Monday, March 15, 2010

Malnutrition Challenge in India, Pakistan

Although it's a subject I have often written about, this particular post about fighting child malnutrition is inspired by a recent email from Col. Pavan Nair, an Army officer turned social activist, and a patriotic Indian with a deep sense of service to those in the greatest need in his country and its neighborhood.



In 2009, the Indian government banned the import of Plumpy'Nut nutrient bar by UNICEF to treat moderate to severe acute malnutrition among Indian children. Defending the government action, Mr. Shreeranjan, the joint secretary of the Ministry of Women and Child Development, told the Reuters that "Nothing should come behind our back. Nothing should be done in the name of emergency when we have not declared an emergency."



Clearly, Mr. Sheeranjan does not see the food emergency that is causing almost half of India's children to be malnourished. According to UNICEF's State of the World's Children's report carried by the BBC, India has the worst indicators of child malnutrition in South Asia: 48% of under fives in India are stunted, compared to 43% in Bangladesh and 37% in Pakistan.

Meanwhile 30% of babies in India are born underweight, compared to 22% in Bangladesh and 19% in Pakistan. UNICEF calculates that 40% of all underweight babies in the world are Indian.

Malnutrition is the leading cause of death in children in developing countries, including India and Pakistan. According to World Health Organization about 60% of all deaths, occurring among children aged less than five years in developing countries, could be attributed to malnutrition.

Those who survive the trauma of early childhood malnutrition suffer various degrees of brain damage and continue to lack sufficient cognitive and motor skills later in life.

According to World Bank's HNP (Health and Nutrition) paper "India's Undernourished Children", here is some data on the scale of the problem India faces:

1. 47% of Indian children under 5 suffer from malnutrition.
2. 60 million in all, highest in the world.
3. Two million Indian children under 5 die each year.
4. At least one million of them die from low immunity attributable to malnutrition.
5. Ten million children out of the statistical range a year suffer from lack of motor and cognitive skills for the rest of their lives.
6. Most of the retardation occurs between two to three years of age.

In the face of such shocking data, what is particularly disturbing is the lack of focus in pursuing solutions to this problem that affects tens of millions of children in the developing world, especially in sub-Saharan Africa and South Asia.

If the governments, such as India, are concerned about dependence on foreign food imports, they need to have policies and plans in place to encourage development of local alternatives to what are called ready to use therapeutic food (RUTF) bars such as Plumpy'Nut made from fortified peanut paste.

Community-based therapeutic care is being pushed in Pakistan by an Agha Khan University project. It is an attempt to maximize broad impact through improved coverage, access, and cost-effectiveness of treatment for malnutrition. Such community-based nutrition packages can provide effective care to the majority of acutely malnourished children as outpatients, using techniques of community mobilization to engage the affected population and maximize coverage and compliance. Children with SAM without medical complications are treated in an outpatient therapeutic program with ready-to-use therapeutic food and routine medications. It proposes the use of Ready-to-use Therapeutic Food (RUTF) and Fortified Supplementary food for the treatment of moderate and severe malnutrition. The advantage of these commodities is that they are ready-to-use paste which does not need to be mixed with water, thereby avoiding the risk of bacterial proliferation in case of accidental contamination.

While the advantages of the RUTF solutions such as Plumpy'Nut and Cipla's generic equivalent Nutrinut are proven, the cost of such treatment needs to be made a lot more affordable than it is. A standard Plumpy'nut treatment goes for four weeks (twice a day) at a cost of 12 Euros in Africa. India's Cipla also makes a generic version of Plumpy'Nut. It's being used in Nepal for Nepali Rupees 52 (~75 US cents) for a 500 Kcal bar. At 92 grams net weight; 12.5 grams protein; 32.86 grams lipid). It has the same nutritional content of F-100 milk formula and plumpy’Nut.



On the extreme affordability front, Bangladesh is setting an example for others to follow. Bangladeshi Nobel Laureate Mohammad Younus's Grameen, in joint venture with Danone of France, is producing a special yogurt called Shakti Doi from pure full cream milk that contains protein, vitamins, iron, calcium, zinc and other micronutrients to fulfill the nutritional requirements of children of Bangladesh and contribute in improving their health. While 'Shakti Doi' (which means 'power yogurt') is primarily intended for children, it is also appropriate for adults. The price of each 80 gram cup of yogurt is only 5 takas, equivalent to Euro 0.05 (five cents). It is an affordable price even for the poor people of Bangladesh. It's locally made and significantly cheaper than Plumpy'Nut, costing about one-tenth of the cost of solutions offered outside Bangladesh.

In his email to me, Col. Nair has proposed a solution for India with the target cost of one Indian rupee or less. His solution seeks to address protein energy malnutrition (PEM), iron deficiency anemia (IDA), and vitamin A deficiency (VAD) found among Indian children. Nair's idea is to develop a nutrient bar consisting of locally produced oats mixed with honey and crushed peanuts weighing about 15-20 grams, and fortified with iron (50%), vitamin A (75%), vitamin B6 and B12 (25% each), vitamin C (50%), vitamin E (50%), Iodine (50%), zinc (50%), and other nutrients like biotin, folic acid, calcium, sodium and potassium.

I am not a nutritionist. However, I do think Col. Nair's proposal to develop a low-cost solution to address the massive problem of child malnutrition in India and Pakistan deserves a serious look and concrete follow-up. It's an opportunity for social entrepreneurs and the corporate sector to jump in with their creative energies and dollars to meet the challenge thrown by Col. Nair. Meeting this common challenge as joint India-Pakistan effort will ensure a better future for all south Asians, and bigger future profits from a brainy, healthy and highly productive next generation of Indians and Pakistanis.

Related Links:

Child Malnutrition India Video

Persistent Hunger and Malnutrition in South Asia

Social Entrepreneurs Target India and Pakistan

Light a Candle, Don't Curse Darkness

Grinding Poverty in Resurgent India

Amartya Sen on Hunger in India

India Tops World Hunger Chart

Food, Clothing and Shelter in India and Pakistan

Mixed Messages in Hunger Report

ActionAid's World Hunger Score Card

World Food Program in India

World Food Program Pakistan

28 comments:

Anonymous said...

I agree with the thought of the plight of the poor in the developing country. However to some extent it is the making of these poor. Carefull analysis will reveal that the family size of the poor is larger than the middle class or rich. government give focus for educating the people for smaller family along with the subsidies otherwise, it will only allow procreation of lazy who produce and leave the child for the responsibility of the government which is already corrupt and inefficient.

