We need to reconsider what public policy experts, politicians, activists, intellectuals and NGOs have to say on the issue of malnutrition in India. It’s less about food shortages and more about safe drinking water
What causes malnutritionIJ Ask this question to politicians, activists, NGO-wallahs, intellectuals, etc, and the answer will more or less be the same — food shortage. The more enlightened among them would add one more point, pointing towards lack of ‘nutritious’ food. But, using height-for-age parameters, 25.3 per cent kids belonging to highest quintile in the countryside are malnourished too. How do we understand this phenomenonIJ
If at all there is any kind of equality in the countryside, it is about sources of drinking water. In Uttar Pradesh, for instance, most people use water drawn from hand pumps. A new beginning has been made as the Government is now providing Deep Bore India Mark II Hand Pumps, thus ensuring safe drinking water. But they are far and few — three to four in a village.
More often than not, the water level of an ordinary hand pump is equal to that of a village pond. That being the case with most hand pumps in villages, people in rural areas are prone to using unsafe drinking water. This brings us to the question: Can the unsafe drinking water cause malnutritionIJ
Following are excerpts from a World Health Organisation (WHO) report on what causes malnutrition: “Malnutrition is a major health problem, especially in developing countries. Water supply, sanitation and hygiene, given their direct impact on infectious diseases, especially diarrhoea, are important for preventing malnutrition. Malnutrition, inadequate water supply and sanitation are linked to poverty. The impact of repeated or persistent diarrhoea on nutrition-related poverty and the effect of malnutrition on susceptibility to infectious diarrhoea are reinforcing elements of the same vicious circle, especially amongst children in developing countries.”
According to the WHO, water and hygiene standards can cause serious health problems. It further explains: “Malnutrition essentially means ‘bad nourishment’. It concerns not enough as well as too much food, the wrong types of food, and the body’s response to a wide range of infections that result in malabsorption of nutrients or the inability to use nutrients properly to maintain health. Clinically, malnutrition is characterised by inadequate or excess intake of protein, energy and micronutrients such as vitamins, and the frequent infections and disorders that result. People are malnourished if they are unable to utilise fully the food they eat, for example, due to diarrhoea or other illnesses (secondary malnutrition), if they consume too many calories (overnutrition), or if their diet does not provide adequate calories and protein for growth and maintenance (undernutrition or protein-energy malnutrition).”
The WHO is a highly-rated institution in the world. It involves some of the world’s greatest health experts to make a statement. Policymakers, therefore, ought to go by what institutions like this say on matters of public interest.
Going by the WHO’s understanding of malnutrition, we need to address issues that ordinary people can’t manage. Of the three main culprits — food shortage, unsafe drinking water, and hygienic conditions — people on their own can’t address the last two even if they want to. It is too expensive to install a Mark-2 Hand Pump. It is next to impossible in a country where people cannot build a drainage system. The world over, drainage systems are built by the state.
Most people, however, can find food on their own. After all, hunger makes people more active. They try locally. They migrate. People do everything to conquer hunger. But they cannot build drainages on their own. The state, therefore, should do what people can’t. It should encourage people to fight hunger on their own.
The WHO prescription apart, do food habits contribute in malnutritionIJ Ask any dietician on how many times do we need to feed a kid every day, and the answer would be simple — at least six times a day. Take a round of the richest of the family in a village, and ask how many times kids are fed; the answer might be three or four times! Also, does food taboo contribute in malnutritionIJ This question is not even raised.
Keeping all this in mind, we need to reconsider what public policy experts, politicians, activists, intellectuals and NGO-wallahs have to say on the issue of malnutrition. It’s not just about food shortage, after all.