Mandipanka, Kandhamal district (Odisha): Back home after a week in the intensive care unit of a government hospital, Sushma Patmajhi, 28, looked pallid, exhausted from her brush with death, the hospital stay and the 145-km bus ride home from the hospital in Berhampur.  

Around 11 am on 28 October 2024, here in the village of Mandipanka in  central Odisha, once the the men of the household had left to graze the cattle after a sparse meal of  torani (leftover rice water)—and after the children had been dispatched to the anganwadi centre where they would be served a meal—the women in Patmajhi’s family cooked a gruel of crushed mango kernel.

Two days later, two young women of the family, residents of Mandipanka’s tribal Christian Sahi or Christian colony, died after repeated bouts of vomiting and abdominal pain. A third woman from the same family died during treatment in Cuttack, 312 km east of Mandipanka. 

It was Runu Majhi, 26, who cooked the gruel. The stone-ground mango kernel  developed a fungus—one of its known risks—while in storage at home, so the young woman had fried it in a wok before making a gruel. 

“Runu called all the women of the family and we ate sitting on that porch,” said Sushma Patmajhi weakly, pointing to the house’s verandah made of mud with an asbestos sheet for a roof where three women of the household had eaten what would be their last meal. 

“It tasted sour,” she said, “but we were hungry, so we ate it.”

Asked why they ate it despite knowing the kernel of the fruit had developed fungus, she said, “Ghare aau kichi khaibaku nathila.” 

There was nothing else to eat at home.  

In Odisha’s large tribal belt, mango kernel is a common addition to meals, particularly in southern and western Odisha, in districts such as Koraput, Rayagada, Kandhamal, Balangir, Kalahandi and Boudh. The kernel of the wild growing mango is especially eaten during periods of food stress. 

In Kashipur in Rayagada district, for example, tribals have eaten the mango kernel since the 1990s, breaking it into pieces and placing these in a bamboo basket that is then left in a stream’s running water for a week and then sun-dried. The kernel pieces are then ground and cooked into a gruel, to be eaten with rice or ragi (finger millet) if available. 

Stored improperly, mango kernels develop fungus that may cause food poisoning if consumed. 

The recent deaths in far-flung Mandipanka village put the spotlight once again on gaps in the supply of public distribution system (PDS) rice and persistent food insecurity (see here, here and here) in Odisha’s tribal districts. 

Hunger and near-starvation have continued to be reported from the eastern state despite a government claim of a 48% decline in multi-dimensional poverty in Odisha between 2015-16 and 2019-21. 

The Odisha government provides subsidised rice at Re 1 per kg instead of the market rate of Rs 40-Rs 50 per kg. Remote villages in hilly or forested districts, however, have been receiving their quota of food grains for two or three months together, causing wide gaps in the supply. 

According to the National Family Health Survey (2019-2021) conducted by the ministry of health and family welfare, 65.6% of rural children in Odisha up to the age of 5 years were anaemic; 65.2% of non-pregnant women and 62% of pregnant women up to the age of 49 years were anaemic too. 

With some of the country’s worst poverty, the situation in Adivasi Odisha reflects India’s “serious” level of hunger, ranking 105 of 127 countries in the 2024 Global Hunger Index, improving only marginally over 2016. 

India’s neighbours, including Sri Lanka, Bangladesh and Nepal do better, with hunger in those countries ranked “moderate”. The union government in 2023 disputed the index, calling it “an erroneous measure of hunger” and stating that it “suffers from serious methodological issues” and “shows malafide intent”. 

Prafulla Samantaray, convenor of the civil society group Lokshakti Abhijan,  said it was “alarming” that tribal communities, some of Odisha’s most marginalised people, continued to rely on mango kernels in their regular diet. 

“It is a  distress coping mechanism, despite the known health risks,” he said. 

The practice reflected the prevalent widespread “semi-starvation conditions, chronic hunger and food insecurity” in rural pockets of Odisha, he said. Local communities have limited access to nutritious foods, with their farms providing no more than subsistence agriculture. 