Riaz Haq said...

anon: "Carefull analysis will reveal that the family size of the poor is larger than the middle class or rich. government give focus for educating the people for smaller family along with the subsidies.."

Ignoring the problem, or blaming the poor victims, will not make the problem go away.

And even if we assume momentarily that you are justified in blaming the parents, it is callous to punish the innocent children born to these parents. It is the responsibility of the state, the corporate sector, the philanthropists, and the more fortunate in society, to break the vicious cycle of poverty, illiteracy, and ill-health and make the children contributing members of society in the future.

Pavan said...

Excellent post! Thanks very much. It has improved on what I have
suggested. I have sent this to the Planning Commission. Syeda Hammed
who is taking care of the women and child department has acknowledged
but you know how our governments work. We have to get someone like
Indira Nooyi involved. Does Pepsico have a presence in Pakistan?

Riaz Haq said...

Pavan,

I am impressed with Syeda Hameed's repeated acknowledgment of the problem. Let's hope it turns into concrete action soon.

As to the corporations like Pepsico, they do have substantial presence in Pakistan, with lots of advertising dollars used in sponsoring sports. They will have to be shamed into acting to help the poorest of the poor who are not their target market.

Riaz Haq said...

Here's shocking study about lead poisoning from popular Indian spices, as reported by ABC News:

A study published today in the journal Pediatrics said young children who regularly ingest some imported Indian spices may be exposed to lead -- a dangerous neurotoxin.

The study, conducted from 2006 to 2008, followed patients from the Pediatric Environmental Health Center at Children's Hospital in Boston who had ingested or been exposed to Indian spices and powders.

One 12-month-old boy in the case study was found to have lead poisoning after regularly eating spices such as tumeric, black mustard seed and asafetida.

When the family discontinued use of the spices, his blood lead levels went down within six months.

But of greater concern to researchers are religious powders like cherry-colored "sindoor" -- which is applied cosmetically on the skin and which Tilak also uses routinely in her home.

Some of these ritual powders comprise 47 to 64 percent lead, according to the study, and can be particularly dangerous when applied on young children.

Food products had a lower percentage of lead compared with powders, but researchers were particularly concerned about children who are chronically exposed to these products -- up to several times a week -- at a young age.

Anonymous said...

Well, in India's case there is no emergency (situation concerning hungry bellies) unless one is declared officially.

The Hague Convention's purpose, among other things, was to make life easier for the world's citizenry in the matter of trans-national documentation. India is a signatory but discards the Convention and insists on pre-Convention attitudes. But it gets the hapless citizen to sign a waiver of insistence on the same Convention in it's favor.

So an emergency concerning hungry people does not exist if the government does not say it does. And, anyway, UNICEF is just there for job opportunities.

Anonymous said...

A old proverb is that god helps people who helps themself. I am not for a moment saying that the children must be punished for the mistake of the parents, however even developed countries / oil rich countries are not in a position to subsidies unlimited attention as the funds are not available with the government.

Further these illiterates only vote the most corrupt politicians to power. Today mayawati the so called representative of dalit was wearing a mala of 1000 inr note. It is estimated that the mala might be worth crores.

It is this uneducated masses who create the monster like mayawati.

If you carefully observe that the self made millionaires of india do contribute more for the social cause than the corrupt politicians. Since the power is in the hands of the politicians who are elected by these poor ignorant people, nothing can be done for them.

Riaz Haq said...

Here's a recent report on high food prices in India which are likely to worsen food access for the poor and the children:

New Delhi, Feb 4 (IANS) India’s annual food inflation based on wholesale prices rose to 17.56 percent for the week ended Jan 23 from 17.4 percent the week before, according to official data released Thursday.
Prices of some essential items remained firm with vegetables dearer by 13.02 percent and fruits by 6.54 percent during the 52-week period. However, prices of onions fell 10.5 percent.

The limited data on the wholesale index released by the commerce and industry ministry further showed that while the index for primary articles fell 14.56 percent, that for fuels rose 5.88 percent.

India’s overall inflation rate, based on the wholesale prices index, had risen sharply to 7.31 percent in December from 4.78 percent the previous month mainly on account of higher food prices.

The price rise of some essential food items over the 52-week period:

- Potatoes: 44.91 percent

- Pulses: 44.43 percent

- Cereals: 13.37 percent

- Rice: 10.96 percent

- Milk: 13.95 percent

- Wheat: 15.96 percent

- Vegetables: 13.02 percent

- Fruits: 6.54 percent

Prime Minister Manmohan Singh is slated to discuss the issue of price rise with state chief ministers Feb 6. The meeting was earlier scheduled for Jan 27.

Riaz Haq said...

Here's a BBC report about Kerala's economy and social indicators:

Kerala defies all stereotypes of a "socially backward" Indian state - swathes of people living in abject poverty, men outnumbering women because of female foeticide, internecine caste politics.

Many of its social indicators are on par with the developed world and it has the highest human development index in India.

It also has the highest literacy rate (more than 90%) and life expectancy in India, lowest infant mortality, lowest school drop-out rate, and a fairly prosperous countryside.

That's not all.

In contrast to India's more prosperous states, like Punjab and Haryana, Kerala can boast a very healthy gender ratio - women outnumber men here.

Life expectancy for women is also higher than for men, as in most developed countries. Thanks to a matrilineal society, women, by and large, are more empowered than in most places in India.

When it comes to low population growth, Kerala competes with Europe and the US. And all but two districts of the state have a lower fertility rate than that needed to maintain current population levels.
----------------
And thanks to pioneering land reforms initiated by a Communist government in the late 1950s, the levels of rural poverty here are the lowest in India. Decent state-funded health care and education even made it the best welfare state in India.

Yet, today, Kerala is a straggler economy almost entirely dependent on tourism and remittances sent back by two million of its people who live and work abroad, mostly in the Gulf.

Joblessness is rife due to the lack of a robust manufacturing base - more than 15% in urban areas, three times the national average. More than 30 million people live in the densely populated state, a third of which is covered by forests

More people here are taking their lives than anywhere else in India. Alcoholism is a dire social problem - the state has India's highest per capita alcohol consumption. People migrate because there are no jobs at home.
---------------------------------
Clearly, Kerala needs a new contract between the state and its people to move ahead and build upon its enviable gains.

Anonymous said...

