Malnutrition Is a Matter of Political Economy!

Malnutrition is a matter of political economy!

Sachin Kumar Jain

“When people go hungry, it’s not simply the food that is in short supply, it’s JUSTICE!”

-From unknown reference

Can you enjoy song and dance, if you are empty stomach? Can you walk towards a holy place for prayers, if you are hungry? You are provided with best playgrounds and schools; will your child be able to utilize those infrastructures, if she has not eaten food for few days? Can you survive, if you are fed with cereals alone every day? Do you think, you would like to do swimming in the swimming pool, if are fed with the food, which fulfils half of your requirements regularly? In such a situation, would you decide to for purchasing mobile phone or iPod? Your response to these questions is the response to the title of this article.

Violation of Right to Food
A vicious circle of: dispossession from land, livelihood and resources-
hunger, starvation, malnutrition
> > stunting
> > > even more dispossession and exclusion.
Creates chronic hunger leading to malnutrition, exclusion & deprivation!!
Hunger affects children the most and kills them FIRST

Let me refer to about a recent visit the Vikas Samvad made to a village in Sheopur district of Madhya Pradesh. I am from Madhya Pradesh, a state that lies at the heart of India – madhya means 'central' in Hindi – and Sheopur is an adivasi majority district - the adivasis are India’s indigenous tribal communities. The Sahariya community lives in Kakra village. The village is under Pohri Development Block. The village stretches eight kilometres along the roadside from the block headquarters.

When we entered the village we saw many children cracking nuts of a berry-like fruit to

retrieve its kernel to eat it. I sat beside the children by the side of the road, and joined them in breaking the nuts to get at the kernels. Then I asked one of the children what this fruit was? The boy pointed to a nearby mound of cattle dung and innocently told me the village cattle ate the fruit while grazing in the forest and excreted the nut along with their dung.

I was taken aback. I am sure that most of you would also have reacted similarly.

We then visited some houses in the village. All of them presented a similar picture. Pot-bellied infants in the lap of their mothers or grandmothers, peering at us through matter-encrusted eyes, munching dry roti –ie., the unleavened, homemade wheat bread that is the main stay of the Indian diet. Almost every home had about 20 kg of wheat - which is what each family gets every month through the government’s public distribution system. There was no sign of any other food grain … absolutely nothing. Upon inquiry we found that no house had pulses to be cooked for the past 20 days.

The concept of nutrition was absent in this village, and none could afford it.

Seeking drinking water, the villagers must cross the road, walk over half a kilometer downhill, to reach the two hand-pumps installed by the government. That was their only source of water and there is no water storage facilities provided in the village.

If you think this village is an exception, let me tell you I have visited scores of similar villages in the state. In fact, if you make photocopies of your mental image of Kakra you could paste them across large swathes of India.

Malnutrition is linked to food insecurity and children are its prime victims

In 2001, the People’s Union for Civil Liberties (PUCL), a civil society group, filed public-interest litigation (PIL) in the Supreme Court of India questioning the role of the state in ensuring food security for the people and to prevent starvation deaths. The PIL took the cloak off a bitter truth – that starvation was an integral part of children's lives, widowed women, the aged, the differently abled, indigenous tribes and caste groups that faced social discrimination.

Malnutrition is a national crisis today and the condition is endemic in India. Children are the most susceptible victims. A staggering 65 million children aged below five years – 42 percent of the country’s population in that age group – are inescapably trapped in its web. Of the estimated 1.47 million children in this age group who die every year (given the child mortality rate of 64 per 1,000 live-births), malnutrition is a prime cause of death in 1.1 million cases. One in every two child is under-nourished, a third of the children who die every year across the world are Indian, and 8 out of every 15 women of child-bearing age are anemic.

The Indian government conducts a National Family Health Survey every seven years to collate information on social and other factors influencing the health and nutritional status of the people. According to its third survey (2005-06), 42.5 percent of the child population is underweight, 48 percent is stunted, and only 24.5 percent was breastfed within an hour of birth.

The situation is even more dismal in the adivasi and dalit population – dalits are the most socially discriminated against castes in India’s caste system. Growth is stunted in 53.9 percent of children while 54.5 percent of adivasi children and 47.9 percent of dalit children are underweight for their age.

