Author : Josette Sheeran
The global financial crisis and the high cost of food mean different things in different places. In those parts of the world where hunger is on the march, their impact can be measured in empty stomachs and blighted lives. That is why, during my recent visit to India, I traveled to a remote district called Chhatarpur in the central state of Madhya Pradesh (MP). I went there because I wanted to see for myself the plight of people in India’s hunger heartland. I particularly wanted to listen to the experiences of the local women. As always in such situations, the women are the ones in the front line of the war against hunger.
So serious is the food-security situation in MP that, when inserted into the country table of the Global Hunger Index, the state falls between Ethiopia and Chad which are among the 10 poorest-performing countries in the world. One third of the children under five in MP suffer from wasting (too thin for their height) and 60 per cent are underweight (too thin for their age), according to India’s most recent National Family Health Survey.
Chhatarpur, in the north of the state, is one of a number of MP districts in the grip of malnutrition. “Severely insecure” is how it is described in the forthcoming Report of Food Security in Rural India, a joint initiative of the World Food Programme and the MS Swaminathan Foundation. Climate change would appear to be contributing to the problem. Persistent drought during the past five years has led to crop failures and cattle losses, driving many farmers into severe debt. A woman called Krishna told me her husband is jobless, their land barren. They have four small children whom they are struggling to feed. So bad is the situation, they have even been thinking of selling off their land to raise badly-needed cash.
This year, as last year, children died from hunger-related diseases in Chhatarpur. Women whom I met told me of the crushing difficulties they face every day in feeding their children. At a Nutrition Rehabilitation Centre where severely malnourished children are nursed back to health, I learnt first-hand about the ravages of hunger. Some of the women had not just one but several malnourished children to care for. The mothers were so busy with looking after their large families and performing endless household chores that, even when they did have enough food, they often did not have the time to prepare it properly and feed it to their babies.
The point about malnutrition, though, is that it is not like cancer. It does not need some new scientific discovery for us to tackle it. We already have the tools to eradicate hunger and history will judge us if we do not use them.
India is home to more than 230 million undernourished people - the highest number of any one country in the world. But it is also at the forefront of the race to produce innovative nutrition technology. WFP’s India operation is currently developing a “smart” nutritional intervention for children of 6-24 months - exactly the age group of children at the Rehabilitation Centre in Chhatarpur.
This new ready-to-use food is made from ingredients such as chickpeas and dry skimmed milk powder with a range of added micronutrients. There is huge scope for this type of nutritional supplement in India which has the highest prevalence of underweight children in the world, higher even that sub-Saharan Africa. This latest addition to our hunger toolbox can be used not just for rehabilitating malnourished children but for preventing them becoming malnourished in the first place.
This product can be made locally and at relatively low cost - a daily ration costs just five rupees (10 cents). Being oil-based, it does not require water for its preparation, giving it a longer shelf life and making it particularly suitable for use in places with poor sanitation. Nor does it require cooking which makes it ideal for distribution in disaster zones - which is why we deployed it as part of our relief package after the recent cyclone in Myanmar.
It has already excited significant interest in the region and beyond. Afghanistan, Nepal and Bangladesh have all expressed interest in making this product part of their national food programmes. When I produced a sachet at the African Union Summit in Ethiopia not long ago, Prime Minister Meles Zenawi said he wanted to start producing locally it in his own country.
I really feel we are embarking on a new age of tackling malnutrition. For the first time, we have a range of products which can deliver the kind of nutritious ‘punch’ that is needed to hit hunger where it matters.
Another initiative that WFP has pioneered in India has been rice fortification. This has huge potential and could be particularly useful in countries like India which has the largest population suffering from vitamin and mineral deficiencies in the world.
Just one kernel of this fortified rice, added to 99 regular rice kernels, gives an undernourished child or an adult all those micronutrients they so desperately need.