2 Days To Visit A Doctor 

On 28 October, two hours after consuming the mango kernel gruel, Runu Majhi and Ramita Patmajhi complained of stomach pain, diarrhoea and vomiting. A few hours later, the other women developed the same symptoms. 

“It didn’t stop for the entire day,” said Sushma Patmajhi. 

When their condition started to deteriorate, on 30 October, the menfolk  called an ambulance and took Runu Majhi to the nearby primary health centre (PHC) at Brahmanigaon, 9 km from their village. The doctor at Brahmanigaon referred her to MKCG medical college and hospital at Berhampur. 

As the other women had symptoms too, all of them were taken to MKCG hospital in a hired vehicle. 

Asked why the family waited two days before seeking medical help, Sushma Patmajhi  said, “We are poor and we need money in hand to go to hospital.”

The family took a loan of Rs 17,000 from local moneylenders to meet the medical expenses and the cost of transporting the bodies back home. 

Runu Majhi died en route to the hospital in Berhampur. Ramita Patmajhi died later the same day, during treatment. 

The doctors referred Jita Majhi and Tuni Majhi to the Srirama Chandra Bhanja (SCB) hospital and medical college in Cuttack, 250 km away, when their condition started to deteriorate. They remained in  critical condition for two weeks. 

On 18 November, Jita Majhi died while undergoing hemodialysis with ventilator support. Drengalo Patmajhi continues to be under treatment at MKCG hospital, while the remaining three women who ate the gruel, Sushma Patmajhi, Prabhati Patmajhi and Jibanti Majhi, returned home. 

By the end of November, Tuni Majhi was also discharged from SCB Hospital.  

Cyclical Food Insecurity  

Food security for Kandhamal’s rural households is limited to four-six months of the year. 

Surrounded by hills and lush forests, Mandipanka has nearly 300 households, belonging to the Adivasi Kondh and Dalit communities. Located 40 km from Daringbadi, the nearest tehsil town, Mandipanka’s people all belong to below-poverty-line (BPL) families, a government classification of families with an annual income below Rs 1 lakh.  

Though they depend heavily on the government’s public distribution system, the supply of food grains is irregular, with people often receiving their entitlements only once in three months instead of on a monthly basis. This is more evident in the remote hinterland and other hard-to-reach areas where tribals and other most vulnerable and poor communities reside. 

The National Food Security Act (NFSA) 2013 is central to poverty alleviation measures in Odisha. 

At the end of 2023, the government of India said it would extend its free foodgrain programme for five years, benefiting 813.5 million people or two thirds of all Indians, at a cost of Rs 11.8 trillion (over $141 billion). Days later, then chief minister Naveen Patnaik followed suit, extending by five years the state’s food security programme that covers those left out under the NFSA.     

“One person receives 5 kg rice per month through PDS. If they eat rice three times a day, it lasts for 10-15 days in a month,” said Rasenta Patmajhi, Sushma’s husband. As the rice stock depletes mid-month, families mix rice with ground mango kernel or ragi, locally known as mandia. 

The Patmajhi family last received the rice they are entitled to under the NFSA in the month of July, meant to be for the next three months. “We did not receive rice in October,” Rasenta Patmajhi said. 

The village received their entitled quota of rice under the PDS regularly during 2020, 2021 and 2022. In 2023, the supply slowed to once every two months, and in 2024 the gap in supply widened to three months.

Three days before the ill-fated meal too, the Patmajhis had consumed mango kernel gruel, he said.  

Exclusion From Ration Cards

Many households in Mandipanka also said not all family members’ names were included in their ration cards, creating an additional aspect of food insecurity. 

Anil Patmajhi, 26, who lost his wife Ramita to the mango kernel gruel, said he was worried for the future of his two children. Still to recover from the shock of losing his wife due to the lack of food at home, Anil Patmajhi told Article 14 he got married in 2018, and had since been trying to get her name included in the family’s ration card. 

“I went to the block office many times to request officers,” he said. Three times, he was asked to return later. Unable to incur the loss of a day’s wages on account of a trip to the block office, he stopped trying.  

