New Delhi: “I eat one meal and drink water whenever I feel hungry. We don’t have money. We never have money,” a five-year-old girl who lives on the streets of Delhi, near Munirka, told The Wire.
According to the 2019 Global Hunger Index, India has been ranked 102 out of 117 countries in terms of severity of hunger.
Nutrient deprivation in children decreases immunity, making them unlikely to survive diseases that are otherwise treatable. “By saying that children are the future of the country, the issue gets diluted. They are the present too and we need to intervene now to secure their future, “said Dr Antaryami Dash, a nutrition expert at Save the Children.
Vinod Paul, a member of NITI Aayog, said after the GHI’s release, “Only a part of child mortality is related to nutrition but the causes of under 5 mortality are diseases, per say diarrhoeal diseases, pneumonia, new born diseases, which have nothing to do with nutrition.” He repeatedly emphasised that food security is not a fundamental problem, but is about people’s behaviour.
Dash, however, said, “The immediate impact of malnutrition is child mortality.” He referred to a Lancet series to say that globally, malnutrition is the cause of at least 45% of child mortality, while in India this number is 68.2%.
According to UNICEF, a third of the world’s malnourished children live in India.
Dash added that in terms of burden, the hotspots of malnutrition are Uttar Pradesh, Bihar, Jharkhand, Madhya Pradesh and Rajasthan, which contribute to more than 50% of the country’s malnutrition, stunting and wasting.
Malnutrition is a multi-faceted problem, so several co-related factors need to be dealt with. “Malnutrition is not something like floods or droughts; it’s not acute. We are facing chronic malnutrition, so we need chronic attention to be paid as well,” pointed out Dipa Sinha, a Right to Food Campaign activist and a faculty at Ambedkar University, Delhi, in context with the lack of addressing the issue.
“It’s not entirely true to say that we have slipped. The rank numbers are changing because of change in methodology. What’s more important is where we are and who are we lagging behind? In South Asia, India is the worst,” stated Sinha.
“If you look at the countries mapped around the same level as India in the report; they are war torn, civil riots prone, no democracy kind of countries. Clearly something is really a miss. And we are not doing enough,” she added.
Dash’s expressed a similar opinion: “The GHI score and methodology discourages to do a time series comparison.”
A disinterested government
“Though the past government didn’t do enough ground work, the process completely got cut off in the present government regime. The good thing about the launch of Poshan Abhiyan is that it is creating a lot of noise but what is happening on the ground?” asked Sinha. She recommended not considering the method of adding nutrients to a single food source, for example inducing vitamins, minerals and supplements in wheat flour, over a balanced diet.
Dash seemed to agree.”Poshan Abhiyan was launched in 2017. There has been a reduction in the level of child malnutrition based on CNSS but NITI Aayog should face the fact that with the present reduction rate, we will be way off track from the targets.”
The government has launched campaigns but has failed to institute a concrete policy, the experts said. For example, in Karnataka, 48,000 anganwadi workers haven’t been paid for four months.
“The anganwadi team are called volunteers and aren’t given an employee status. They are paid a minimal salary and are expected to take part in anganwadi centres as an extension to their motherhood, so gender inequality sitting becomes a core issue,” explained Sinha.
The GHI reports for 2019 were declared on October 16, the same the day when Supreme Court reserved its verdict after a 40-day hearing about the Ayodhya controversy. The headlines were largely about the verdict, and news of the GHI slipped many people’s attention.
“They can pretend that things are great because they are great for some people. That’s where media comes into picture. You have to keep bombarding such news, it has to make front page news. It has to stop presenting this issue with a perspective of mere a behavioural problem of the undernourished,” said Sinha on being asked about the role of media for such issues.
She further added, “The media creates a public opinion. The people who read the newspapers are not malnourished but they are the people who are opinion makers, so it needs to come out to capture attention and demand public action.”
Basic problem solving
In spite of intervention from the Supreme Court in response to PILs and government’s role in framing various welfare campaigns, there is much scope for improvement. The anganwadi set-up, for instance, is the world’s largest early childhood development scheme. But as Sinha and Dash pointed out, the scheme’s implementation needs to be formalised and more money injected into the system.
Mid-day meals in government schools also often fail to meet the set standards of nutritional values. The community kitchens introduced to make a basic balanced meal accessible to the poor might have at times led to diseases and infections due to compromised hygienic conditions.
Sinha suggested a few basic steps to take based on her experience. She emphasised providing maternity entitlements to women irrespective of their profession and eliminating the limitation of claiming it for the first birth only. She also said the conversion of a few anganwadi centres into anganwadi-cum-creches would reduce the burden for mothers. Additionally, improving the supplementary nutrition in anganwadi and take-home rations, better sanitation facilities and healthcare could help fight malnutrition.
Contrarily, Dash said that a lot of comprehensive solutions have come up in India but rigorous implementation and accountability at every level needs to be ensured, so the reinforcements should happen at the lowest administrative level.