Working in partnership with a Dutch company and the authorities in Orissa, WFP is starting on a pilot project to fortify 10,000 metric tones of rice in the eastern Indian state. This will be distributed over a two-year period through the Indian government’s mother-and-child feeding programme, reaching up to a quarter of a million beneficiaries. The idea is that what happens in Orissa will serve as a model for the Indian government to extend rice fortification to other parts of the country.
Micronutrient powder is another intervention we’ve been working on in India. Sprinkled on cooked food, this tasteless powder delivers meals that contain the daily recommended intake of essential vitamins and minerals. Again, this innovative idea has applications for use way beyond India and the South Asia region.
We’re looking at nothing short of a nutritional revolution here, a change in the way we target specific needs and specific communities. Another issue we have been exploring in India is how to improve the nutritional status of people with HIV and AIDS. Working closely with India’s National AIDS Control Organisation, WFP has devised a special fortified food supplement called ‘NutriPlus’, made from wheat and full-fat soya. Pilot projects in Orissa and in the southern Indian state of Tamil Nadu are now leading the way in the nutritional care of this particular sector of society in India.
Such new products and initiatives come at a crucial moment. In this time of financial crisis and high food prices, people make cut-backs where they can. What goes first is the nutritional content of a family’s diet. My experiences in Chhatarpur and elsewhere in the world have shown me that, when push comes to shove, vulnerable people either cut down on the number of meals they eat or reduce the servings of food. This is particularly hard on children and babies who need that nutrition and those minerals to grow up into healthy, fully-functioning adults.
If we can target the most vulnerable - particularly young children - with tailored nutritional interventions during the crucial early months of their lives, then we will have gone a long way towards winning our battle against malnutrition.
Showing posts with label Malnutrition. Show all posts
Showing posts with label Malnutrition. Show all posts
Tuesday, April 7, 2009
Thursday, March 26, 2009
As Indian Growth Soars, Child Hunger Persists
By SOMINI SENGUPTA
Published: March 12, 2009
NEW DELHI — Small, sick, listless children have long been India’s scourge — “a national shame,” in the words of its prime minister, Manmohan Singh. But even after a decade of galloping economic growth, child malnutrition rates are worse here than in many sub-Saharan African countries, and they stand out as a paradox in a proud democracy.
China, that other Asian economic powerhouse, sharply reduced child malnutrition, and now just 7 percent of its children under 5 are underweight, a critical gauge of malnutrition. In India, by contrast, despite robust growth and good government intentions, the comparable number is 42.5 percent. Malnutrition makes children more prone to illness and stunts physical and intellectual growth for a lifetime.
There are no simple explanations. Economists and public health experts say stubborn malnutrition rates point to a central failing in this democracy of the poor. Amartya Sen, the Nobel prize-winning economist, lamented that hunger was not enough of a political priority here. India’s public expenditure on health remains low, and in some places, financing for child nutrition programs remains unspent.
Yet several democracies have all but eradicated hunger. And ignoring the needs of the poor altogether does spell political peril in India, helping to topple parties in the last elections.
Others point to the efficiency of an authoritarian state like China. India’s sluggish and sometimes corrupt bureaucracy has only haltingly put in place relatively simple solutions — iodizing salt, for instance, or making sure all children are immunized against preventable diseases — to say nothing of its progress on the harder tasks, like changing what and how parents feed their children.
But as China itself has grown more prosperous, it has had its own struggles with health care, as the government safety net has shredded with its adoption of a more market-driven economy.
While India runs the largest child feeding program in the world, experts agree it is inadequately designed, and has made barely a dent in the ranks of sick children in the past 10 years.
The $1.3 billion Integrated Child Development Services program, India’s primary effort to combat malnutrition, finances a network of soup kitchens in urban slums and villages.
But most experts agree that providing adequate nutrition to pregnant women and children under 2 years old is crucial — and the Indian program has not homed in on them adequately. Nor has it succeeded in sufficiently changing child feeding and hygiene practices. Many women here remain in ill health and are ill fed; they are prone to giving birth to low-weight babies and tend not to be aware of how best to feed them.