*Citizens for Justice and Peace*
Saturday 20, 2010

Urgent Media Invite

Release of Tehelka Tapes in the Public Domain

Selected Tapes of the Sting Operation where Interviewees who speak of the
Direct and Indirect Role of Shri Narendra Modi in the 2002 massacre

*Press Invite*

*Press Conference: Victim Survivors and CJP address the Media*

*Venue: PRASHANT, DRIVE IN ROAD*
*Time: 2 p.m.*
*Date Monday, March 22, 2010*


*The summons to chief minister Narendra Modi on charges of mass murder and
criminal conspiracy is historic and unprecedented.*
___________________________________________________________________________

The present complaint against chief minister Narendra Modi and 61 others is
being investigated by the Special Investigation Team (SIT) following an
order of the Supreme Court of India in SLP 1088/2008 filed by Smt Zakia
Ahsan Jafri and Citizens for Justice and Peace (CJP) asking for registration
of an FIR on charges of mass murder and criminal conspiracy. This complain
was dated June 8, 2006 and went uninvestigated and non-registered by the
Gujarat police who was by the time it was sent, headed by Shri PC Pande
former Commissioner of Police Ahmedabad, by then promoted to seniormost
police officer, Director General of Police , Gujarat.

While the matter was still in the Gujarat High Court a tremendous boost to
the complainants was given by the exposure of the extrajudicial confessions
of Tehelka’s Operation Kalank (October 25-27 2007) that, in many parts spoke
of the direct role of chief minister Narendra Modi in directing and
masterminding the massacre. These tapes have been authenticated by the CBI
under direct orders of the National Human Rights Commission. Both the
Gujarat High Court and the Supreme Court of India directed that they be used
as evidence at the appropriate time.

Today, *Tehelka,* a magazine devoted to the public interest has agreed to
release portions of these tapes in the public domain especially those
portions that speak of the direct role of Shri Modi. We, at CJP
representing the victim survivors of the Gujarat genocidal carnage of 2002
acknopwledge the role of *Tehelka* and put these out in the public domain as
evidence. So far they were restricted for use to one news channel, severely
limiting their reach.

Hence, victim survivors and CJP together, acknowledging our gratitude to *
Tehelka* release these in the public interest.


*Tehelka’s Operation Kalank*

*Modi’s Direct Role*



Please do attend and give wide coverage to the conference.
*Teesta Setalvad*
*Secretary *
*CJP *

*Nirant, Juhu Tara Road, Juhu, Mumbai – 400 049. Ph: 2660 2288 email:
cjp02in@yahoo.com, teesteesta@gmail.com*

Riaz Haq said...

Here's an interesting commentary on India's growing social inequality threatening stability published in Fast Company:

Can a country where a third of the population is illiterate be an Information Technology superpower? Can a country where 78 million rural homes have never seen electricity be an economic superpower? Can anyone feel safe living in islands of prosperity in a sea of poverty? While India’s educated elite are reveling in their new found status on the global stage, inequitable distribution of wealth and opportunities are shaking the very foundation of India’s new economy. Will the Indian government’s apathy towards the rural poor bring India’s party to an abrupt end?

In the last 12 years, India's economy has grown at an average annual rate of about 7 percent, reducing poverty by 10 percent. However, 40 percent of the world's poor still live in India, and 28 percent of the country's population continues to live below the poverty line. More than one third live on less than a dollar a day, and 80 percent live on less than two dollars a day. India's recent economic growth has been attributed to the service industry, but 60 percent of the workforce remains in agriculture.

The rate of increasing disparity between the ‘haves’ and the ‘have-nots’, is hard to miss in tech centers like Bangalore, Chennai and Delhi. Technology professionals are returning, having made their millions in the US. They are driving expensive cars and living in luxury apartments. Cities are growing in all directions. Farmlands are being acquired to build luxury townships, golf courses, five star hotels, spas and clubs. Poor farmers get paid off, and are forced to move further away from the city. And while global leaders and businessmen wax eloquent about India’s growing status as an IT superpower, everyone turns a blind eye to the majority of the population untouched by the economic growth.

And the scenario is not too different in smaller cities. Nagpur is a bustling metropolis in the heart of India, in a region known as Vidarbha. There are signs of economic boom everywhere in the city – shopping arcades, multiplexes, pubs, and luxury clubs. Yet, right outside the city, farmers are committing suicide due to their inability to repay debts as small as $100. In the last five years, almost two thousand farmers in the region have killed themselves.
------------
While, the government must own primary responsibility for social upliftment, the answer to India’s woes probably lies in a public-private partnership towards addressing India’s deprived poor. It’s happening in pockets. Companies like the Tata Group have ingrained social responsibility in their DNA. Azim Premji Foundation, promoted by the Wipro Chairman, is working with state governments to improve grassroots level education in rural India. What’s probably now needed is for all private enterprises and government bodies to collaborate, to create a larger, more meaningful, nationwide impact.

Corporations should not view it purely from a philanthropic perspective. A bigger pool of educated and employable population will mean availability of better quality human resources. And a stable society creates a far more secure environment to do business in. Cleansing the environment where you are running your operations definitely makes better long term business sense. And the sooner corporations realize this, the better it is for everyone.

Riaz Haq said...

India has unofficially become the world's child death capital, with a study claiming that over 5,000 children die in the country every day of "totally preventable causes". According to the study, Child Health Now, by the NGO World Vision, India accounts for the highest number of child deaths (under five years of age) in the world at 1.95 million per year.

The study revealed that the majority of the deaths occur in the child's first year itself. The causes included diarrhoea, pneumonia and neo- natal problems.> Simple life- saving measures such as oral rehydration solutions, basic vaccinations, breastfeeding and using mosquito nets could bring down the dismal number by more than two thirds, the report said.

Nigeria and the Democratic Republic of Congo follow India in the list. Together, the three nations account for 40 per cent of the total child deaths in the world. It was also found that the three countries allocated the least share of funding - less than three per cent - to maternal and child heath in the health sector allocation.

Reni Jacob, the advocacy director for World Vision India, said, "When hundreds die in a disaster, it is considered an emergency. But when 5,000 children die every day, it is not considered one. This is the biggest human rights and child rights violation of all times." The fact that simple interventions can go a long way in preventing child deaths is evident from the disparities that exist within India itself. While states like Orissa have a high infant mortality rate of 10 per cent, in others like Kerala, the rate is just a little over 1 per cent. And that is primarily because of initiatives in child care and maternal health services.

Indeed, the report found that children in states like Uttar Pradesh and Bihar are more vulnerable than those in Kerala and Tamil Nadu. In Bihar, less than one- third infants are breast- fed and 50 per cent of children are stunted because of malnutrition. The state has a high infant mortality rate of 85 deaths per 1,000 live births.

World Vision has launched a five- year campaign in India to address the alarming situation. It has also urged the government to revamp the National Rural Health Mission and widen the focus of the Integrated Child Development Scheme to less than three- year- olds.


http://gregmathews.livejournal.com/19622.html

March 30, 2010 5:54 PM

Riaz Haq said...

