India in a predicament

The nation’s conscience must wake up to poverty, hunger, and health.

BY Dr. Arun Mitra20 Oct 2017 4:52 PM GMT

Whether or not the death of an 11-year child because of hunger in Simdega district in Jharkhand has shaken the conscience of those at the helm of affairs is anybody's guess, but it has definitely reconfirmed the gravity of the situation of hunger in the country. That India has been pushed to the 100th rank in the Global Hunger Index 2017 released by the International Food Policy Research Institute (IFPRI) is a cause of grave concern for our country. Our ranking is as low as Rwanda, a country which has been war-stricken for several years leading to over a million deaths as a result of civil strife. We rank even below many of our neighbouring countries such as China at 29th rank, Nepal ranked at 72, Myanmar at 77, Sri Lank at 84, and Bangladesh at 88. According to IFPRI, India has "consistently fallen into the upper half of the serious hunger levels" category in the past few years. This situation needs urgent review because nutrition is directly related to the health status.

Hunger index is calculated on the basis of nourishment status, child mortality, child wasting - which means acute malnutrition and stunting - which is regarded as chronic malnutrition. Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median.

Since 1972 poverty has been defined on the basis of money required to buy food worth 2100 calories in urban areas and 2400 calories in rural areas. Poverty is one of the main problems that have attracted the attention of sociologists and economists. It indicates a condition in which a person fails to maintain a living standard adequate for his physical and mental efficiency. Poverty is the major cause of nutrition-related health problems. Poverty and malnutrition adversely affect productivity.

A balanced diet with all ingredients is needed to remain healthy. These requirements are met by carbohydrates, protein, fats, minerals, and vitamins. All these are essential for our physical and mental growth. Because of lack of supply of these nutrient materials, there occur multiple physical problems like lack of appetite, fatigue, diarrhoea, weakness, slower breathing, numbness of hands and feet, dryness of skin, loss of hair, subcutaneous haemorrhagic spots etc. The mental changes occur in the form of irritability, lack of concentration, reduced receptive capacity.

Malnutrition as a result of hunger may lead to Marasmus and Kwashiorkor. Marasmus occurs more often in young children and babies. It leads to dehydration and weight loss. Starvation is a form of this disorder. The symptoms of Marasmus include weight loss, dehydration, chronic diarrhea and shrinkage of stomach.

Kwashiorkor occurs in people who have severe protein deficiency. Having a diet of mainly carbohydrates and deficiency in protein lead to this condition. Common symptoms of Kwashiorkor include oedema or puffy or swollen appearance due to fluid retention, bulging of the abdomen and inability to gain weight.

The protein and fat requirements are 48 gms and 28 gms per capita per day, respectively, in rural areas; and 50 gms and 26 gms per capita per day in urban areas. Poverty line set by the government denotes a monthly per capita consumption expenditure of Rs.972 in rural areas and Rs.1,407 in urban areas in 2011-12. For a family of five, this translates into a monthly consumption expenditure of Rs.4,860 in rural areas and Rs.7,035 in urban areas. With increase in the cost of living, the BPL definition of the government that a person earning Rs.32 per day in rural and Rs.47 per day in urban areas is not at all realistic. This is not even sustenance wage because to lead a life one needs not only food, there are other requirements as well.

(Dr. Arun Mitra is senior vice President Indian Doctors for Peace and Development, Former Chairman Ethical Committee Punjab Medical Council & Member core committee ADEH (Alliance of Doctors on Ethical Healthcare) Views are strictly personal.)

India in a predicament

The nation’s conscience must wake up to poverty, hunger, and health.

Dr. Arun Mitra

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