As the infection rates go up, job losses increase and workers leave cities to walk back home, there is a silent food crisis striking the country. The levels of malnutrition and Severe Acute Malnourishment (SAM) are bound to go up significantly. Those who will bear the brunt of this debacle the most are children and expectant mothers, who must have healthy and nutritious food now but are denied even basic calories. Those who are falling ill among these are suffering from huge weight losses that will come about because of 15 days of high fever in any case.
This tragedy will play out in various horrifying ways in the future and must be addressed right away. Our stimulus package promises large amounts of money as loans, which will take time to reach the poor, while hunger is an immediate problem as former Reserve Bank of India governor Raghuram Rajan pointed out recently.
Over the last 15 years, ever since the District Level Health Survey in 2004 showed that 53% of children in India’s worst-affected 100 districts were underweight, there has been a steady improvement in these numbers. The Mid-day Meal Scheme, National Health Mission, Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), increased outlays for Integrated Child Development Services (ICDS), rise in women’s groups, self-help groups (SHGs), and a decisive movement by the current government towards setting up the POSHAN Abhiyaan have shown improvements.
Nutrition had finally got its due. However, with such massive increases in unemployment and impoverishment in the last two months, there seems to be a significant backsliding. Most surveys being done show that up to 70% of respondents report food distress.
Vinita Bali, one of the most vocal nutrition champions, says clearly that, “I fear that this spell of hunger and malnutrition will take us back a significant distance. While for a small minority, this hiatus will not matter, a large section of our population, particularly the migrants, will suffer from the disruption in food supply and will negate all our recent achievements in nutrition security.”
Most of the 1.4 million Anganwadi centres, where food is distributed from, have all but stopped working. This was where the poor children and women got their food from. Despite this huge disruption, there is no public discourse nor a statement from any responsible official about any attempt to correct this massive debacle.
The 120 million mid-day meals that were being fed to children across the country have been stopped. Children are suffering the most because of this lockdown and they do not have reserves that can help them through this extended period of denial of food and nutrition.
The fear of a resurgence in SAM cases is real, and that would be catastrophic. We need to strengthen the Community-based Management of Acute Malnutrition (CMAM) in the country again. More than 40% of the world’s SAM cases are found in India. This number will likely go up as we are now unable to feed our children. CMAM would help as it provides treatment and therapeutic food to those suffering from SAM.
What we should remember is that there is enough evidence that the denial of nutritious food to expectant mothers results in a serious and long-term impact on the country’s population. Purnima Menon of the International Food Policy Research Institute (IFPRI) points out the criticality of nutrition when she says: “The impact of the Dutch Food crisis post World War II is a significant case study that shows that pregnant mothers who went without food then gave birth to children who suffered lifelong disabilities. This is because of the metabolic imprint in the fetus that does not get adequate food. Expectant mothers should never go hungry.”
It is important to note that roughly 70,000 babies are born every day in the country. Those being born now face several challenges. Institutional deliveries themselves have come down, mothers are impoverished and hungry, hospitals are prone to opportunistic infection and vaccination facilities have been withdrawn.
Menon insists that the government should be tackling food insecurity closely. Large datasets like the National Sample Survey Office (NSSO) should include direct questions on people’s food and nutrition distress. We should also record carefully antenatal visits, Anganwadi worker outreach and their impact on women’s health.
Vinita Bali suggests that in a situation where we cannot supply mid-day meals, Anganwadi centres should ramp up the provision of dry food ration, maybe even double or triple the quantity given till now. There will be some oversupply. But we should not worry about any overdistribution now, even if it is up to 30% of what we need.
Our godowns are stacked and overflowing with 77 million tonnes of foodgrains already. If not now, when are we going to use this reserve? In any case, the food supply chain wastes more than that due to poor storage and transportation.
(Dr Amir Ullah Khan is Fellow at Rajiv Gandhi Institute for Contemporary Studies, New Delhi, and Saleema Razvi is Health Economist at the Copenhagen Consensus Centre)
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