Dr Arun Mitra
The report published in the Drug Today Medical Times on 19thFebruary 2019 by B S Rawat that 244 malnutrition deaths occurred in Delhi hospitals in 4 years is highly alarming. This report is based on the information received on an RTI information provided by Deputy Director of Delhi based State Family Welfare Bureau C K Dutta to Raj Hans Bansal. It is an extremely serious matter because Delhi is capital of the country and despite its serious pollution problems it is a dream city for millions of Indians who come here for education and in search of jobs besides tourism. Large number of workforce come to Delhi from different states to work in factories, dhabas, households and other places. Many of them live in shanty areas without proper water supply, hygiene or housing.
Quoting Health Minister Deepak Sawant the PTI had reported on 22nd July 2018 that as many as 19,799 children died in Maharashtra between April 2017 and March 2018 due to various reasons, including poor weight and respiratory illnesses. The main reasons of death during the period were poor weight at the time of birth, premature delivery, contagious diseases, congenital respiratory illnesses and deformities, besides others. The Minister said this in a written reply during the Monsoon Session of the Legislative Council in Nagpur.
Despite the claims of substantial growth in the GDP our country is unable to provide sufficient food to feed its population; it is unable to provide access to food to a large number of people, especially women and children. According to Food and agriculture Organisation (FAO) estimates in ‘The State of Food Security and Nutrition in the World, 2018″ report, 195.9 million people are undernourished in India. By this measure 14.8% of the population or 1 in 4 children is undernourished in our country. Also, 51.4 percent of women in reproductive age between 15 to 49 years are anaemic.
Further according to the report 38.4 percent of the children aged under five in India are stunted (too short for their age), while 21% suffer from wasting, meaning their weight is too low for their height. Malnourished children have a higher risk of death from common childhood illnesses such as diarrhea, pneumonia, and malaria. The Global Hunger Index 2018 ranks India at 103 out of 119 countries on the basis of three leading indicators — prevalence of wasting and stunting in children under 5 years, under 5 child mortality rate, and the proportion of undernourished in the population.
The Malnutrition is caused due to lack of balanced diet. India’s malnutrition problem results not from calorie intake but from dependence on a carbohydrate based diet low in protein and fat. Another factor triggering malnutrition is inadequate sanitation, which triggers an increase in infection-borne deficiencies in nutrients. There are two major types of malnutrition- protein-energy malnutrition – resulting from deficiencies in any or all nutrients and micronutrient deficiency diseases – resulting from a deficiency of specific micronutrients. According to the reports up to 40 per cent of the food produced in India is bound to get wasted. About 21 million tonnes of India’s entire wheat produce are wasted and 50 per cent of all the food across the world meets the same fate. India wastes As Much Food As United Kingdom Consumes. Child malnutrition impacts on economic productivity. The mental impairment caused by iodine deficiency is permanent and directly linked to productivity loss. Maternal malnutrition increases the risk of poor pregnancy outcomes including obstructed labour, premature or low-birth-weight babies and postpartum haemorrhage. Animal studies have shown that malnutrition can cause decrease in brain volume, number of neurons, synapses, dendrites and reactive zones. … The greatest effect of malnutrition on brain development is experienced during the time of rapid brain growth which is first three years of life. This is the period during which the brain is vulnerable.
To prevent malnutrition one needs plenty of fruit and vegetables, plenty of bread, rice, potatoes and other starchy foods, some milk and dairy foods, some meat, fish, eggs, beans and other non-dairy sources of protein.
The Lancet, one of the most authentic medical journals has come out with daily dietary recommendation for 2500 calories from various food items fulfilling caloric requirements, as well as ingredients essential for growth of different body parts and mental faculties. An estimation of the cost of this daily diet based on the present day price of the food items comes out to be approximately Rs.130 per person per day. For a family of 5 members this comes out to be Rs.650 per day or Rs.19500 per month. This is impossible to be met with in present day economic structure of our country.
The minimum wage in India as recommended by the expert Committee, in the name of national minimum wage, amounts ranging from Rs 8892 to Rs 11,622 per month meant for unskilled worker. This is far below the level of minimum wage recommended by 7thPay Commission. The trade unions have been demanding minimum wage to be Rs.18000/- even though this also does not meet the nutritional requirements. The major work force in our country is in the unorganized sector where these acts are hardly implemented. The agriculture labour and the marginal farmer is worst affected.
Bold socio-economic initiatives coupled with public movements are needed to ameliorate the situation if we really want to care for our children and make them physically and mentally strong and to a strong nation. Midday meal is a good scheme. It needs to be implemented effectively. But ultimately it is the increase in purchasing capacity of the people which can sort out the issue of mal nutrition. (IPA)
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