Here is a Times of India report about Transparency International Survey:

Around seven lakh BPL households in India paid bribe in the last one year to avail services related to school education of their children - the total amount paid as bribe being estimated to be around Rs 12 crore. Another nine lakh BPL households used contacts to get their child admitted or promoted in school. However, another five lakh BPL households weren't that lucky - their children couldn't avail such services because they were either too poor to pay bribe or had absolutely no contact or influence to use as an advantage.

The survey - that covered 22,728 randomly selected BPL households across 31 states and union territories - said a majority of those who paid bribe did so for getting their children admitted in the school or for getting promotion of their children from one class to another. Issuing school-leaving certificate was another lucrative business for corrupt schools authorities. However, the amount bribed was highest when it came for allotment of hostel. In comparison, a higher proportion of urban BPL households (40%) paid bribe for new admission and issuance of certificate as against rural areas (33%).

On the other hand, a higher proportion of rural BPL households (32%) paid bribe for promotion of their children from one class to another as against urban households (28%). The same is the case in applying for scholarship where 12% rural BPL families paid bribe compared to 3% urban BPL households. Of those who paid bribe, 86% paid it directly to officials of the school while 12% paid it through middlemen.

According to the report, on an average, a BPL household had to pay Rs 171 as bribe in the last one year related to school education of their children. While looking at states with moderate or high corruption in the school education sector, the level of corruption in Bihar, Uttar Pradesh, Meghalaya and Goa was found to be “alarming”.

Riaz Haq said...

The Development Set

By Ross Coggins

Excuse me friends, I must catch my jet,
I’m off to join the Development Set.
My bags are packed and I’ve had all my shots;
I have travelers checks and pills for the trots.

The Development Set is bright and noble.
Our thoughts are deep and our vision global.
Although we move with the better classes,
Our thoughts are always with the masses.

In Sheraton Hotels in scattered nations,
We damn multi-national corporations.
Injustice seems easy to protest,
In such seething hotbeds of social unrest.

We discuss malnutrition over steaks
And plan hunger talks over coffee breaks.
Whether Asian flood or African drought
We face each issue with open mouth.

We bring in consultants whose circumlocution
Raises difficulties for every solution,
Thus guaranteeing good eating
By showing the need for another meeting.

The language of the Development Set
Stretches the English alphabet.
We use swell words like “epigenetic”
“Micro”, macro and logarithmatic.

It pleasures us to be esoteric—
It’s so intellectually atmospheric!
And though establishments may be unmoved,
Our vocabularies are much improved.

When the talk gets deep and you’re feeling dumb,
You can keep your shame to a minimum.
To show that you, too, are intelligent,
Simply ask, “Is it really development?”

Or say, “That’s fine in practice, but don’t you see,
It doesn’t really work in theory.”
A few may find this incomprehensible,
But most will admire you as deep and sensible.

Development Set homes are extremely chic,
Full of carvings, curios and draped with batik.
Eye-level photos subtly assure
That your host is at home with the great and the poor.

Enough of these verses—on with the mission!
Our task is as broad as the human condition.
Just pray God the biblical promise is true,
The poor ye shall always have with you.

Riaz Haq said...

In rural Pakistan where about 70% of Pakistanis live, people spend 55% of their income on food, according to a World Resources Institute (WRI) report.

The bottom two BOP (Bottom of Income Pyramid) groups alone account for more than 50% of national food spending in Pakistan. Average annual food spending per household in the BOP in Pakistan is $2,643. While BOP3000 households have 6 times as much income on average, they outspend BOP500 households in the food market by a ratio of only 2:1 in Cameroon, 2.3:1 in South Africa and Pakistan, 2.4:1 in Kazakhstan, 1.9:1 in Uzbekistan, and 3:1 in Peru.

Currently, food inflation in Pakistan is running at 15.49 percent, hitting the poor the hardest.

According to a recent Daily Times report, Non-perishable food item prices increased 14.76 percent whereas perishable food items recorded 21.30 percent increase in their prices.

Fuel & lighting index rose 20.19 percent during January this over the last year whereas house rent index posted 13.38 increase this month.

Transport & communication index rose 9.43 percent, education expenses increased 13.68 percent and medical expenses increased 5.88 percent.

The detailed analysis of the SPI prices for Jan-10 reveals that few items, within the food category, were observed to post over 100bps MoM increase in prices. Sugar (1.92 percent weight in the CPI) remained exceptional with 19 percent MoM increase and food prices (40.3 percent weight in the CPI) contributed passively this time around to the CPI in Jan-10 due to being relatively stable.

Riaz Haq said...

In a recent interview, food campaigner Jean Dreze aid, "For Indians to eat like the Chinese, let alone the French or the Italians, there will have to be a lot more food around."

Here are some excerpts from it:

"Firstly, I would not agree that India is “self-sufficient” in food production. It looks self-sufficient only because food intake is abysmally low, not only in terms of quantity but also in terms of quality. For Indians to eat like the Chinese, let alone the French or the Italians, there will have to be a lot more food around. Having said this, low food production is not the main issue, and food production itself would easily go up if there were enough purchasing power among the masses. The main issue is people’s inability to secure essential things that are required for good nutrition. These include not only food but also other inputs such as clean water, health care, sanitation, basic education and child care. All these fields of public policy have been grossly neglected for a long time."

"The NREGA can certainly help, and it does. In a recent survey of 1,000 NREGA workers conducted in 10 districts of North India, 69 per cent of the respondents felt that the NREGA had “helped them to avoid hunger” [see “The Battle for Employment Guarantee”, Frontline, January 2009]. But even if the NREGA functioned really well, which is not the case, it would have a limited impact on the nutrition situation, for many reasons. Some people are unable to participate in NREGA work because of illness, disability, old age, and so on. Those who do participate earn a meagre income at best, even if they work for 100 days in the year. And most importantly, good nutrition is not a matter of income alone. This applies especially to child nutrition, which is the foundation of good nutrition for all.

Even among households that are relatively well-off in economic terms, child under-nutrition is not uncommon, for reasons that can range from low birthweight and poor breastfeeding practices to lack of health care or gender discrimination. This is why a range of complementary interventions are required. It would be pointless to expect a single intervention, whether it is the NREGA or the PDS or the ICDS, to ensure food security."

Riaz Haq said...

Part of the problem fueling anger and insurgencies is the growing number of the poor in India. Here's a recent Reuters report:

India now has 100 million more people living below the poverty line than in 2004, according to official estimates released on Sunday.

