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Dealing with the hidden hunger of our children

Coomi Kapoor | Blog Bytes<br><p> A recent article in the New York Times by Somini Sengupta points out that despite galloping economic growth in India,we have one of the worst malnutrition rates in the world.

Written by Coomi Kapoor | New Delhi |
April 6, 2009 2:44:10 pm

A recent article in the New York Times by Somini Sengupta points out that despite galloping economic growth in India,we have one of the worst malnutrition rates in the world. Sub-Saharan Africa,which conjures up images of famines and emaciated babies,has almost half our percentage of underweight children.

So why is there little discussion in the Indian media on the whole issue of malnutrition? When you speak of malnutrition,the response is often glazed eyes and a bored look. In journalism slang,subjects which excite a reader’s attention instantly are termed “sexy”,those which do not evoke immediate interest are termed “turnoffs”. For instance,people respond immediately when they read about starvation deaths during famines and disasters. But it is less easy to evoke sympathy and support when the plight of the victims does not hit you squarely in the face. Ninety per cent of malnutrition cases in India are of the chronically undernourished,where there are not necessarily obvious outward symptoms. Nevertheless this malnutrition doubles our infant mortality rate,making the child twice as susceptible to disease because of lowered immunity.

In India,we suffer largely from “hidden hunger” which does not always manifest itself in an emaciated appearance. It is a hunger caused by the constant or recurrent lack of food of sufficient quality and quantity. It is the deprivation of vitamins and minerals,essential micronutrients which are necessary for proper growth,physical fitness and mental development. Seventy per cent of Indian children suffer from anaemia (iron deficiency) and over 50 per cent suffer from serious vitamin A deficiency.

If hidden hunger is a not a sexy subject,debates on how to fight this malady are even more of a turnoff. This perhaps explains why articles on nutrition programmes in India focus generally on the only sexy solution,the need for hot cooked meals. There is a tendency to look with suspicion on other nutrition initiatives,acceptable worldwide,to combat malnutrition. Sometimes writers even hint darkly that other initiatives promoted by reputed international bodies are simply conspiracies to favour corrupt contractors or business interests.

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No one interested in rooting out the scourge of malnutrition would contest the supremacy of hot cooked meals for children over three. But I have never understood why the proponents of the hot cooked meals ignore the needs of children below this age. These infants do not eat adult food and experience has shown that their mothers do not have the time to bring them to the anganwadis for a meal they can only nibble at. Children below the age of three require small quantities of calorie and micronutrient-dense food several times a day as a weaning food,and not one solid meal. Weaning food,incidentally,is certainly not biscuits or packaged snacks as some partisan opponents to complementary food try to insinuate.

Only one third of Indian children receive adequate complementary food after they are weaned off breast milk,but this major lacuna has not been addressed because of a closed mindset. Breastfeeding is no doubt the best alternative,but there is a responsibility of the state to find an adequate substitute for the 50 per cent of Indian children who are not fortunate enough to be breastfed or weaned early. Our government food programmes for children have unfortunately ignored the needs of this very vulnerable age group,which is most susceptible to malnutrition.

Credit should,therefore,be given to the Ministry for Women and Child Welfare,which last month released a note to all state governments laying down nutritional feeding norms for the Integrated Child Development Services (ICDS) scheme. The guidelines are trendsetting. While doubling the budget,the ministry has specified hot cooked meals for children over three. But due recognition has finally been given to the feeding habits of children below this age. The guidelines call for takeaway home rations. It is specified that the complementary food to children under three must be in a form that is palatable to the child and cannot be consumed by the entire family. The guidelines emphasize in addition,the importance of hygiene,micronutrient fortification of food served in the ICDS programmes and spreading the important message of breastfeeding within one hour of birth. Finally,a step in the right direction.

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