A tour of Jahangirpuri, a slum in this richest of Indian cities, put the challenge on stark display. Shortly after daybreak, in a rented room along a narrow alley, an all-female crew prepared giant vats of savory rice and lentil porridge.
Purnima Menon, a public health researcher with the International Food Policy Research Institute, was relieved to see it was not just starch; there were even flecks of carrots thrown in. The porridge was loaded onto bicycle carts and ferried to nurseries that vet and help at-risk children and their mothers throughout the neighborhood.
So far, so good. Except that at one nursery — known in Hindi as an anganwadi — the teacher was a no-show. At another, there were no children; instead, a few adults sauntered up with their lunch pails. At a third, the nursery worker, Brij Bala, said that 13 children and 13 lactating mothers had already come to claim their servings, and that now she would have to fill the bowls of whoever came along, neighborhood aunties and all. “They say, ‘Give us some more,’ so we have to,” Ms. Bala confessed. “Otherwise, they will curse us.”
None of the centers had a working scale to weigh children and to identify the vulnerable ones, a crucial part of the nutrition program.
Most important from Ms. Menon’s point of view, the nurseries were largely missing the needs of those most at risk: children under 2, for whom the feeding centers offered a dry ration of flour and ground lentils, containing none of the micronutrients a vulnerable infant needs.
In a memorandum prepared in February, the Ministry of Women and Child Development acknowledged that while the program had yielded some gains in the past 30 years, “its impact on physical growth and development has been rather slow.” The report recommended fortifying food with micronutrients and educating parents on how to better feed their babies.
A World Food Program report last month noted that India remained home to more than a fourth of the world’s hungry, 230 million people in all. It also found anemia to be on the rise among rural women of childbearing age in eight states across India. Indian women are often the last to eat in their homes and often unlikely to eat well or rest during pregnancy. Ms. Menon’s institute, based in Washington, recently ranked India below two dozen sub-Saharan countries on its Global Hunger Index.
Childhood anemia, a barometer of poor nutrition in a lactating mother’s breast milk, is three times higher in India than in China, according to a 2007 research paper from the institute.
The latest Global Hunger Index described hunger in Madhya Pradesh, a destitute state in central India, as “extremely alarming,” ranking the state somewhere between Chad and Ethiopia.
More surprising, though, it found that “serious” rates of hunger persisted across Indian states that had posted enviable rates of economic growth in recent years, including Maharashtra and Gujarat.
Here in the capital, which has the highest per-capita income in the country, 42.2 percent of children under 5 are stunted, or too short for their age, and 26 percent are underweight. A few blocks from the Indian Parliament, tiny, ill-fed children turn somersaults for spare change at traffic signals.
Back in Jahangirpuri, a dead rat lay in the courtyard in front of Ms. Bala’s nursery. The narrow lanes were lined with scum from the drains. Malaria and respiratory illness, which can be crippling for weak, undernourished children, were rampant. Neighborhood shops carried small bags of potato chips and soda, evidence that its residents were far from destitute.
In another alley, Ms. Menon met a young mother named Jannu, a migrant from the northern town of Lucknow. Jannu said she found it difficult to produce enough milk for the baby in her arms, around 6 months old. His green, watery waste dripped down his mother’s arms. He often has diarrhea, Jannu said, casually rinsing her arm with a tumbler of water.
Ms. Menon could not help but notice how small Jannu was, like so many of Jahangirpuri’s mothers. At 5 feet 2 inches tall, Ms. Menon towered over them. Children who were roughly the same age as her own daughter were easily a foot shorter. Stunted children are so prevalent here, she observed, it makes malnutrition invisible.
“I see a system failing,” Ms. Menon said. “It is doing something, but it is not solving the problem.”
Hari Kumar contributed reporting.
Published: March 12, 2009
NEW DELHI — Small, sick, listless children have long been India’s scourge — “a national shame,” in the words of its prime minister, Manmohan Singh. But even after a decade of galloping economic growth, child malnutrition rates are worse here than in many sub-Saharan African countries, and they stand out as a paradox in a proud democracy.