The poverty rate has risen to 37.2 percent of the population from 27.5 percent in 2004, a change that will require the Congress-ruled government to spend more money on the poor.

The new estimate comes weeks after Sonia Gandhi, head of the Congress party, asked the government to revise a Food Security Bill to include more women, children and destitutes.

"The Planning Commission has accepted the report on poverty figures," Abhijit Sen, a member of the Planning Commission told Reuters, referring to the new poverty estimate report submitted by a government panel last December.

India now has 410 million people living below the U.N. estimated poverty line of $1.25 a day, 100 million more than was estimated earlier, officials said.

India calculates how much of its population is living below the poverty line by checking whether families can afford one square meal a day that meets minimum nutrition needs.

It was not immediately clear how much more the federal government would have to spend on the poor, as that would depend on the Food Security Bill when it is presented to the government after the necessary changes, officials say.

India's Planning Commission will meet the food and expenditure secretaries next week to estimate the cost aspects of the bill, government officials said.

A third of the world's poor are believed to be in India, living on less than $2 per day, worse than in many parts of sub-Saharan Africa, experts say.

http://in.reuters.com/article/topNews/idINIndia-47791820100418

Riaz Haq said...

Here are some excepts of Nehru University's Prof Jayanti Ghosh's video interview on Real News Network in which she says there is "no Indian miracle":

JAY: So in India you're saying there never was major reforms and it's getting worse.

GHOSH: Absolutely. If you look at the pattern of Indian growth, it's really more like a Latin American story. We are now this big success story of globalization, but it's a peculiar success story, because it's really one which has been dependent on foreign—you know, we don't run trade surpluses. We don't even run current account surpluses, even though a lot of our workers go abroad to Saudi Arabia and the Gulf, to California, as IT workers. We still don't really run current account surpluses. So we've been getting capital inflow because we are discovered as this hot destination. You know, we are on Euromoney covers. We are seen as this place to go. Some of our top businessmen are the richest men in the world. They hit the Fortune top-ten index. All of that kind of thing. This capital inflow comes in, it makes our stock market rise, it allows for new urban services to develop, and it generates this feel-good segment of the Indian economy. Banks have been lending more to this upper group, the top 10 percent of the population, let's say. It's a small part of the population, but it's a lot of people, it's about 110 million people, which is a pretty large market for most places. So that has fuelled this growth, because otherwise you cannot explain how we've had 8 to 10 percent growth now for a decade. Real wages are falling, nutrition indicators are down there with sub-Saharan Africa, a whole range of basic human development is still abysmal, and per capita incomes in the countryside are not growing at all.

JAY: So I guess part of that's part of the secret of what's happening in India is that the middle, upper-middle class, in proportion to the population of India, is relatively small, but it's still so big compared to most other countries—you were saying 100, 150 million people living in this, benefiting from the expansion. And it's a lot bigger. It's like—what is it? Ten, fifteen Canadas. So it's a very vibrant market. But you're saying most of the people in India aren't seeing the benefits.

GHOSH: Well, in fact it's worse than that. It's not just that they're not seeing the benefits. It's not that they're excluded from this. They are part of this process. They are integrated into the process. And, in fact, this is a growth process that relies on keeping their incomes lower, in fact, in terms of extracting more surplus from them. Let me just give you a few examples. You know, everybody talks about the software industry and how competitive we are. And it's true. It's this shiny, modern sector, you know, a bit like California in the middle of sub-Saharan Africa. But when you look at it, it's not just that our software engineers achieve, it's that the entire supporting establishment is very cheap. The whole system which allows them to be more competitive is one where you are relying on very low-paid assistants, drivers, cooks, cleaners. You know, the whole support establishment is below subsistence wage, practically, and it's that which effectively subsidizes this very modern industry.

Riaz Haq said...

Here is a Dec 2006 report published in The Telegraph, Calcutta, India, that deals with birthrates and other demographic differences in India:

Narendra Modi should take note. The Sachar committee debunks the myth that Muslims have more children than other communities.

“Strictly speaking, there is no ‘Muslim fertility’ as such in the sense that Muslims in general cannot be identified as having a particular level of fertility,” says the panel’s report, tabled in Parliament on Thursday.

Muslims have a low fertility rate in states with low fertility rates. “Muslims in southern states have lower fertility than in northern and central states,” says the committee, tasked to find out Indian Muslims’ status in all spheres of life and activity.

A myth within the myth has been that Muslims have more children because they marry early. “Data, however, show that Muslims do not have a lower age at marriage than the average,” Sachar says.

The report asserts that over a third of Muslim couples do use some form of contraception. “Data in the National Family Health Survey show the use of contraception is widely prevalent among Muslims, though to a lesser degree than the average.”

The bogey of Muslims’ “higher” fertility — and the demographic “threat” it poses to Hindus — has held sway for decades. Modi, Gujarat’s Muslim-baiting BJP chief minister, had played on this fear a few years ago with his mock slogan “hum paanch, hamara pachis (the five of us and our 25 children)”.

Sachar also reveals that only 4 per cent of Muslim students go to madarsas; most of the rest go to government or government-aided schools.

He then goes on to make a surprising revelation. For all the disadvantages Indian Muslims suffer from, the mortality rate among infants and under-fives in the community is lower than that among Hindus (excluding the scheduled castes and scheduled tribes).

Christians and Sikhs have an even lower mortality rate.

“The scheduled castes and scheduled tribes suffer the highest infant and under-five mortality rate followed by the Hindus. Muslims have the second-lowest infant and under-five mortality rate among all socio-religious communities,” the report says. “This is somewhat surprising given the economically disadvantaged position of Muslims.”

One possible explanation could be the higher urbanisation of the community. Yet the finding seems to fly in the face of accepted wisdom.

Socio-economic variables that are supposed to reduce child mortality rates include the mother’s education as well as the household’s socio-economic status and access to safe drinking water, sanitation and electricity.

But Muslims in general have lower levels of income and education. “The only states where child mortality among Muslims has worsened are Madhya Pradesh and Rajasthan,” Sachar says.

The advantage in infant and under-five mortality is not carried over to the later stages of childhood. “Muslims suffer from the highest rates of stunting and the second-highest rate of underweight children among all social groups.”

But Sachar admits that the difference is negligible. Hindu children, too, are at high risk of stunted growth and malnutrition, while the SC/STs fare worse than Muslims.

Riaz Haq said...

Here's a BBC report about India considering declining British aid:

The Indian government is debating whether it should still accept any development aid from Britain.

India is currently the biggest recipient of UK development aid, receiving more than £800m (about $1.25bn) over the three years to 2011.