Figure 1

If Malnutrition is the base for drawing boundaries of country's political MAP; It is the new world!

The Indian Context
Ø  World’s second fastest growing economy at 6% to 8% growth rate; Produces 235 million tonnes of food grain annually of which 78% is wheat and rice alone; less space for other nutritious millets;
Ø  Public Distribution System (PDS) and ICDS, world’s largest food subsidy programme. Procures 85 Million tonnes food grains directly from the farmers for PDS, buffer and price stabilisation.
Ø  Yet, for 63% population that depends on agriculture situations are bad. 253000 farmers committed suicide (1995-2012) due to distress & debt. Millions of tonnes of food grain rot annually, improper storage and maintenance and hence do not reach the poor.
Ø  10 central food, employment, social security programs (Direct Food Support, Employment to Earn food and cash assistance.
Ø  Protein and energy deficiency, yet policies focus on cereals & mono-cropping.
Ø  42.5% children malnourished, more than 50% women anemic, 77% population surviving on less then US 40 cents (Rs 20) per day and 80% not getting prescribed level of energy (calories), 1.4 million child deaths every year.
Ø  Results are catastrophic. 65 million children are malnourished and a whopping 60 million stunted.
Malnutrition matters in India
Ø  High calorie gap among children ranging from 550 to 1000 calorie against ICMR standards of 1250 calories for children at the age of 1 & 1650 calories for those below 5, causing irreversible damages;
Ø  Budget allocation less than 1% for children under 6, but writes off US 537 billion in 6 years as corporate tax exemptions and reliefs;
Ø  Businesses then opposes government welfare schemes for the poor;
Ø  Governments cites lack of funds as the primary reason for rejecting demands like universalisation of ICDS;
Ø  Government promotes a targeted approach for key social welfare schemes and remains non-committal on nutritional Security in the National Food Security Bill 2011.
Perspectives on childhood hunger
Ø  Womb to grave: Malnourished mothers – condition deteriorates during infant/young feeding, most perish; Causes disability;
Ø  The families caught in the web of displacement and distress migration complicate the situation;
Ø  Diseases; lack of access to primary health services; sanitation;
Ø  Contrasts state obligation to protect rights and guarantee health;
Ø  Nutrition programme focuses on delivering cereals occasionally (as calories should come from varied sources ranging from fats to fruits), lacking universal coverage and adequate resource allocation (US $ 0.12 per day per children);
Ø  Institution and market-based approach to deal with micronutrient fortification and medicalisation of Food ;
Why?
Ø  Governance by consultation has stopped;
Ø  NFSB 2011; Only English language version of the Bill was available on WEBSITE; for a period of 25 days; no discussion out of the Parliament; advertisement published in 12 newspapers; 9 were English; when a people’s organisation takes this to the people; defined as threat to the State;
Ø  Annual budget is consulted with corporate entities not with farmers; even no scope for MPs;
Ø  Five-year plans made by Planning Commission, decides how 35% of India’s budget to be spent; without any discussion in the Parliament;
Ø  Public opinion should find respect or not??
GDP Vs Hunger
Ø  Growth-based development concept does not decline malnutrition;
Ø  GDP Growth rates (2001-2010) – 5% to 8.5%
Ø  Malnutrition declined – 0.1% per year or 1% decline in 10 Years
Ø  Nutritional poverty – increased from 64% to 80%
Ø  Increasing divide between RICH and POOR; where RICH are being treated with EQUITY in GROWTH, whereas POOR are treated with most MINIMUM WAGES.
The Buffer Stock
Ø  Buffer stock of food grains ~31 million tonnes to deal with emergency, to keep market prices stable and to feed people in different conditions. The food grain is procured from farmers on MSP in crop seasons every 6 months;
Ø  BUT State has stocks of 85 million tonnes of food grain; if you pile-up food-grain bags one above the other, it can reach the moon -- thrice;
Ø  It is rotting, Supreme Court asserted that state cannot let people die of hunger amidst this rotting of food and directed it to distribute it among the people but PM said don’t interfere in policy matters.
Malnutrition matters in India
Ø  High calorie gap among children ranging from 550 to 1000 calorie against ICMR standards of 1250 calories for children at the age of 1 & 1650 calories for those below 5, causing irreversible damages;
Ø  Budget allocation less than 1% for children under 6, but writes off US 537 billion in 6 years as corporate tax exemptions and reliefs;
Ø  Businesses then opposes government welfare schemes for the poor;
Ø  Governments cites lack of funds as the primary reason for rejecting demands like universalisation of ICDS;
Ø  Government promotes a targeted approach for key social welfare schemes and remains non-committal on nutritional Security in the National Food Security Bill 2011.
Perspectives on childhood hunger
Ø  Womb to grave: Malnourished mothers – condition deteriorates during infant/young feeding, most perish; Causes disability;
Ø  The families caught in the web of displacement and distress migration complicate the situation;
Ø  Diseases; lack of access to primary health services; sanitation;
Ø  Contrasts state obligation to protect rights and guarantee health;
Ø  Nutrition programme focuses on delivering cereals occasionally (as calories should come from varied sources ranging from fats to fruits), lacking universal coverage and adequate resource allocation (US $ 0.12 per day per children);
Ø  Institution and market-based approach to deal with micronutrient fortification and medicalisation of Food ;
Why?
Ø  Governance by consultation has stopped;
Ø  NFSB 2011; Only English language version of the Bill was available on WEBSITE; for a period of 25 days; no discussion out of the Parliament; advertisement published in 12 newspapers; 9 were English; when a people’s organisation takes this to the people; defined as threat to the State;
Ø  Annual budget is consulted with corporate entities not with farmers; even no scope for MPs;
Ø  Five-year plans made by Planning Commission, decides how 35% of India’s budget to be spent; without any discussion in the Parliament;
Ø  Public opinion should find respect or not??
GDP Vs Hunger
Ø  Growth-based development concept does not decline malnutrition;
Ø  GDP Growth rates (2001-2010) – 5% to 8.5%
Ø  Malnutrition declined – 0.1% per year or 1% decline in 10 Years
Ø  Nutritional poverty – increased from 64% to 80%
Ø  Increasing divide between RICH and POOR; where RICH are being treated with EQUITY in GROWTH, whereas POOR are treated with most MINIMUM WAGES.
The Buffer Stock
Ø  Buffer stock of food grains ~31 million tonnes to deal with emergency, to keep market prices stable and to feed people in different conditions. The food grain is procured from farmers on MSP in crop seasons every 6 months;
Ø  BUT State has stocks of 85 million tonnes of food grain; if you pile-up food-grain bags one above the other, it can reach the moon -- thrice;
Ø  It is rotting, Supreme Court asserted that state cannot let people die of hunger amidst this rotting of food and directed it to distribute it among the people but PM said don’t interfere in policy matters.

