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

Tuesday, January 26, 2010

Jhabua - Unlearning malnutrition?

Staff interviews - day 1, district 1, 70 women

In Jhabua we had the good luck that a prestigious organization has just shut down its three year malnutrition intervention in the district and we therefore had an excess of extremely qualified candidates coming out for our job interviews. These trained women joined dozens of others, with varied experience and qualifications, in our soon-to-be NRC, to interview for our 11 Jhabua posts.

The Jhabua group had done their homework and this made my day miserably boring. Every other woman who came in could recite the malnutrition workers' manifesto front and back, dropping all the key buzz words, but when asked to think of an original approach or to think critically about elements of nutrition programs, they were stumped. When we asked "what approaches don't work?" and "do you have any ideas that have never been done before about how to prevent malnutrition in the village?" - most women were silent.

Interestingly, and retrospectively predictably, some of the most interesting answers and ideas we received were from women with little background in malnutrition.

In selecting our staff now out of the many qualified and deserving women, we're faced with a dilemna. Do we chose the women with the most training and experience in malnutrition? Do we run the risk then of making all the same mistakes that their previous employer made before? Will we be able to get rid of these stale ideas and approaches that proved not to be effective in the field? Its not helpful to just read laundry lists of ideas to women in villages to educate them on malnutrition, we have to find ways to help to help turn awareness building into practical application. We need staff who will look for challenges and nuance, adapting and changing to what works and what doesn't.

Do we chose women who are untrained in nutrition but who have a keen sense of the communities and who can communicate any message? With fresh minds, will we finally be able to do something different in malnutrition and break the 30 years of 1% improvements in India? Or will our staff be overwhelmed and not prepared for this task even after our trainings?

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