Foreign Secretary Nirupama Rao told the BBC no final decision had been made.

Britain's Department for International Development (DfID) says it is reviewing its spending, and close dialogue with the Indian government will continue.

The BBC's Chris Morris in Delhi says there are those who argue that a country like India, which has an economy growing at nearly 10% a year and a massive defence budget, simply does not need British development assistance.

On the other hand, nearly half a billion people in India are still desperately poor and efforts to reduce global poverty will make no significant progress if those figures do not improve, our correspondent says.
Leaked memo

An internal memo - written by Mrs Rao and leaked to a local newspaper - appeared to suggest that India had already decided it did not want any more development aid from Britain after April next year.

But Mrs Rao says the quotes used have been taken out of context.

She admits that there is a debate within government about whether any development aid is still needed. But no decision has been taken, and there will be full consultation with London.

British officials say the tone of the leaked memo does not reflect what they are hearing from the rest of the Indian government.

When Prime Minister David Cameron met his Indian counterpart Manmohan Singh in Delhi recently, it was agreed that no-one would make a decision about giving or receiving development aid without a proper consultation process.

Britain is already reviewing its development budget, and re-examining its priorities.

"All DfID's country programmes are currently under review to ensure our aid helps the poorest people in the poorest countries," a spokesperson in London said.

India's Finance Minister, Pranab Mukherjee, told parliament recently that India would prefer to voluntarily surrender money if Britain made a decision to cut aid.

So as well as financial considerations in both countries, there is an element of national pride at stake, our correspondent says - if Britain decides to cut aid to India, Delhi may say it does not want the money anyway.


http://www.bbc.co.uk/news/world-south-asia-11318342

Riaz Haq said...

A horror tale of a 17-year-old girl living in slavery and abused for nearly five years by a businessman's family for a mere Rs 7,000 has surfaced in the city on the eve of the Republic Day, according to Times of India.

The girl was rescued last Thursday by volunteers of Childline, an NGO, and is now undergoing rehabilitation in the state government's Karuna women's shelter home on Katol Road.

The matter is under investigation by the Koradi police who are, however, yet to register an offence.

According to activists of Childline, the girl (name withheld) was virtually pawned with the family of businessman Rajesh Janiani, a resident of Mankapur, some five years ago when she was just 12-years-old. Her mother Sita (name changed on request), a resident of Lashkaribagh, desperately needed money for the treatment of her elder daughter Sunita, then 14, who was later diagnosed with brain tumour. Sita works as domestic help in some houses. Her husband, a habitual alcoholic, does no work.

Sita approached the Janianis through a neighbour Sheela who used to work as domestic help with them. Janianis apparently extended a loan of Rs 7000 to Sita. They asked her to let her children work with them for some time in order to repay the loan. Sita says she agreed since it was summer vacation and sent her daughter and son to work with Janianis who run a grocery store in Sadar.

Initially, the girl was first sent to Agra for six months to look after a handicapped relative of the Janianis. After the person's death, she was brought to the city.

Sita says since then she was not allowed to meet her daughter. Janianis allegedly kept the girl at their home while her brother was employed at their shop. Both suffered frequent beatings at the slightest pretext. The girl has revealed to her rescuers that she was given just four rotis with pickles every two days to eat and a cup of tea with one biscuit in the morning.

Childline volunteers said neighbours had confirmed hearing the girl being beaten up by the Janianis and crying. The couple's two grown up sons, both in their 20s, too used to beat her up. Whenever the family went out, the girl would be locked up in the store room with a stock of rotis and water to last her for the period of the outing. On Wednesday, the Janianis were all set to go to Goa for a vacation after locking her up thus.

After suffering abuse for about two years, her brother ran away to Bilaspur. A missing complaint was lodged about this but he returned on his own about a week later and resumed working with the Janianis. Since then, Sita says he did not suffer beatings and was working in Janiani's shop only during the day. They were not allowed to meet the girl though.

According to Sita, whenever she went to see her daughter, she was sent away on some excuse or only shown the girl from a distance. She was all the time assured the girl was fine.

Sita says the kids were not paid anything for their work. She continued with the arrangement even after the loan amount was settled because she thought the girl was being taken care of and was even getting some education. When for prolonged period, Sita could not see her daughter she became apprehensive.

She says she even went to the Koradi police who did not entertain her complaint. Sita approached the crime branch a few days ago but the cops here too made perfunctory enquiries with Janianis who told them they did not have any girl in the house. Finally she was helped by Aruna Gajbhiye, principal of Tirpude College of Social Work, who suggested that she approach Childline, a central government initiative to help children in distress run with the help of NGOs.

Riaz Haq said...

Is India too wealthy for British aid? asks the BBC:

Bihar children being fed under a government scheme More than a million children in Bihar suffer from severe malnutrition
Continue reading the main story
Related Stories

* How UK overseas aid will be spent
* 'More poor' in India than Africa
* Ignoring India's 'republic of hunger'

Britain's decision to give £280m ($457m) in annual aid to India for the next four years has prompted questions in the UK about whether India needs the aid these days. The BBC's Geeta Pandey travels to the northern state of Bihar to see where a sizeable chunk of the British money will be spent.

About two dozen children squat in a narrow lane separating mud and brick homes in Madhaopur village.

It's a hot sunny afternoon and the children sit facing each other, hugging the wall where a thin sliver of shade keeps them out of direct sunshine.

A woman puts steel plates in front of each child, another ladles out khichdi - a rice and lentil dish - onto each plate.

Within minutes, the chattering ceases and the children begin to eat hungrily, scooping out khichdi with their hands and putting it in their mouths.

Ideally, the children should be served inside the Anganwadi (government sponsored child development) centre, but the pokey, window-less room that passes for the centre is too small to accommodate them all.
'Malnourished'

The building provides pre-school education to children between three and six years and gives them one cooked meal a day to supplement their nutritional needs.

"Nearly 50% children here are malnourished," says Geeta Verma, who is part of the technical assistance team of DfiD (Department for International Development).
A baby being vaccinated in Bihar DfiD supports vaccination programmes in the villages of Bihar

"They are given a daily meal by the Anganwadi workers. It's a naturally fortified meal - for proteins we use lentils, for micronutrients, we use leafy vegetables," she explains.

Research has shown that the diet in Bihar leaves children with a 300-calorie deficit and this meal aims to bridge that gap.

"This meal provides each child with 300 calories and 10 grams of protein," Ms Verma says.

The team has helped prepare the menu and has been coaching the women in the important role nutrition plays in the physical and mental growth of their children.