Anil Patmajhi lives in a family of seven members including his father Kupisa, mother Drengalo, a sister and their two young children—a three-year old son and six-month-old infant daughter. Only four family members are listed on their PDS card. 

The paddy from his farm sustains the family for less than six months, he said, so there are long stretches of food scarcity at home. “If there had been sufficient rice at home she would not have eaten the mango kernel,” he said. 

In Sushma and Rasenta Patmajhi’s home too, the children have not yet been included in the ration card and therefore do not have any food grain entitlements under the PDS. 

To minimise the need for food at home, the couple enrolled their 11-year-old daughter in a nearby ashram school (a residential school for children of tribal families) so that she could have nutritious meals twice every day. 

Their eight-year-old son lives with them in Mandipanka, but his major source of nutrition is the mid-day meal served in school. More than 110 million children in 1.1 million schools across India benefit from the hot cooked mid-day meal served under a programme initiated in 1995 to provide nutritional support to primary school students, a union government programme that was recast as the PM-Poshan scheme in 2021.  

“When we bring the ration foodgrain home, in the first few days we eat a full plate of rice,” said Sushma Patmajhi. “As days progress, the quantity of rice reduces, and then there are days when we sleep with little or no food at all.”

Kernels & Seeds For Dietary Diversity

The daily dietary diversity of villagers, particularly belonging to indigenous communities, in  remote villages in Kandhamal is poor, locals acknowledged. Carbohydrates form the major food, while proteins and fats are minimal or non-existent. 

The district reports high rates of anemia among women and child malnourishment. According to data from the NFHS-5, at least 34.2%  of children under the age of 5 years in the district were stunted, while 23.2%  in the same age group are acutely malnourished. At least 48.9% of women in Kandhamal between the age group of 15-49 years suffer from anemia. 

Rasenta Patmajhi said in addition to their daily intake of mandia pej (ragi gruel), rice, salt and green chilies, they consume green spinach, amaranthus, yam, all seasonally gathered from hills and forests, along with beans and papaya grown in their backyard. 

However, the months of September, October and November are always lean months when food stress and hunger are common as food gathering and foraging do not yield adequate results.

In order to cope with food stress during the summer months of April and May and the September-November period, families preserve mango kernels, jackfruit seeds and bamboo shoots, sometimes for periods of time stretching up to a year or more. 

Most of the Mandipanka’s families have little or no liquid savings, and little by way of assets. They depend on agriculture, but own less than 2 acres of land each. Some villagers own livestock and poultry, but not the Patmajhis.  

Anil Patmajhi owns less than 2 acres of land, from which he manages to harvest just about enough paddy to serve the family’s needs for six months of the year. To meet their financial needs, he works as a daily wage labourer, earning Rs 200 a day when work is available. During the harsh summers and in other extreme weather conditions, work as an unskilled labourer is almost impossible to find nearby. 

The Mango Kernel Debate 

Odisha is not new to deaths on account of consuming mango kernel gruel. In the 1990s, during J B Patnaik’s rule as chief minister, there were multiple incidents of tribals dying in remote pockets after consuming mango kernel gruel. 

In 2001, during the term of the Biju Janata Dal-Bharatiya Janata Party coalition government led by former chief minister Naveen Patnaik, 24 tribals in Kashipur block of Rayagada district died after eating mango kernel gruel. In 1996, in Kandhamal, one person died in Butendi village under Saramuli gram panchayat, 20 km from Mandipanka. 

Asked why villagers continue to consume the item despite its known connection with fatal incidents, villagers said simply that when the supply of PDS rice is irregular and without any income-earning avenues, there was simply no choice but to eat what was available.

Bidyut Mohanty, an activist and a convener of the Right to Food Campaign in Odisha, said the continuing discussions in some circles regarding the  nutritional value of mango kernel gruel diverts from the real issue at hand. 

“The villagers were supposed to get PDS rice in October, but they did not, which forced them to eat mango kernel gruel,” Mohanty said. “Impoverished tribals in remote pockets eat mango kernel gruel to beat hunger, it is a coping mechanism for them.”

