifestation of this was reached in the last three years of a right-wing government. Look at the topics that have convulsed the nation in this period: lynchings for suspected eating of/possessing beef, shutting of abattoirs, sedition cases for ‘anti-national’ sloganeering, Gau Rakshaks, ‘Love Jihad,’ ‘anti-Romeo’ squads, national anthem in film theatres, singing Vande Mataram, ban on Pakistani actors, national flags and army tanks on university campuses, the killing of rationalists who have taken on religious fundamentalism and so on.
The outpouring of religious/nationalist symbolism at the cost of living and sustenance is clearly visible in the re-naming spree of cities, streets and stations. Thus, Elphinstone Road Station, where the stampede took place (despite repeated submissions by commuters about its dangerous condition) was re-named recently after goddess Prabhadevi, and another station in Oshiwara, Mumbai, was named as Ram Mandir. The re-named Chhatrapati Shivaji station and airport in Mumbai, were further re-christened with the addition of Maharaj to the name! This has not prevented the devastation caused by floods either in Mumbai or Gurgaon (now known as Gurugram), both supposedly modern cities, but with actually crumbling urban infrastructure.
The violence following the conviction of Gurmeet Ram Rahim will be seen as another instance of religion overrunning the public sphere. But what is missed in the mocking of his supporters is the question as to why oppressed castes like Dalits find alternative religious practices attractive. Here, it is not just the promise of the ending of caste discrimination or religious succour, but also the provision of material goods like healthcare. This demonstrates in no uncertain terms how religious groups fill the governance void left by the state.
But the religious imagination that is constructed here is not emancipatory or liberatory, but crude and instrumental.
As Marx had recognized long ago, the “‘religious sentiment’” is itself a social product. But it is one thing for godmen to exploit vulnerable populations, it is another for a government to propagate religious nationalism as its fundamental agenda. This is when public health—improving health through education and prevention of diseases— and disease care should be the fulcrum of government policy and national conversations.
After all, India, the seventh largest economy in the world has a shocking public expenditure of 1.4% of GDP on healthcare and a majority of the healthcare needs are met by the largely-exploitative private medical sector. India’s public expenditure is less than the South Asia average of 1.6%, which itself is the lowest in the world. To put it in perspective, Indian government spends less than war-torn Afghanistan and Iraq.
The Gorakhpurs, thus, do not happen in a vacuum. In the early 2000s, only 4.4% of the UP population had access to a primary health centre. This year, UP became the worst state in India for infant and under-five mortality. Is it surprising, then, that the same Gorakhpur hospital saw 1250 child deaths this year (till August) alone, or the hospital in Farrukhabad had one doctor employed?
It is ironic that a government whose slogan is “India is transforming” and “India is moving ahead,” and which has unveiled a New Health Policy supposedly seeking to take health seriously (and declaring to increase public spending to 2.5% of GDP) took to the apathetic argument that killer diseases have always existed and that sanitation is poor in response to Gorakhpur. The worst example of this normalization of diseases and human negligence is that when Prime Minister Modi finally responded to Gorakhpur, he called it a “natural calamity.”
If Gorakhpur is abandoned to the tyranny of the news cycle, the result will be more catastrophic. The lack of public outrage meant that there were no resignations at the ministerial level and instead there was scapegoating of minor functionaries. Without follow-up and continued attention, contradictions like the arrest of the oxygen supplier a few days ago when the UP government denied that lack of oxygen supply was the cause of the tragedy will go unexamined.
If the Gorakhpurs are quickly forgotten, they will keep recurring as long as civil society and state focuses on a politics that closes their eyes to the fundamental material deprivations of, what is still, a ‘Third World’ nation. Robust public health will not result through a government or nation pursuing symbolic religious nationalism. There has to be a systemic reordering of priorities to focus on secular goods.
Public health will also not be built through mere government benevolence and policy announcements. It can only be through democratic struggles which overcome apathy and which build institutions. More importantly, these institutions have to be forced to be accountable through sustained public pressure. It can only happen when prime-time television gives as much prominence to ‘real’ issues like universal healthcare or making health a fundamental right as much as it does to singing Vande Mataram.
Gorakhpur should be a constant and grim reminder of the fact that a nation which is focused on providing ambulances for cows will have to sacrifice children at some point.
Nissim Mannathukkaren is Chair, Department of International Development Studies, Dalhousie University, Canada.