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

Saturday, February 13, 2010

Kalwa - Second try

A week after our first failed attempt at hiring in Khandwa we returned to Khandwa with a new strategy. We ditched our jeep in the city and jumped on motorcycles with one of our new friends, an accountant with a heart of gold who lived in Kalwa for years and who still has deep ties to the community.

Kalwa is a spectacularly beautiful backdrop to the abject poverty it holds. Rolling hills, thick forests, and whimsical rivers surround villages ignored by development, struggling to match crop yields with the rising prices of foods, and with limited connectivity to markets, schools, and hospitals. Off the road, the scenery gets more spectacular and the malnutrition more severe.

Our plan for Kalwa is to choose our villages based on the good workers we can find. We’re requiring basic literacy – enough to fill out simplified reporting formats – and the charisma and communication skills to carry our messages. We’re going to hire women from larger villages (still pretty remote) who will cover the more rural villages within reach of their village. The larger villages are where we were able to find a handful of literate women and are usually located in the center of a cluster of smaller villages (small is still 1000 people). We’ll provide used bicycles to the Kalwa staff so that they can cover the substantial, but usually flat, distances between villages (we’ll call it a green initiative!).

By spending the day stopping through larger villages in the middle of rural ones, following contacts and hunting down leads we were able to find 5 staff members to cover almost 50 villages in the most remote areas of Kalwa. While many people said we wouldn’t be able to find women willing to cover more than a few villages, our new staff happily gave us a list of 10+ villages within a 10km radius of their village that they would cover.

We still need to do one more swoop of Khandwa to find the rest of our staff there, but we’re confident that this cluster approach will yield effective staff and a sustainable model.

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