China, that other Asian economic powerhouse, sharply reduced child malnutrition, and now just 7 percent of its children under 5 are underweight, a critical gauge of malnutrition. In India, by contrast, despite robust growth and good government intentions, the comparable number is 42.5 percent. Malnutrition makes children more prone to illness and stunts physical and intellectual growth for a lifetime.
There are no simple explanations. Economists and public health experts say stubborn malnutrition rates point to a central failing in this democracy of the poor. Amartya Sen, the Nobel prize-winning economist, lamented that hunger was not enough of a political priority here. India’s public expenditure on health remains low, and in some places, financing for child nutrition programs remains unspent.
Yet several democracies have all but eradicated hunger. And ignoring the needs of the poor altogether does spell political peril in India, helping to topple parties in the last elections.
Others point to the efficiency of an authoritarian state like China. India’s sluggish and sometimes corrupt bureaucracy has only haltingly put in place relatively simple solutions — iodizing salt, for instance, or making sure all children are immunized against preventable diseases — to say nothing of its progress on the harder tasks, like changing what and how parents feed their children.
But as China itself has grown more prosperous, it has had its own struggles with health care, as the government safety net has shredded with its adoption of a more market-driven economy.
While India runs the largest child feeding program in the world, experts agree it is inadequately designed, and has made barely a dent in the ranks of sick children in the past 10 years.
The $1.3 billion Integrated Child Development Services program, India’s primary effort to combat malnutrition, finances a network of soup kitchens in urban slums and villages.
But most experts agree that providing adequate nutrition to pregnant women and children under 2 years old is crucial — and the Indian program has not homed in on them adequately. Nor has it succeeded in sufficiently changing child feeding and hygiene practices. Many women here remain in ill health and are ill fed; they are prone to giving birth to low-weight babies and tend not to be aware of how best to feed them.
A tour of Jahangirpuri, a slum in this richest of Indian cities, put the challenge on stark display. Shortly after daybreak, in a rented room along a narrow alley, an all-female crew prepared giant vats of savory rice and lentil porridge.
Purnima Menon, a public health researcher with the International Food Policy Research Institute, was relieved to see it was not just starch; there were even flecks of carrots thrown in. The porridge was loaded onto bicycle carts and ferried to nurseries that vet and help at-risk children and their mothers throughout the neighborhood.
So far, so good. Except that at one nursery — known in Hindi as an anganwadi — the teacher was a no-show. At another, there were no children; instead, a few adults sauntered up with their lunch pails. At a third, the nursery worker, Brij Bala, said that 13 children and 13 lactating mothers had already come to claim their servings, and that now she would have to fill the bowls of whoever came along, neighborhood aunties and all. “They say, ‘Give us some more,’ so we have to,” Ms. Bala confessed. “Otherwise, they will curse us.”
None of the centers had a working scale to weigh children and to identify the vulnerable ones, a crucial part of the nutrition program.
Most important from Ms. Menon’s point of view, the nurseries were largely missing the needs of those most at risk: children under 2, for whom the feeding centers offered a dry ration of flour and ground lentils, containing none of the micronutrients a vulnerable infant needs.
In a memorandum prepared in February, the Ministry of Women and Child Development acknowledged that while the program had yielded some gains in the past 30 years, “its impact on physical growth and development has been rather slow.” The report recommended fortifying food with micronutrients and educating parents on how to better feed their babies.
A World Food Program report last month noted that India remained home to more than a fourth of the world’s hungry, 230 million people in all. It also found anemia to be on the rise among rural women of childbearing age in eight states across India. Indian women are often the last to eat in their homes and often unlikely to eat well or rest during pregnancy. Ms. Menon’s institute, based in Washington, recently ranked India below two dozen sub-Saharan countries on its Global Hunger Index.
