Haq's Musings

Riaz Haq writes this data-driven blog to provide information, express his opinions and make comments on many topics. Subjects include personal activities, education, South Asia, South Asian community, regional and international affairs and US politics to financial markets. For investors interested in South Asia, Riaz has another blog called South Asia Investor at http://www.southasiainvestor.com and a YouTube video channel https://www.youtube.com/channel/UCkrIDyFbC9N9evXYb9cA_gQ

Showing posts with label Malnutrition. Show all posts

Wednesday, October 18, 2023

Global Hunger Index 2023: India's Child Wasting Rate is the Highest in the World

India's child-wasting rate of 18.7% is the highest in the world, according to the Global Hunger Index (GHI) 2023 released recently. The South Asian country’s child wasting rate is higher than that of war-torn Yemen (at 14.4%) and Sudan (at 13.7%), which are ranked second and third in the world. Pakistan's child wasting rate is 8%. It represents the share of children under age five who have low weight for their height, reflecting acute undernutrition. The child wasting rate of the South Asia region is 14.8%, the highest of any world region and more than twice the child wasting rate of Africa. India is home to a quarter of the world's most undernourished people. According to the United Nations, India has nearly 195 million undernourished people. This is more than any other country, including China.

India Tops in Child Wasting Rate. Source: The Wire

India Tops the World in Child Wasting. Source: Global Hunger Index 2023

India's Hindu Nationalist government of Prime Minister Narendra Modi wants to project India as a superpower launching moon missions and hosting G20 summits. Since the GHI 2023 report runs counter to this PR exercise, New Delhi has rejected its findings. But its own National Family Health Survey 5 (NFHS 5) says that "Thirty-six percent of children under age five years are stunted; 19 percent are wasted; 32 percent are underweight; and 3 percent are overweight. Children born to mothers with no schooling and children in the lowest wealth quintile are most likely to be undernourished".

Overall, India ranks at the 111th position out of 124 countries, with neighboring Pakistan (102nd), Bangladesh (81st), Nepal (69th) and Sri Lanka (60th) faring better than India in the index. India has slipped four notches from its 107th position in 2022.

India has slipped 4 places, from 107 in 2022 to 111 in 2023, on GHI. Pakistan ranking has also slipped 3 places, from 99 to 102. It is not a huge surprise since the country is still facing the aftermath of the disastrous floods of 2022. It is also suffering from a serious economic crisis. Meanwhile, India's Modi government is making claims to being the world's fastest growing economy. And yet, Indian children are the most malnourished in the world.

India Malnutrition Indicator Trends. Source GHI 2023

Pakistan Malnutrition Indicator Trends. Source GHI 2023

There's a close relationship between hunger and poverty. At the $3.65 poverty line, India accounts for 40% of the slight upward revision of the global poverty rate from 23.6% to 24.1%, according to the World Bank September 2023 Global Poverty Update. It is the same update that made the following recent headline in the Indian and Pakistani media about Pakistan: "Pakistan's 40% Population Lives Below Poverty Line, Says World Bank". Fact: 45.9% of Indians and 39.4% of Pakistanis live below the $3.65 a day poverty line as of September, 2023, according to the the latest World Bank global poverty update that takes into account the impact of inflation on poverty rates. But neither the Pakistani media nor India's compliant "Godi Media" reported it. Nor did they question why poverty in India is growing despite the Modi government's claim to be "the world's fastest growing economy".

Global Child Poverty Rate. Source: UNICEF

Another recent report by UNICEF that went unnoticed by the media is that the child poverty rate in India far exceeds the rate in Bangladesh and Pakistan: At $2.15 poverty level, India has 11.5% children under poverty, Pakistan 5.6% and Bangladesh 5.1%. At $3.65 poverty level, India has 49.8% children under poverty, Pakistan 45% and Bangladesh 35.2%.

Child Poverty Rate By Year By Region From 2013 to 2022. Source: UNICEF

The UNICEF data shows that the South Asia region's child poverty rate at $2.15 for any year since 2013 drops to about a half when India is excluded.