Experts said consumption of mango kernel gruel and similar items was an indicator of extreme food distress and chronic hunger.  

Mango kernels are stored in the households of families belonging to marginalised communities  to be consumed during food stress periods. However, often, these mango kernels are not treated properly before consumption, leading to adverse health outcomes. 

Nilakantha Mishra, Odisha’s director of public health, said the two patients  admitted to SCB were diagnosed with pulmonary hepatic failure, or lung failure on account of liver disease, which was caused by a fungal infection. 

“They were also being treated for multi-organ failure,” Mishra said. A final report on the viscera of the deceased was awaited, but the suspicion was that the three women died of fulminant hepatitis or acute liver failure. 

Migration To Kerala, Andhra Pradesh

With limited or no work opportunities available in the village, able-bodied men migrate from Mandipanka to other states—most of them to Kerala, almost 1,800 km to the south from their homes—to work in factories, mines, quarries, hotels, rubber plantations, beer bars etc. Many work as construction labourers. 

Male migrants in search of work leaving villages like Mandipanka are often still adolescents. 

At least one male member from each of Mandipanka’s 300 households has migrated to the southern Indian states in search of livelihood. Remittances from them help the left-behind members of their families to survive. 

In 2023, Anil Patmajhi went to Ernakulam in Kerala, and earned Rs 9,000 per month working at a bar. 

Anil Patmajhi said, “With that money I used to buy rice from the market at Rs 40 to Rs 45 per kg.” In 2024, he decided to stay home and look for work as a day wage labourer. 

Rasenta Patmajhi migrated every year to Andhra Pradesh and Tamil Nadu during the years 2007 through 2012, but suspended his long journey in search of work once he got married. 

In the early years, he received work under the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), 2005, India’s showcase workfare programme that guarantees 100 days of paid work every year, on demand. Most male members in the village have the job cards needed in order to demand work, but the Patmajhis and others said they had received no work over the September-November 2024 period. 

Anil Patmajhi and Rasenta Patmajhi said they last worked under MGNREGA for only three to five days, earning Rs 500 a day, during 2023-24. 

Advocate Sujata Jena, who works on labour rights issues said many villagers work as labourers but do not have labour cards issued by the state government. 

Young men who migrate to Kerala register on the portal of the state’s labour department. Their families are entitled to benefits such as accident insurance. 

In Mandipanka, however, with no internet connectivity, the men find it difficult to file and submit online forms to procure labour cards. “This prevents them from accessing social security benefits in cases of accident or death and other entitlements,” said Jena.

Villagers sometimes climb a tree located on the outskirts of the village hoping to connect to a network. 

On the day the Patmajhi women’s condition deteriorated alarmingly too, somebody climbed the tree to call an ambulance to go to the PHC, the family said.

Jena, who keeps a track record of migrants, said Daringbadi block where Mandipanka is located, has a high rate of distress migration. “Workers face difficulties and harassment in their destination places,” she said. At least 24 migrant workers from Daringbadi block died in 2024 alone, of various causes,  indicating significant risks to their lives, he said.    

Cultivation Of Pulses Prohibited 

A fact-finding team of civil society groups including the Odisha Khadya Adhikar Abhiyan (Odisha State Right to Food and Work Campaign) and the  Civil Society Forum on Human Rights visited Mandipanka village on 8 November and interacted with the victims’ families. Their findings said irregular PDS supply and lack of work and income opportunities had forced the families to consume the mango kernel gruel.

Additionally, while the villagers had received titles to plots of forest land that they traditionally occupied and cultivated (the titles were for individual forest rights granted under the Scheduled Tribes and Other Traditional Forest Dwellers (Recognition of Forest RIghts) Act, 2006, the forest department prevented them from cultivating such land on grounds that the communities follow the slash-and-burn practice of preparing the soil for sowing. 

Forest department regulations also prohibit them from cultivating pulses such as kandula (a type of pulse), black gram, beans and green gram, making it difficult for the villagers to access protein-rich food. Rasenta Patmajhi said, “This year I cultivated turmeric, and I hope to get a better income.”

