Nearly 800 million Indians live without sanitation, 170 million have no access to clean drinking water and a woman dies giving birth every five minutes, an aid agency said Thursday, urging the government to do more to provide basic services.
The problems are starkest in India, a country of more than 1 billion people that is positioning itself as an emerging global power.
But the same issues span South Asia, according the report from the British-based group Oxfam.
The report, which highlighted lack of access to education, health, water and sanitation, called on the governments of India, Pakistan, Bangladesh, Sri Lanka, Afghanistan and Nepal to step up their financial and political commitments to provide these basic needs.
"Without strong government participation there will be no development of essential services," said Ben Philips, Oxfam's acting regional director. "There is a lack of investment and political will."
The report also praised these countries, saying recent progress — particularly in Sri Lanka — proved that developing nations can provide for their citizens.
Focusing on India, the region's largest country, the report said that despite its economy growing at around 8 percent over the last few years, it had failed to translate that into improved services.
Indian medical facilities blasted
The report was especially critical of India's inability to supply adequate medical services, saying it was causing millions of unnecessary deaths — particularly infant and maternal mortality.
"Every half an hour six nameless Indian women die in childbirth," said the report's author, Swati Narayan, noting that only 40 percent of rural clinics have labor rooms.
The relatively high costs of medicine for the poor also deterred many from seeking medical treatment or drove them to visit medical charlatans, she said. Those who did seek treatment were often pushed over the poverty line by the costs.
The problems are spotlighted by India's emergence as a medical tourism destination.
An estimated 175,000 foreigners came to India in 2005 for medical treatment attracted by the "cost effective treatment in state-of-the-art hospitals," according to a regular column in the Hindustan Times newspaper titled "India: The next superpower?"
‘It is a matter of priorities’
The article published Thursday said medical tourism could contribute some $5 billion to the Indian economy annually.
"Resources do exist," Narayan said. "It is a matter of priorities."
Other problems in India were identified as 70 percent of the population lacking access to toilets, 170 million people with no clean drinking water and a primary school dropout rate of 38 percent, according to Oxfam and U.N. figures.
"There has been an utter failure in our systems to deliver services," acknowledged Said Hameed, who is responsible for medical services on the government planning commission that sets out India's soviet-style five-year economic plans.
Hameed said health problems were exacerbated by a severe gender bias in India.
"A girl in India is up to 50 percent more likely to die before her fifth birthday than her brother," he said.
These issues were being addressed very seriously by the Indian government, said Abhijit Sen, who sits on the same commission, headed by Indian Prime Minister Manmohan Singh.
Sen said the plan called for school dropout rates to fall 20 percent and to cut maternal mortality by three-quarters to one death per 1,000 births by 2012.
"These are all achievable targets that don't require much in the way of resources or time to achieve them," Sen said.
Oxfam also listed positive developments in the countries and said they presented an example to be followed by others.
The report singled out Sri Lanka as an example of a developing country that has achieved universal free schooling, drastically reduced infant mortality rates and boosted life expectancy to levels comparable to developed countries.
Bangladesh was also praised for achieving equality in school enrollment between boys and girls.