Childhood anemia, a barometer of poor nutrition in a lactating mother’s breast milk, is three times higher in India than in China, according to a 2007 research paper from the institute.
The latest Global Hunger Index described hunger in Madhya Pradesh, a destitute state in central India, as “extremely alarming,” ranking the state somewhere between Chad and Ethiopia.
More surprising, though, it found that “serious” rates of hunger persisted across Indian states that had posted enviable rates of economic growth in recent years, including Maharashtra and Gujarat.
Here in the capital, which has the highest per-capita income in the country, 42.2 percent of children under 5 are stunted, or too short for their age, and 26 percent are underweight. A few blocks from the Indian Parliament, tiny, ill-fed children turn somersaults for spare change at traffic signals.
Back in Jahangirpuri, a dead rat lay in the courtyard in front of Ms. Bala’s nursery. The narrow lanes were lined with scum from the drains. Malaria and respiratory illness, which can be crippling for weak, undernourished children, were rampant. Neighborhood shops carried small bags of potato chips and soda, evidence that its residents were far from destitute.
In another alley, Ms. Menon met a young mother named Jannu, a migrant from the northern town of Lucknow. Jannu said she found it difficult to produce enough milk for the baby in her arms, around 6 months old. His green, watery waste dripped down his mother’s arms. He often has diarrhea, Jannu said, casually rinsing her arm with a tumbler of water.
Ms. Menon could not help but notice how small Jannu was, like so many of Jahangirpuri’s mothers. At 5 feet 2 inches tall, Ms. Menon towered over them. Children who were roughly the same age as her own daughter were easily a foot shorter. Stunted children are so prevalent here, she observed, it makes malnutrition invisible.
“I see a system failing,” Ms. Menon said. “It is doing something, but it is not solving the problem.”
Hari Kumar contributed reporting.
Thursday, September 4, 2008
42 kids die of malnutrition in Madhya Pradesh
Thu-Sep 04, 2008
Bhopal / Indo-Asian News Service
People from 150 villages of Madhya Pradesh's Satna district, where malnutrition has led to 42 deaths in the last three months, have decided to boycott elections if the women and children continue to suffer for want of food.
Madhya Pradesh's drive - involving the United Nations Children's Fund (Unicef) and the World Food Programme (WFP) - against malnutrition among children notwithstanding, 42 child deaths have occurred in the past three months in Satna district.
"It is symbolic of a deep-rooted problem afflicting over 80,000 underprivileged children in this state," child rights activists said.
"Children in Satna district villages are dying of malnutrition but the authorities are reluctant to accept the fact and say that the deaths have been caused by various diseases," Prashant Dubey of MP Right to Food campaign (MPRTFC) said.
The state has with the assistance of Unicef and the WFP unveiled several special schemes like the Bal Shakti Yojana, the Shaktimaan and the Bal Sanjeevani Abhiyan which seek to treat severely malnourished children. It includes medical services necessary for such kids.
Still, there are 33,000 malnourished children in Madhya Pradesh in the 0-5 years age group, according to National Family Health Survey (NFHS) data. That is about 60 per cent of the total child population in the state.
The recent deaths have come soon after the twelfth phase of the Bal Sanjivani Abhiyan (campaign to bring down level of malnutrition among children) - conducted by the state's Women and Child Development (WCD) Department across the state from May 15. The campaign was carried out in cooperation with Unicef.
"The government claims to have made efforts to curb malnutrition for which it has spent millions of rupees in the past three years. But one can make out the level of nourishment provided to children from the state of Anganwadis (government-run creches) in the district. They lack even basic facilities like seats, drinking water, separate toilets or space to cook," said Dubey.
"Anganwadis remain closed. Foodgrains are never available at fair price shops. How do we feed our children in such a case?" asked Bandelal Kol, a resident of one of the affected villages. He had come to the Majhgawan block headquarters of Satna district during a meeting called by the Adivasi Adhikar Manch.
Residents of 150 villages participated in the meeting which resolved to boycott the polls if the government fails to secure the health of their women and children.