I do not see malnutrition as an accident. Nor is it caused by any disease agent like a bacteria or virus. It is a ‘systemic’ disease, the inevitable outcome of the low priority the state accords to food security. It is the outcome of children not getting nutritious food according to their developmental needs for long periods of time – or sick children not receiving proper medical and rehabilitative care. In its initial phase, malnutrition does not require medical intervention. What is needed is just plain, wholesome, nutritious food.

A weakened physique lowers immunity, ensnaring children in a web of infection and making them susceptible to illnesses such as diarrhea, pneumonia, and measles. Their physical and mental development is arrested and if their condition degenerates to a critical level, death will result. It is not a coincidence or chance that the largest number of deaths in the world from pneumonia and diarrhea occur in India.

The State’s policy priorities
Heads / Allocation by the Government of India 2012
Agriculture / Rs. 20208 Crore / US $ 3742 Million
Child Survival / Rs. 16500 Crore / US $ 3055 Million
Health / Rs. 30702 Crore / US $ 5685 Million
Defence / Rs. 193407 Crore / US $ 35816 Million

Malnutrition needs to be seen as a social and economic crisis that robs people of their ability to contribute their mental and physical labour for the well being of society.

There is a pattern behind the contradiction between ‘want’ amidst ‘plenty’

So the question we need to answer here is: Why is malnutrition endemic in India when the country is witnessing unprecedented progress, clocking the highest-ever growth rates since independence?