Understanding malnutrition in India

Malnutrition is one of the largest factors supressing India's spectacular growth. In a country of lunar missions, billionaires, and nuclear power, a staggering 46% of all India children under 5 years old are still underweight. In India, where everything is on a large scale, malnutrition is daunting - an estimated 200 million children are underweight at any given time, with more than 6 million of those children suffering from the worst form of malnutrition, severe acute malnutrition. Experts estimate that malnutrition constitutes over 22% of India's disease burden, making malnutrition one of the nation's largest health threats.

The causes of malnutrition and therefore the solutions to the problem vary as much as the Indian people. To understand and solve malnutrition requires patience, nuance, flexibility, and above all determination.

Follow me as I set out to understand malnutrition in the subcontinent and begin to tackle it

Monday, November 30, 2009

Malnutrition Exaggerated

http://www.hindu.com/2009/11/28/stories/2009112857052000.htm

An article recently came out in the Hindu which claims that 25 children died from malnutrition in the month of October in just two villages in the Meghnagar district of MP. The deaths are attributed to malaria, anemia, and malnutrition.

The article then goes on to site malnutrition figures from around the state, but gives no clear evidence or authority for the deaths in Jhabua. The author is accusatory of government officials being complacent and the anganwadi system failing.

While I'm usual right on board with many of these criticisms and believe that journalist have an important role in highlighting situations like this, unfortunately I have to say that this article is wrong, and irresponsible journalism.

Meghnagar is our main district in Jhabua. We have health workers and a wide network of contacts throughout the district. When a child has SAM we usually know, when a child dies, we almost always hear. So far in the past month we've recorded 4 children dying from malnutrition. This is a number that has been confirmed by the Joint Director of Health for the area. I consider even 4 children's deaths due to malnutrition alarming. This should be enough to make newspaper headlines and to pressure government officials and social organizations to act.

But creating a panic and over-reporting the problem can cause a negative backlash. More time gets spent investigating and proving the allegations wrong then actually fixing the root of the problem.

We'll try our best over the next few days to further look into these claims to ensure that, God-willing, this article has exaggerated the situation.

Wednesday, November 4, 2009

New "Community Kitchen" scheme launched in MP

http://www.thaindian.com/newsportal/politics/scheme-to-tackle-malnutrition-launched-in-madhya-pradesh_100269553.html

Today we went to visit the anganwadi center in Umri, a town close to Jhabua's district center but rife with malnutrition. When I asked the anganwadi the standard question about the supplements she was providing to the children, she led me around to the back of the school adjacent to the center to a smoke-filled kitchen. The room was so poorly ventilated that I couldn't see without squinting and couldn't stand in the room without holding my breath, but through red eyes, I was able to see a delicious looking pot of dal and fresh rotis being cooked on a skillet.

The three women who braved these kitchen conditions were part of a newly formed local self-help group (SHG) who are now in charge of making the meals for the anganwadi center and the elementary school next door.

This is part of the Chief Minister's new solution for malnutrition, Sanjha Chulha, creating community kitchens to prepare full, hot meals as midday meals and anganwadi supplements instead of pre-packaged foods.

First week on, things seem to be going pretty well. The former system, which relied on many centrally located self-help groups to prepare ready-made food, was problematic and rife with corruption. I often saw wheat meant for schools on sale at the market. Common were stories of SHGs who made substandard food and profited from their economy. Anganwadis, who are already overburdened with responsibilities in health, nutrition, and education, spent large portions of their days cooking. There is plenty room for corruption in this model as well, but at least there will be more visibility and accountability will be placed with the community. While communities aren't always the best monitors or good at demanding the services they deserve, they're more reliable than a hand full of government inspectors and monitors. This will also provide a small income to women in the community (many mothers of small children themselves) and will foster greater community involvement in the centers.

While I don't agree that this program is revolutionary, nor will it greatly affect the incidence of severe acute malnutrition (those kids aren't going to the anganwadi centers), this is certainly a great concept and an improvement to the system.