The latest World Bank and UNICEF reports remind me of the famous Indian writer and poet Javed Akhtar who told his audience at a conference in Mumbai earlier this year that he saw "no visible poverty" in Lahore during his multiple visits to Pakistan over the last three decades. Responding to Indian novelist Chetan Bhagat's query about Pakistan's economic crisis at ABP's "Ideas of India Summit 2023" in Mumbai, Akhtar said: "Unlike what you see in Delhi and

Mumbai, I did not see any visible poverty in Lahore". This was Akhtar's first interview upon his return to India after attending "Faiz Festival" in Lahore, Pakistan.

Javed Akhtar at ABP Ideas Summit in Mumbai

Chetan Bhagat began by talking about high inflation, low forex reserves and major economic crisis in Pakistan and followed it up by asking Javed Akhtar about its effects he saw on the people in Pakistan. In response, Akhtar said, "Bilkul Nahin (Not at all). In India you see poverty right in front of you, next door to a billionaire. Maybe it is kept back of the beyond. Only some people are allowed to enter certain areas. But you don't see it (poverty) on the streets. In India, it is right in front of you...amiri bhi or gharibi bhi (wealth and poverty). Sare kam apke samne hain (It's all in front of you). Wahan yeh dekhai nahin deta (you don't see it in Pakistan)".

Alhamra Arts Center, Lahore, Pakistan

Disappointed by the response, Bhagat suggested that the Indian visitor could have been guided by his hosts through certain routes where he couldn't see any poverty. Javed Akhtar then said "it's not possible to hide poverty. I would have seen at least a "jhalak" (glimpse) of it as I always do in Delhi and Mumbai....I have been to Pakistan many times but I have not seen it".

What Javed Akhtar saw and reported recently is obviously anecdotal evidence. But it is also supported by hard data. Over 75% of the world's poor deprived of basic living standards (nutrition, cooking fuel, sanitation and housing) live in India compared to 4.6% in Bangladesh and 4.1% in Pakistan, according to a recently released OPHI/UNDP report on multidimensional poverty. Here's what the report says: "More than 45.5 million poor people are deprived in only these four indicators (nutrition, cooking fuel, sanitation and housing). Of those people, 34.4 million live in India, 2.1 million in Bangladesh and 1.9 million in Pakistan—making this a predominantly South Asian profile".

Global Multidimensional Poverty Index 2022. Source: OPHI/UNDP

Income Poverty in Bangladesh, India and Pakistan. Source: Our World in Data

The UNDP poverty report shows that the income poverty (people living on $1.90 or less per day) in Pakistan is 3.6% while it is 22.5% in India and 14.3% in Bangladesh. In terms of the population vulnerable to multidimensional poverty, Pakistan (12.9%) does better than Bangladesh (18.2%) and India (18.7%) However, Pakistan fares worse than India and Bangladesh in multiple dimensions of poverty. The headline multidimensional poverty (MPI) figure for Pakistan (0.198) is worse than for Bangladesh (0.104) and India (0.069). This is primarily due to the education and health deficits in Pakistan. Adults with fewer than 6 years of schooling are considered multidimensionally poor by OPHI/UNDP. Income poverty is not included in the MPI calculations. The data used by OHP/UNDP for MPI calculation is from years 2017/18 for Pakistan and from years 2019/2021 for India.

Multidimensional Poverty in South Asia. Source: UNDP

The Indian government's reported multidimensional poverty rate of 25.01% is much higher than the OPHI/UNDP estimate of 16.4%. NITI Ayog report released in November 2021 says: "India’s national MPI identifies 25.01 percent of the population as multidimensionally poor".

