Malnourishment and the Lack of Information on How to Overcome It Plagues Bundelkhand's District

With the malaise of malnourishment turning into a spectre haunting the poor in Uttar Pradesh, new-borns being the worst hit, one suspects the “youngest India by 2020” statistics is only taking stock of urban demographics.

Gorakhpur might have taken centrestage recently when it became the horrific site of a mass grave for children, babies, new-borns as young as ten days. But in the area, these deaths are counted among the usual.

According to the World Health Organization report of 2016, 35.7% of children in the age group of 0-5 years in India are malnourished. Of that, Uttar Pradesh occupies the top spot – at 46.3% of malnourished children in that age group, it is unarguably the state with the highest number. As local Bundelis would tell you, tongue-firmly-in-cheek, “Chalo, kisi mein toh number one hua UP (Oh come on, at least UP is number one in something).”

But sarcasm doesn’t abet the problem or the pain.

In fact, if you were Hema, it would be irrelevant. A resident of Ladhpur village in Jaitpur block of Mahoba, a district in Bundelkhand, she is visibly upset. One look at her new-born baby will tell you why. Hema complains that her three-month-old daughter is always running a high fever; plus, she’s suffering from constant diarrhoea and vomiting. “Every hour, she’s either vomiting or crapping” – clear indications of a severe malnourishment that has resulted in a dehydration very close to dangerous levels. A biscuit or two is all she’s been able to feed her for days. “We have had no support from the aanganwadis”, she says.

Anita echoes the sentiment but is more forthcoming with information, which she has very little. Her son Piyush was born underweight, but she is not sure what to make of her child’s “bahut zyaada kamzori (extreme weakness)”. Her husband tries to helpfully add, “An aanganwadi worker came to check on him, but we were not given any help or information.”

The lack of information is as severe as the problem itself. One intensifies the other in a lethal chicken-and-egg situation.

There are schemes in place to specifically overcome malnourishment – Janani Suraksha Yojna, a “safe motherhood” intervention programme under the National Rural Health Mission, and the Poshan Mission Yojna that works specifically on child and adolescent nutrition and was implemented by the Akhilesh Yadav government.

At the rural level, there exist – or are supposed to exist – the Poshan Punarvaas Kendra, or the Nutrition Rehabilitation Planning Centres conceptualised primarily and precisely to counter malnourishment in children. But if information is power, then these are the people paying the price for not having any of it. They find themselves disadvantaged. In this case, young children – short of their first, second, fourth birthdays – pay for it with their lives.

When we head to the local anganwadi to pull up the karmcharis, one of the workers there, Sheela, informs us that as of now, “no facilities are available”. When we press on her to share details, she says, “We advise the women who come here on how to take care of the child. That the child needs vitamin, iron, protein… Doodh pilaao, daliya khilao.” But what action is taken when the child is quite visibly, or even diagnosed as underweight? “Yes, we ask them to weigh the child every month”, says Sheela, promising us a few handy charts that spell out the optimum height-age-weight facts. She also leaves with us the crystal-ball-gazing moment, many a government worker’s favourite in the parts where we report from: “When the things come, we will distribute them. No doubt.”

Asha, another worker, is quite straightforward with her analysis. “The mother should take care of the child.”

The Child Development Project Officer (CDPO) Pushpa Gurudev is in a buoyant mood when we meet her, buzzing with information of her own. The aanganwadi diwas, it seems, is upon Mahoba. “That’s the day all the women should come, and we will definitely let everyone know.”

But this mood turns into one of celebration at the ultimate peak of the rural health policies pyramid – the Chief Medical Officer, one Dr S.K. Vaashnay, who is feeling – there is no other word for it – positively happy. He says as much, “Mujhe khushi hai ki sarkar ki yojnayein achchi chal rahi hai (I am glad that the government has run some very good schemes)”. He lists them out again and shares with us that his favourites are the Janani Suraksha Yojana and the Poshan Mission. When we remind him of why we’re there, he qualifies, “See, even though the Anganwadi workers have done a lot of work, they have still not been able to make a difference.”

And then it comes – the cause of his joy – there is yet another scheme on its way. Of course.

“The Mega Call Centre”, he tells us, “is going to revolutionise all this”. How? Dr. Vaashnay tells us, “See, it will start at the district level wherein we will get the information on malnourished children after meeting the head of the village. The calls will go directly to him.”

He ends our meeting with a claim not tall by his standards, he adds modestly. He has great faith in the Mega Call Center. “We will end malnourishment in the district in the next six months”, he says.

We’ll be there for a follow-up, rest assured.

This piece first appeared on Khabar Lahariya.

Khabar Lahariya is a rural, video-first digital news organisation with an all-women network of reporters in eight districts of Uttar Pradesh.

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