In Madhaopur, DfiD is also supervising and assisting with immunisation of babies and has helped with a project to teach illiterate women.
'Too wealthy?'

Since being opened up in 1991, the Indian economy has grown rapidly. And at a time when most economies around the world are in recession, India's continues to grow at an enviable 9%. This has helped lift millions out of poverty.
Continue reading the main story
“Start Quote
Sangeeta Kumari

Bluntly speaking we are struggling for existence, we are trying to perform our best in the midst of a crisis. We have very poor infrastructure.”

End Quote Sangeeta Kumari Bihar government official

This has led to some in the UK wondering if India is too wealthy to qualify for receiving aid. They say the £280m could be put to better use in Britain where the economy is ailing and many services are being cut back.

Critics also point out that India has 69 dollar billionaires; it has its own space programme; plans to send a man to the Moon; spends billions of dollars annually on defence; and even has its own overseas aid programme.

But India has its areas of darkness too - according to World Bank estimates, 456 million live on less than $1.25 a day; tens of millions of children suffer from acute malnutrition; millions of Indians are illiterate; hundreds of thousands continue to die of totally preventable causes; and eight million children remain out of school.....

Riaz Haq said...

Here's a piece by Nobel Laureate Amartya Sen on economic growth and quality of life in India and China:

It could, however, be asked why this distinction should make much difference, since economic growth does enhance our ability to improve living standards. The central point to appreciate here is that while economic growth is important for enhancing living conditions, its reach and impact depend greatly on what we do with the increased income. The relation between economic growth and the advancement of living standards depends on many factors, including economic and social inequality and, no less importantly, on what the government does with the public revenue that is generated by economic growth.

Some statistics about China and India, drawn mainly from the World Bank and the United Nations, are relevant here. Life expectancy at birth in China is 73.5 years; in India it is 64.4 years. The infant mortality rate is fifty per thousand in India, compared with just seventeen in China; the mortality rate for children under five is sixty-six per thousand for Indians and nineteen for the Chinese; and the maternal mortality rate is 230 per 100,000 live births in India and thirty-eight in China. The mean years of schooling in India were estimated to be 4.4 years, compared with 7.5 years in China. China’s adult literacy rate is 94 percent, compared with India’s 74 percent according to the preliminary tables of the 2011 census.

As a result of India’s effort to improve the schooling of girls, its literacy rate for women between the ages of fifteen and twenty-four has clearly risen; but that rate is still not much above 80 percent, whereas in China it is 99 percent. One of the serious failures of India is that a very substantial proportion of Indian children are, to varying degrees, undernourished (depending on the criteria used, the proportion can come close to half of all children), compared with a very small proportion in China. Only 66 percent of Indian children are immunized with triple vaccine (diphtheria/pertussis/tetanus), as opposed to 97 percent in China.

Comparing India with China according to such standards can be more useful for policy discussions in India than confining the comparison to GNP growth rates only. Those who are fearful that India’s growth performance would suffer if it paid more attention to “social objectives” such as education and health care should seriously consider that notwithstanding these “social” activities and achievements, China’s rate of GNP growth is still clearly higher than India’s.


http://www.nybooks.com/articles/archives/2011/may/12/quality-life-india-vs-china/

Riaz Haq said...

The number of children under five who die each year has plummeted from 12 million in 1990, to 7.6 million last year, according to Child Mortality Report 2011 prepared by UNICEF and the World Health Organization.

About 21,000 children are still dying every day from preventable causes.

India leads the under-5 death toll with 1.7 million deaths, followed by Nigeria 861K, Dem Rep of Congo 465K, Pakistan 423K, China 315K, Ethiopia 271K and Afghanistan 191K.

In terms of deaths per 1000 live births, Pakistan is still at 87, compared with Bangladesh 48 and India 63.

Pakistan's rate of child mortality decline at 1.8% a year between 1990 and 2010 is among the slowest in the world, compared with 3% in India and an impressive 5.5% in Bangladesh.

Burkina Faso at 176 deaths per 1000 live births, Angola 161, Afghanistan 149, and Nigeria 143 are among the highest in the world.

http://www.unicef.org/media/files/Child_Mortality_Report_2011_Final.pdf

Riaz Haq said...

Here's a shocking story by BBC's Soutik Biswas about a battered Indian toddler girl:

For close to two weeks, the distressing story of a two-year-old toddler has grabbed India's attention.

A teenage girl brought the battered toddler to a hospital in Delhi and left her there. Doctors found she had serious injuries - human bite marks all over her body, broken arms and a partially smashed head. They said they had not seen abuse of this level on such a small child. Nearly a fortnight after she was brought to the hospital, the toddler is on life support in the intensive care unit.

It is still not clear who the mother of the toddler is, and who assaulted her and why. Sketchy details emerging in the media suggest she was passed around by a number of women before she landed in the hands of a 14-year-old girl. The girl has reportedly told the police that she got the toddler from a married man, who had befriended her and lived with her.

The man, a taxi driver, apparently acquired the child from a woman and wanted to raise her. The story of the teenage girl, if reports are to be believed, is equally shocking. She has apparently told investigators that her parents beat her when she was a child and when she arrived in the city, a number of men raped her and she was forced into the sex trade.

We still do not know who the toddler's parents are, why she was abandoned and why she suffered such brutality.

The story is, sadly, not unusual and mirrors the neglect, abuse and social bias that girl children suffer in largely patriarchal India. India has one of the highest female infant mortality rates in the world. Unchecked illegal sex selection abortions have led to a skewed sex ratio - 112 boys are born for every 100 girls in India, against the natural sex ratio at birth of 105 boys for every 100 girls.

India's record on protecting its children is shoddy. Thousands go missing every year and it doesn't appear to be a major concern for the authorities. A report by Bachpan Bachao Andolan (BBA) found that 11 children go missing in India ever hour. The 2010 National Crime Records Bureau says 10,670 cases of kidnapping and abduction of children were reported during the year, up 19% over 2009. The majority of these children belong to poor, marginalised families living in slums and resettlement colonies.

Most of us believe that a nation that cannot protect its children is a failure. The least the authorities can do is declare war on gangs who kidnap and traffic in children. Six years ago, federal investigators told the Delhi High Court that there were more than 815 gangs, comprising more than 4,000 people, involved in kidnapping children for the sex trade, for begging or for ransom in India. Was there ever a crackdown on them? We still don't know.


http://www.bbc.co.uk/news/world-asia-india-16828725

Riaz Haq said...

Here's an ET story on child malnutrition in Pakistan:

Malnutrition in some parts of Pakistan is as high as in Africa, says Jean-Luc Siblot, World Food Programme’s country representative for Pakistan.

