Hungry kis liye?
“Hungry kya?” asked a memorable advertisement from Domino’s Pizza some 10 years ago. Young Hinglish-speaking urban India responded heartily. But the trouble is, not enough people ask “Hungry kaun?” and “Hungry kis liye?” This question of what we, and especially our children, are actually eating and not eating is becoming more and more critical.
Last week, it popped up at a Bill and Melinda Gates Foundation-supported event, billed as the “TEDxChange@TEDxDelhi”. One of the panelists at this star-studded gathering, which included Melinda Gates, was Manoj Kumar, chief executive officer of the Hyderabad-based Naandi Foundation, a non-governmental organisation working on poverty, child rights and related issues. Mr Kumar plans to stir up “hungama” on an issue which he believes is critical to the future of this country.
Naandi Foundation will soon release its first Citizen’s Hunger and Malnutrition Report. Catchily called the “HUNGaMA”, a word play on hunger and malnutrition, the report focuses on how children are faring nutritionally in 100 districts ranked worst on child-related indicators. These are in Bihar, Jharkhand, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh. Altogether, some 160 million people including about one-fifth of India’s children have been covered. The report will focus on some of the key indicators of hunger and malnutrition, drawing particular attention to the condition of children under the age of five, given the critical impact of nutrition early in life. For many mothers, who have been interviewed by the foundation’s team of researchers, it was a novel experience as they are not used to being asked so many questions. Many refused to believe that their child was malnourished because there were “so many others” like him or her in the neighbourhood and because the child had not stopped playing.
Why should this be of interest to us when there are already masses of information and insights about malnutrition? The short answer is that while most of us know some things about malnutrition, we don’t know many other things that are absolutely vital. India still has the dubious distinction of having the highest number of malnourished children in the world. Some states fare worse than sub-Saharan Africa. The most recent National Family Health Survey (NFHS) tells us that 43 per cent of Indian children under five years are underweight; 48 per cent (i.e. 61 million children) are stunted due to chronic undernutrition; India accounts for more than three out of every 10 stunted children in the world; the percentage of children who are severely underweight is almost five times higher among children whose mothers have no education than among children whose mothers have 12 or more years of schooling. And so on.
But this data is five to six years old. At this point, when India is making an ambitious plan for food security, we don’t have real-time data on the nutritional status of children.
One of the biggest concerns is the chilling lack of awareness in this country about the impact of malnourishment on brain development.
The maximum brain development takes place during the first five years of a person’s life and proper nutrition is critical to the process. Far too many people otherwise educated, however, do not know what this proper nutrition should be. One of the big myths is that only poor, rural women do not know that lack of proper nutrition can impair the mental as well as physical development of a child.
Everyone recognises the importance of “food” in the growth of a child, but far fewer are aware of micronutrient deficiencies, the importance of the right amount of iron, iodine, vitamins and so on in the diet of a child. Iron-deficient diet is a common problem that starts, in many cases, even before birth. Women not getting enough iron in their diet give birth to infants who are anaemic and stay anaemic. This takes a toll on physical growth, mental development and school performance. At the other end of the spectrum are the rising problems of child obesity and child diabetes, again often a result of poor diets. New research suggests that type 1 diabetes may be responsible for problems in attention, concentration and problem solving found in some children.
Many among the educated middle class in towns and cities typically think of malnutrition as something to do with only hunger and starvation — issues that do not affect them. “The middle class is not worried about malnutrition because it is not contagious. I wish it was like SAARS or HI1N1. Then everyone will sit up and take notice. But malnutrition affects the middle class and rich as well because many among the educated don’t know how to feed their young. Many children survive but they suffer from the ill effects of child malnutrition in the form of cognitive and physical deficiencies which affect their whole life. So, while we are talking about food security, we should also talk about nutrition security”, points out Mr Kumar.
A telling example: very few know the crucial importance of colostrum, the highly nutritious milk a mother produces right after giving birth. Far too often, it is thrown away instead of being given to the child, due to what Mr Kumar calls the “firewall of cultural taboos” which prevails not only in rural communities but also among the urban and the rich in this country. Many families that Mr Kumar’s team interviewed admitted that they did not know the value of colostrum to the newborn. Often, the “right time” for a mother to start breastfeeding her child is decided by the local priest and is dependent on astrological rather than medical factors. The really interesting thing I learnt from Mr Kumar is that even many of Mumbai’s über-rich celebrities did not know about colostrum’s vital role in providing protective antibodies, essential nutrients, strengthening the child’s immune system and helping in brain development and bone and muscle strength.
So, “Hungry kis liye?” is a question we need to ask loudly. Hopefully, the report will illuminate not only the reality in the 100 targeted districts but also trigger a debate in middle-class urban India, which also needs to know about what and how much to feed our very young and vulnerable.
Patralekha Chatterjee writes on development issues in India and emerging economies and can be reached at email@example.com