The growing popularity of cultivating hybrid maize has also affected food security. 

Ravi Shankar Behera, an independent researcher and social development advisor, said hybrid maize that is primarily grown for use as chicken feed requires large quantities of water, fertiliser and pesticides. “It erodes the soil of  nutrients at a much faster rate, rendering it barren in a couple of years,” he said. 

The crop also displaces the normal cropping cycle in which certain food crops are cultivated for household consumption. “Local tribal communities have started growing hybrid maize hoping to earn more, not thinking about their own household food and nutrition security,” said Behera. 

In Mandipanka too, Taran Patmajhi, the husband of Parbati, one of the women hospitalised after consuming the mango kernel gruel, took a loan from a local money lender at an interest rate of 36% per annum in order to start maize cultivation.

The panel also said that the families had not been made beneficiaries of a bevy of government schemes that could have ameliorated their circumstances. These include the Krushak Assistance for Livelihood and Income Augmentation (KALIA) scheme launched by the government of Odisha in 2018-19; the Subhadra scheme that aims to pay 10 million women Rs 10,000 a year and the PM-AWAS scheme that provides a subsidy for housing. 

Poor infrastructure, lack of awareness and absence of internet connectivity further hindered the villagers from applying for government entitlements or updating their e-KYC information required to update their ration cards. 

Government Orders Probe 

On 27 November, Odisha food supplies and consumer welfare minister Krushna Chandra Patra dismissed the charge of starvation deaths while speaking during the winter session of the Odisha legislative assembly. “Semananka ghare jathesta chaula thila…” he said.  (The families had adequate food supplies at the time.” He said officials who visited the victim’s homes found that they had sufficient rations. 

Patra said some beneficiaries lacked e-KYC for their ration cards, but everyone requiring rations had been duly provided the supplies.

Financial support was extended to the bereaved families, he said. Patra also  described ongoing efforts to streamline the distribution process of PDS foodgrain. He said ration centres were to be opened in remote regions. 

Senior journalist and human rights activist Deba Ranjan said during a recent  visit to Mandipanka and the neighbouring village of Dama, he did find villagers still storing mango kernel to eat during periods of food stress. 

Ranjan said the collection of NTFP (non-timber forest produce) in the region had been affected due to the closure of some cooperative bodies. “In Mandipanka, villagers used to collect Siali leaves (a creeper that grows on Sal or teak trees, whose leaves Adivasis use to make plates) and sell these at reasonable prices through regional cooperatives,” he said. 

The closure of the cooperatives has meant villagers no longer receive fair prices for Siali leaves and other forest produce. 

In response to the Mandipanka tragedy, Odisha chief minister Mohan Charan Majhi reviewed the public distribution system and directed the food supply and consumer welfare department to provide three months’ supply of rice in advance to all beneficiaries. In Mandipanka itself, families received their quota of PDS rice on 2 November, two days after the two women died.

Officials said the Odisha government’s food supplies and consumer welfare department had delayed the supply for about a month owing to indecision over the supply of wheat along with rice and due to updation/integration of point of sales (PoS) machines with digital weighing machines. 

The state government has also ordered a probe into the incident. The Kandhamal district collector visited the village; the administration provided financial assistance of Rs 30,000 each to the families and an additional Rs 10,000 each for those under treatment. 

The Odisha Human Rights Commission (OHRC) issued notices to the secretaries of the food supply & consumer welfare department and the health & family welfare department, as well as to the Kandhamal collector, asking them to submit reports by 20 December. 

The commission, headed by Justice Shatrugna Pujhari, instructed the BJP government to address hunger issues and provide immediate medical attention and nutritious food to the affected tribal families. 

As administration officials, political representatives and media persons continued to make the rounds of Mandipanka, the once-unknown village has been busy. 

For Anil Patmajhi, these developments could not dull the shock and grief. As a single parent, he would have to care for his two children.

“Had there just been a little food at home,” he said, “I would not have lost my wife.”

(Rakhi Ghosh is an independent journalist based in Odisha. She reports on climate change, food security, gender and health.)

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