[Reader-list] RTF (Right to Food) Articles - 5

[Rakesh Iyer]

Indian Express

Dealing with the hidden hunger of our children
A recent article in the New York Times by Somini Sengupta points out that
despite galloping economic growth in India, we have one of the worst
malnutrition rates in the world. Sub-Saharan Africa, which conjures up
images of famines and emaciated babies, has almost half our percentage of
underweight children.

So why is there little discussion in the Indian media on the whole issue of
malnutrition? When you speak of malnutrition, the response is often glazed
eyes and a bored look. In journalism slang, subjects which excite a reader's
attention instantly are termed "sexy", those which do not evoke immediate
interest are termed "turnoffs". For instance, people respond immediately
when they read about starvation deaths during famines and disasters. But it
is less easy to evoke sympathy and support when the plight of the victims
does not hit you squarely in the face. Ninety per cent of malnutrition cases
in India are of the chronically undernourished, where there are not
necessarily obvious outward symptoms. Nevertheless this malnutrition doubles
our infant mortality rate, making the child twice as susceptible to disease
because of lowered immunity.

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In India, we suffer largely from "hidden hunger" which does not always
manifest itself in an emaciated appearance. It is a hunger caused by the
constant or recurrent lack of food of sufficient quality and quantity. It is
the deprivation of vitamins and minerals, essential micronutrients which are
necessary for proper growth, physical fitness and mental development.
Seventy per cent of Indian children suffer from anaemia (iron deficiency)
and over 50 per cent suffer from serious vitamin A deficiency.

If hidden hunger is a not a sexy subject, debates on how to fight this
malady are even more of a turnoff. This perhaps explains why articles on
nutrition programmes in India focus generally on the only sexy solution, the
need for hot cooked meals. There is a tendency to look with suspicion on
other nutrition initiatives, acceptable worldwide, to combat malnutrition.
Sometimes writers even hint darkly that other initiatives promoted by
reputed international bodies are simply conspiracies to favour corrupt
contractors or business interests.

No one interested in rooting out the scourge of malnutrition would contest
the supremacy of hot cooked meals for children over three. But I have never
understood why the proponents of the hot cooked meals ignore the needs of
children below this age. These infants do not eat adult food and experience
has shown that their mothers do not have the time to bring them to the
anganwadis for a meal they can only nibble at. Children below the age of
three require small quantities of calorie and micronutrient-dense food
several times a day as a weaning food, and not one solid meal. Weaning food,
incidentally, is certainly not biscuits or packaged snacks as some partisan
opponents to complementary food try to insinuate.

Only one third of Indian children receive adequate complementary food after
they are weaned off breast milk, but this major lacuna has not been
addressed because of a closed mindset. Breastfeeding is no doubt the best
alternative, but there is a responsibility of the state to find an adequate
substitute for the 50 per cent of Indian children who are not fortunate
enough to be breastfed or weaned early. Our government food programmes for
children have unfortunately ignored the needs of this very vulnerable age
group, which is most susceptible to malnutrition.

Credit should, therefore, be given to the Ministry for Women and Child
Welfare, which last month released a note to all state governments laying
down nutritional feeding norms for the Integrated Child Development Services
(ICDS) scheme. The guidelines are trendsetting. While doubling the budget,
the ministry has specified hot cooked meals for children over three. But due
recognition has finally been given to the feeding habits of children below
this age. The guidelines call for takeaway home rations. It is specified
that the complementary food to children under three must be in a form that
is palatable to the child and cannot be consumed by the entire family. The
guidelines emphasize in addition, the importance of hygiene, micronutrient
fortification of food served in the ICDS programmes and spreading the
important message of breastfeeding within one hour of birth. Finally, a step
in the right direction.