He was talking at a seminar organised on Tuesday to discuss the critical question of food security and analyse the government’s National Zero Hunger Action Plan (NZHAP).

The $16 billion five-year plan aims to address food insecurity, hunger and malnutrition issues by reaching out to almost 61 million people across the country.

The programme includes provision of nutritious and fortified food commodities to the most food insecure and vulnerable sections of society, particularly malnourished children, pregnant women and primary school children. It also features a school feed programme and establishment of “zero hunger shops” in 45 extremely food insecure districts of Pakistan.

Siblot said the programme reflects a very high level of commitment towards addressing the problem of hunger and malnutrition in Pakistan. Other experts echoed his sentiment but added that the plan needs to be implemented swiftly.

Dr Chaudhry Inayat of Ministry of National Food Security and Research said the plan comprises of seven components including policy reforms, establishment of a National Food Security Council, targeted social safety nets, capacity building of the ministry and partnership with international agencies.

The NZHAP, drafted after rigorous consultations with various stakeholders, takes into consideration the dimensions of food insecurity in Pakistan and the steps to be taken to address the problem, Dr Inayat said.

Kevin Gallagher, Country Representative United Nations Food and Agriculture Organisation, speaking at the seminar said that the Zero Hunger Plan was in compliance with the governments “right to food” obligation, which entails provision of nutritious food for everyone.

“It would provide opportunities to vulnerable people who also place conditional obligation on them to secure food by their own,” he said.

Silvia, a UNICEF representative, said that it was alarming to see the stagnant figures of malnutrition in the country. Rates of chronic malnutrition are as high as 50% and that a third of children born in Pakistan are underweight.

“The problem is not with the children but with mothers who do not meet their nutritional needs during pregnancy,” she said...


http://tribune.com.pk/story/369894/seminar-malnutrition-in-parts-of-pakistan-as-high-as-in-africa/

Riaz Haq said...

Here's an NPR story of orange sweet potato helping improve nutrition in sub-Saharan Africa:

A regular old orange-colored sweet potato might not seem too exciting to many of us.

But in parts of Africa, that sweet potato is very exciting to public health experts who see it as a living vitamin A supplement. A campaign to promote orange varieties of sweet potatoes in Mozambique and Uganda (instead of the white or yellow ones that are more commonly grown there) now seems to be succeeding. (Check out this cool infographic on the campaign.) It's a sign that a new approach to improving nutrition among the world's poor might actually work.

That approach is called biofortification: adding crucial nutrients to food biologically, by breeding better varieties of crops that poor people already eat.


Howarth Bouis is one of the people who came up with this idea, and he's been promoting it for the past two decades. He's an economist at the International Food Policy Research Institute in Washington, D.C., and director of an international effort called HarvestPlus that's creating more nutritious crops. But the idea of biofortification, he explains, grew out of earlier studies of vitamin supplements that nutritionists carried out in Asia and Africa.

In some cases, they found that just giving malnourished children a vitamin A capsule every six months cut the death rate among those children by about 25 percent. "This number really astounded the nutrition community," says Bouis. "Then they started looking at iron and zinc and iodine deficiencies." They discovered that these micronutrients make a huge difference in people's health.
-----------
But the idea of biofortification didn't immediately catch on. Public health experts worried it would be a waste of money; crop breeders feared low yields and rejection by the population if the crops looked different.

Two decades later, the advocates have come up with varieties of some crops that have more micronutrients. The HarvestPlus effort is using traditional plant breeding. Others have created a genetically engineered "golden rice," which provides more vitamin A.

Their first real success in the field, though, is the orange sweet potato.

In several African countries, including Uganda and Mozambique, subsistence farmers grow a lot of sweet potatoes. They've been doing it for centuries, ever since the Portuguese brought the first sweet potatoes here from Latin America.

The sweet potatoes that arrived in Africa, however, were white or yellow. Unfortunately, those sweet potatoes don't contain any beta carotene, which the body uses to make vitamin A.

But the orange flesh of the North American sweet potato does.

So when Bouis and others started pushing the idea of biofortification, sweet potato breeders realized that they didn't have to start from scratch. "We realized that the orange-fleshed sweet potato that is eaten in the U.S. really could provide a lot of vitamin A for the people in Africa," says Maria Isabel Andrade, from the International Potato Center, who is based in Mozambique.


http://www.npr.org/blogs/thesalt/2012/08/15/158783117/saving-lives-in-africa-with-the-humble-sweet-potato

Riaz Haq said...

Pakistanis consume over 170 Kg of milk per capita and it's growing, according to FAO.

http://www.fao.org/ag/againfo/programmes/en/pplpi/docarc/wp44_3.pdf

Growing milk consumption can help reduce malnutrition in Pakistan.

Here's a story illustrating the value of milk in reducing malnutrition in Africa:

WFP Executive Director Josette Sheeran kept a promise she made to WFP-supported Rilima health centre last July by giving two cows worth 1,360,000 Frw to help reduce malnutrition among poor communities in the area.

WFP Executive Director Josette Sheeran kept a promise she made to WFP-supported Rilima health centre last July by giving two cows worth 1,360,000 Frw to help reduce malnutrition among poor communities in the area.

The milk produced by the cows will be used to feed severely malnourished children and breast feeding mothers. “The health centre expects to get 50 litres of milk to feed over 200 malnourished children per day,” says Pascal Habyarimana assistant director of the health centre.
Rilima nutrition centre assists more than 37,000 people in the area. WFP provides monthly fortified supplementary food to malnourished children under the age of five years and malnourished pregnant or nursing women.

“Since 2009, more than 20,000 malnourished children have been supported and recovered from malnutrition", says WFP Rwanda Country Director Abdoulaye Balde. "WFP will continue to provide relevant suport to reduce malnutrition among poor communities in Rilima sector”.
Parents and nursing women come to the centre not only to collect fortified food provided by WFP but also to be trained on good nutrition practices. Training is focused mainly on balanced meals, hygiene, disease prevention and family planning.
The idea is that, after receiving assistance from nutritoon centres, parents can become agents for change in their communities with the help of a a trained community health worker.

Local mothers are currently learning how to organize vegetable gardens at home. A garden can be established on a small plot and maintained with waste water from the kitchen. The nutrition centre itself has a model garden and vegetables from it are used for cooking demonstrations.
In partnership with World Vision and Rilima health centre, beneficiaries are encouraged to develop good cooking practice at home and share them with their neighbours.


http://www.wfp.org/stories/wfp-executive-director-donates-cows-reduce-malnutrition-rwanda