Multidimensional Poverty in India. Source: NITI Ayog via IIP

Earlier last year, Global Hunger Index 2022 reported that India ranks 107th for hunger among 121 nations. The nation fares worse than all of its South Asian neighbors except for war-torn Afghanistan ranked 109, according to the the report. Sri Lanka ranks 64, Nepal 81, Bangladesh 84 and Pakistan 99. India and Pakistan have levels of hunger that are considered serious. Both have slipped on the hunger charts from 2021 when India was ranked 101 and Pakistan 92. Seventeen countries, including Bosnia, China, Kuwait, Turkey and UAE, are collectively ranked between 1 and 17 for having a score of less than five.

Here's a video of Javed Akhtar's interview with Chetan Bhagat at ABP's "Ideas of India Summit 2023". Please watch from 4:19 to 6:00 minutes.

https://www.youtube.com/live/pZ5e81ysKGQ?feature=share

Thursday, August 24, 2023

Modi Co-opting Chandrayaan-3 Success For Hindutva Propaganda?

Well before India's Chandrayaan-3 landed on the moon on August 23, India's "Godi Media" started showing split screens with the landing craft’s animated image (no pictures or live video) alongside a photo of Indian Prime Minister Narendra Modi. It was clearly meant to give him exclusive credit for ISRO scientists' major accomplishment after their decades-long hard work. This Hindutva propaganda has echoes of Adolf Hitler’s use of the 1936 Berlin Olympics to promote his Nazi ideology. It is boosting the morale of the hateful Hindu supremacist trolls unleashed by the BJP “IT cell” on social media. It is easy to conclude that the Chandrayaan is now essentially a prestige project for the Hindu Nationalist government in New Delhi. Funding such projects is easier for politicians than implementing social sector programs to uplift hundreds of millions of poor and hungry Indians who are deprived of the most basic necessities.

Chadrayaan3-Modi Split Screen Godi Media Propaganda

It is clear that Mr. Modi wants to claim credit for the moon landing but he refuses to take responsibility for high unemployment and widespread malnutrition in the world’s largest population living in extreme poverty in India. Nor does the Modi regime accept the blame for millions of preventable COVID19 deaths in India in 2020-21. This is what Princeton economist Professor Ashoka Mody, the author of “India is Broken”,refers to as India’s “lived reality”. Here's an excerpt from Mody's book:

"The grim reality is that, to employ all working-age Indians, the economy needs to create 200 million jobs over the next decade, an impossible order after the past decade of declining employment numbers.1 Right from independence, the Indian economy produced too few jobs. For more than 80 percent of Indians, the informal sector employment became the safety net, where workers idled for long stretches, earning below- or barely-above-poverty wages. Demonetization in 2016, a poorly executed goods and services tax in 2017, and COVID-19 in 2020 and 2021 struck hammer blows on the informal sector while creating no new options. Indeed, technology accelerated job destruction, especially in retail and wholesale trade. More Indians just stopped looking for work. Set against this bleakness, many pundits and leaders look back to celebrate and draw hope from India’s high GDP growth rates of the 1990s and 2000s. That celebrated celebrated growth, however, was an outcome of unusually buoyant world trade, rampant natural resource use, and a domestic finance-construction bubble. Even as wealthy Indians accumulated astonishing riches, job creation remained weak. The most severe forms of poverty came down, but still afflicted over 20 percent of Indians; another 40 percent lived precariously, ever at risk of falling back into a dire existence. The median Indian lived in that vulnerable zone—and, looking through a government-induced data fog, still lives there. The unchanging problem through the post-independence years has been the lack of public goods for shared progress: education, health delivery, functioning cities, clean air and water, and a responsive and fair judiciary. Along with scarcity of jobs, the absence or poor quality of public goods makes the lived reality of vast numbers."

India Ranks Low on Social Progress Indicators. Source: Economist

India ranks 110 among 170 countries on the Social Progress Index (SPI), according to a dataset published by the Social Progress Imperative, a non-profit organization. The Social Progress Index combines 52 social and environmental indicators.