Meanwhile, Director of Women and Child Welfare Department (WCD) Kalpana Shrivastava said, “The main problem is that whatever the state provides under schemes to curb malnutrition can only be supplementary nutrition, whether it is through ICDS (the Integrated Child Development Scheme) or mid-day meals. It is hard to tackle malnutrition if non-availability of food and livelihood is the problem.”
The state's budget for the development of women and children went up to Rs 5.9 billion in 2008. Of this, Rs 3 billion was earmarked for providing nutritious food to undernourished women and children. This was Rs 1.9 billion more than 2007.
"However, the per centage of underweight children in Madhya Pradesh increased from 54 in 1998-99 to 60.3 now and the per centage of wasted (extremely malnourished) children has gone up from 20 to 33, according to NFHS, despite Unicef involvement,” a WCD official said on condition of anonymity.
The NFHS report says that only 14 per cent children breastfeed within one hour of birth and 82.6 per cent of children between the six and 35 months (the most critical period of life for mental and physical development) are anaemic. (News X)
Madhya Pradesh's drive - involving the United Nations Children's Fund (Unicef) and the World Food Programme (WFP) - against malnutrition among children notwithstanding, 42 child deaths have occurred in the past three months in Satna district.
"It is symbolic of a deep-rooted problem afflicting over 80,000 underprivileged children in this state," child rights activists said.
"Children in Satna district villages are dying of malnutrition but the authorities are reluctant to accept the fact and say that the deaths have been caused by various diseases," Prashant Dubey of MP Right to Food campaign (MPRTFC) said.
The state has with the assistance of Unicef and the WFP unveiled several special schemes like the Bal Shakti Yojana, the Shaktimaan and the Bal Sanjeevani Abhiyan which seek to treat severely malnourished children. It includes medical services necessary for such kids.
Still, there are 33,000 malnourished children in Madhya Pradesh in the 0-5 years age group, according to National Family Health Survey (NFHS) data. That is about 60 per cent of the total child population in the state.
The recent deaths have come soon after the twelfth phase of the Bal Sanjivani Abhiyan (campaign to bring down level of malnutrition among children) - conducted by the state's Women and Child Development (WCD) Department across the state from May 15. The campaign was carried out in cooperation with Unicef.
"The government claims to have made efforts to curb malnutrition for which it has spent millions of rupees in the past three years. But one can make out the level of nourishment provided to children from the state of Anganwadis (government-run creches) in the district. They lack even basic facilities like seats, drinking water, separate toilets or space to cook," said Dubey.
"Anganwadis remain closed. Foodgrains are never available at fair price shops. How do we feed our children in such a case?" asked Bandelal Kol, a resident of one of the affected villages. He had come to the Majhgawan block headquarters of Satna district during a meeting called by the Adivasi Adhikar Manch.
Residents of 150 villages participated in the meeting which resolved to boycott the polls if the government fails to secure the health of their women and children.
Meanwhile, Director of Women and Child Welfare Department (WCD) Kalpana Shrivastava said, “The main problem is that whatever the state provides under schemes to curb malnutrition can only be supplementary nutrition, whether it is through ICDS (the Integrated Child Development Scheme) or mid-day meals. It is hard to tackle malnutrition if non-availability of food and livelihood is the problem.”
The state's budget for the development of women and children went up to Rs 5.9 billion in 2008. Of this, Rs 3 billion was earmarked for providing nutritious food to undernourished women and children. This was Rs 1.9 billion more than 2007.
"However, the per centage of underweight children in Madhya Pradesh increased from 54 in 1998-99 to 60.3 now and the per centage of wasted (extremely malnourished) children has gone up from 20 to 33, according to NFHS, despite Unicef involvement,” a WCD official said on condition of anonymity.
The NFHS report says that only 14 per cent children breastfeed within one hour of birth and 82.6 per cent of children between the six and 35 months (the most critical period of life for mental and physical development) are anaemic. (News X)
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