Reuters NewMedia - February 16, 2012
SHIVPURI, India (Reuters) - Crying as she is put on an electronic
scale, two-year-old Rajini's naked shriveled frame casts a dark
shadow over a rising India, where millions of children have
little to eat.
The children are scrawny, listless and sick in this run-down
nutrition clinic in central India with its intermittent power
supply. If they survive they will grow up shorter, weaker and
less smart than their better-fed peers.
Rajini weighs 5 kg (11 lb), about half of what she should.
"She's as light as a leaf, this can't be good," says her
grandmother, Sushila Devi, poking her rib-protruding stomach in
the clinic in Shivpuri district in Madhya Pradesh state.
Almost as shocking as India's high prevalence of child
malnutrition is the country's failure to reduce it, despite the
economy tripling between 1990 and 2005 to become Asia's third
largest and annual per capita income rising to $489 from $96.
A government-supported survey last month said 42 percent of
children under five are underweight - almost double that of
sub-Saharan Africa - compared to 43 percent five years ago.
The statistic - which means 3,000 children dying daily due to
illnesses related to poor diets - led Prime Minister Manmohan
Singh to admit malnutrition was "a national shame" and was
putting the health of the nation in jeopardy.
"It is a national shame. Child nutrition is a marker of the many
things that are not going right for the poor of India," said
Purnima Menon, research fellow on poverty, health and nutrition
at the Institute of Food Policy Research Institute.
India's efforts to reduce the number of undernourished kids have
been largely hampered by blighting poverty where many cannot
afford the amount and types of food they need.
Poor hygiene, low public health spending and little education and
awareness have not helped. Age-old customs discriminating against
women such as child marriage have also contributed, but are far
harder to tackle, say experts.
In addition, shoddy management of food stocks, subsidized
carbohydrate-rich food that fuel and fill the poor rather than
truly nourishing them and real shortages in its poorest states
have worsened the problem.
At the Shivpuri clinic, health worker Rekha Singh Chauhan tends
to emaciated young children in a ward with a ganglion of
electrical wires running cross its paint-chipped walls.
"We only have a handful to take care of now, but come April, the
cases will shoot up," says Chauhan, adding that diseases such as
diarrhea and malaria will cause an influx of sick underweight
children with the onset of summer.
"The situation becomes bad. Three children are made to share a
bed and many have to sleep on the floor."
That picture jars with an India clocking enviable 8-9 percent
growth over the last five years that has put money in the pockets
of millions of its people and fuelled demand for everything from
cars and computers to clothes and fancy homes.
It has also catapulted the country onto the world stage, boosting
its claim for a bigger role on forums such as the U.N. Security
Council. This month, it moved closer to buying new fighter jets
worth a whopping $15 billion.
Yet while the urban middle classes dine in swanky shopping malls
where eateries offer everything from sushi to burritos, millions
of children are dying due to a lack of food.
Last month's report by the Indian charity Naandi Foundation, the
first comprehensive data since a 2005/6 study, said India's
"nutrition crisis" is an attributable cause for up to half of all
Yet India's public spending on health, estimated at 1.2 percent
of its GDP in 2009, is among the lowest in the world.
"This isn't a quick-fix that we're looking at here, it's not a
magic bullet," said Jasmine Whitbread, CEO of Save the Children
"Not just in India, but in countries around the world, we know
that you can't just rely on trickle down. There have to be
policies in place, there have got to be political choices that
In Shivpuri, an impoverished tribal-dominated district in Madhya
Pradesh state, that reality is on full display.
The region's malnutrition level for children under five matches
the national average, but child mortality rates are worse at 103
deaths per 1,000. The national average is 66 deaths per 1,000,
according to U.N. children's agency, Unicef.
Most of the children here are from India's most marginalized and
poorest communities, such as tribals and lower castes where
literacy is poor and poverty high.
Their mothers are themselves often undernourished, forced into
early marriage when they reach puberty, and give birth to
underweight babies with weak immune systems.
Illiteracy or lack of awareness takes its toll as well. These
mothers do not breastfeed, offering buffalo milk and contaminated
water instead and making their children prone to illnesses like
diarrhea, which prevents nutrient absorption.
Mostly living on less than $2 a day, these families can hardly
afford anything beyond wheat chapatis that are devoid of
much-needed protein and other nutrients.
India's neglect of its young - 48 percent are stunted, 20 percent
wasted and 70 percent anemic - will have serious repercussions.
The World Bank says malnutrition in the poorest countries slashes
around 3 percent from annual economic growth.
Malnourished children will struggle at school, if they go at all,
and earn 20 percent less during their working life and are more
prone to infections, including HIV, and death.
Human development goals, signed up to at the start of the
millennium by 192 U.N. members, including India, are also at
Reducing child malnutrition by half and child mortality levels by
two-thirds of 1990 levels are unlikely to be met by India by the
2015 deadline, say experts.
In comparison, neighboring China has already achieved its target
on malnutrition and under-five child mortality goals as its
economic growth has been more broad-based, focusing on health,
sanitation and small holder production.
While India has several schemes already running to battle
malnutrition, the Indian government is now vaunting a
multi-billion-dollar food subsidy program as a possible solution.
But the Food Security Bill, which guarantees cut-price rice and
wheat to 63.5 percent of the population may be more a political
gimmick, experts worry, than about providing nutritious food to
those who need it most.
"The Food Security Bill is a very good development, but it is a
food security bill, not a nutrition security bill," said Lawrence
Haddad, director of the U.K.-based Institute of Development
For the children at Shivpuri's nutrition centre, government plans
mean little unless they put enough of the right food in their
"You see her arms? They are almost the width of my thumb," says
Jharna, as she carried her limp, emaciated one-year-old
grand-daughter, Sakshi, into the clinic. "She is too weak. She
can't even sit by herself."
(Writing by Nita Bhalla; Editing by John Chalmers and Sanjeev