Afghanistan´s child mortality rate is second from the bottom, only Sierra Leone´s is worse. A Nepali woman is more likely to die at childbirth than a woman in Niger. The percentage of Bangladeshi children who are underweight because they don´t have enough to eat is the highest in the world-much worse than, say, Somalia. Even Sri Lanka, a country that was regarded as a model of development, is slipping.
Measured by the standard parameters for gauging human quality of life, southern Asia is right down there with the impoverished, dirt poor and war-ravaged African states. Shocking and shameful as these statistics may be, South Asia´s misery stands out even more starkly because neighbouring East Asian countries are doing so well. Countries like Thailand, Malaysia and South Korea, which till 40 years ago were at the same level of development as some South Asian countries, now have education and health statistics at par with industrialised countries.
Asia, in fact, is no longer one continent. The gap in income and quality of life between Southeast Asian countries and South Asia today resembles the gap between Africa and Europe. And measured in terms of the sheer scale of the misery, South Asia´s poor outnumber Africa´s nearly three to one.
More that half of the world´s poorest, 600 million of them, live in South Asia, and half of those, mostly children, do not have enough to eat. One in every three new-bom babies in South Asia is underweight because mothers are undernourished and anemic. There are fewer women per 100 men in South Asia than anywhere else in the world. Reason: preference for male offspring. One in every three South Asians cannot read or write. There are 150 million children here who do not go to school.
To be sure, there are bright spots. Bangladesh´s dramatic reduction in fertility rate over the past decade is regarded as a Third World success story. Literacy rates, even in laggards like Nepal, have gone up. Vaccination and public health awareness campaigns have brought down child mortality to two-digit figures. However anarchic, South Asia´s new-found democracy has brought political pluralism.
But these success stories have to be replicated across all sectors and in a regionwide scope, before they can even keep up with the gathering crisis of meeting the needs of the swelling numbers of South Asia´s poor. A glance at the budgetary allocations for social welfare provides a grim reminder that the region´s planners still have not translated into action the numerous speeches from United Nations pulpits on “investing in human capital”.
Pakistan, for instance, is still spending more than twice as much for its military than what it spends on health and education combined. The 20 MiG -29 fighter bombers India recently ordered from Russia would have paid for primary education for 15 million girls who are out of school in India. Sri Lanka´s massive military expenditures in recent years have hemorrhaged social spending. The once largely ceremonial Sri Lankan army used to take up only one tenth of the amount that was spent on health and education. Today, Sri Lanka´s whopping military budget ($350 million in 1992 reported) eats up nearly double the country´s allocation for those two sectors.
“Education and health status have definitely suffered in Sri Lanka because of the resources being drained by the war,” says a senior economist at the Manila-based Asia Development Bank.
The ADB is lending to Pakistan in what it believes is the key to breaking the country´s poverty cycle: enhancing the status of women with a literacy and basic health campaign. However, the results are not encouraging. A recent poverty assessment report by the World Bank ranked Pakistan at the bottom of a list of countries lagging in primary education, especially for women. Even by South Asian standards, Pakistan ranks low. The country´s under-five mortality rate (the number of children out of 1000 live births who die before their fifth birthday) is at 137, even higher than Nepal´s 128.
Economists at the World Bank and ADB may be gloomy about South Asia in general, but mention Nepal, and they shake their heads in despair. Confided one senior ADB economist who had visited Nepal recently: “In India and Pakistan, the problem is vast but there is a definite commitment and trend towards allocation of budget to social sectors. In Nepal´s official circles there really is no appreciation of the needs of the poor. They are ready to borrow for big power projects but refuse to borrow for primary health care and education.”
“The figures look very bad, Nepal really must get its act together quickly,” says the expert. In 1990, Nepal had only one hospital bed for 4000 people. Only Afghanistan, where hospitals have been bombed and rocketed since 1980, has figures as bad as that. Nepal has only one physician for every 20,000, which is by far the lowest ratio in all of Asia.
The country that shows the most promise in spreading basic services is Bangladesh. Its achievements in reducing fertility rate, in lowering infant mortality through massive immunisation campaigns, and a strong gov-ernment-NGO collaboration for improving literacy, has brought dramatic results. Bangladesh´s contraceptive prevalence rate has shot up from 8 percent in 1975 to 31 percent in 1990, whereas in Nepal it has remained more or less at 15 percent for the past 20 years. Bangladesh´s annual population growth rate is expected to plummet from 2.4 percent in the 1960-1992 period to 2.2 for 1992-2000. (Nepal´s rate will actually go up from 2.4 to 2.6 in 1992-2000, portending a serious drain on the country´s resources.)
In the end, it is ´basketcase´ Bangladesh that might show the way ahead for all of South Asia.