Over 75% of the world's poor who are deprived of basic living standards (nutrition, cooking fuel, sanitation and housing) live in India compared to 4.6% in Bangladesh and 4.1% in Pakistan, according to a recently released OPHI/UNDP report on multidimensional poverty. Here's what the report says: "More than 45.5 million poor people are deprived in only these four indicators (nutrition, cooking fuel, sanitation and housing). Of those people, 34.4 million live in India, 2.1 million in Bangladesh and 1.9 million in Pakistan—making this a predominantly South Asian profile".

Friday, February 19, 2021

Development Boom in Thar Brings Hope For Pakistan's Least Developed Region

New roads, an airport and a water reservoir in Tharparkar are opening up Pakistan's least developed region. Jobs are being created, drought-resistant nutritious trees and crops being planted and fish farms being established for the benefit of the the people of Thar. New water pond is attracting migratory birds that feed on fish.

Tharparkar Peacock

Underground Water:

Fortunately for the people of Thar, Sindh Engro Coal Mining Company has discovered significant amount of underground water, the most precious commodity in drought-hit Tharparkar region of Pakistan. Syed Abul Fazal Rizvi, Chief Executive Officer (CEO) of SECMC and Thar Foundation was quoted by Business Recorder as saying, “While carrying out hydrogeological studies for Thar coal project, we found out abundant water reserves of groundwater at the depth of 450 plus feet in the whole of the desert region." The available water in Thar has the potential to irrigate thousands of acres of land by applying modern watering methods such as drip and sprinkler systems, he added.

Rizvi said in collaboration with Pakistan Agriculture Research Council (PARC) and Institute of Sustainable Halophyte Utilization of Karachi University, Thar Foundation has produced commercially viable amounts of Apple Ber, guava, dates, Rhodes Grass (for livestock feed), Castor (cooking) Oil, Cluster Bean (guar), and vegetables. Utilizing the underground saline water, the foundation has piloted a 40-acre plot of land to grow fruits, vegetables, and local grass species and established Sindh’s largest private sector nursery which nurtures 500,000 saplings at a time. It has also set up a 68-acre Green Park which has grown local species of trees that comprises Neem, Babur, Roheero, Kandi, Moringa, and other species.

Gorano Pond has begun to attract a lot of migratory birds that feed on fish. Some species, the report said, have even started nesting on the partly submerged tree tops, according to the Turkish Andolu News Agency.

Tharparkar Peacock: Courtesy Emmanuel Guddu via Gulf News

Moringa Trees Fight Malnutrition:

Aga Khan University and Sindh Agriculture University are jointly promoting Moringa tree planting in Pakistan's Thar desert to fight malnutrition, according to multiple media reports. Moringa has gained popularity as superfood in the West in recent years. People of drought-stricken Tharparkar have been suffering from malnutrition and disease in the middle of a long-running drought in the region. Sindh Agriculture University, Tando Jam, and the Aga Khan University will plant 40,000 moringa tree seedlings in Matiari, a rural district in central Sindh, in an effort to improve the health of malnourished mothers, children and adolescents in the area. The moringa tree plantation campaign has been funded by the Prince Sadruddin Aga Khan Fund for the Environment, a $10 million fund dedicated to practical solutions to environmental problems.

Moringa tree packs 92 essential nutrients, 46 antioxidants, 36 anti-inflammatories and 18 amino acids which help your body heal and build muscle. Native to South Asia, the hardy and drought-resistant Moringa tree can contribute to everything from better vision and stronger immune system to healthier bones and skin. Moringa has 25 times more iron than spinach, 17 times more calcium than milk, 15 times more potassium than bananas and nine times more protein than yoghurt, according to Dr. Shahzad Basra of the University of Agriculture in Faisalabad, Pakistan. “It also has seven times more vitamin C compared to oranges, over 10 times more vitamin A compared to carrots and three times more vitamin E compared to almonds", he added. No wonder the powder made from Moringa leaves is sold as superfood in the West. Global market for Moringa products is estimated at $5 billion and growing at 8% CAGR.

Fish Production For Protein:

Dewatering operation of the deep aquifers underneath the coal deposits has discovered large amounts of water which has been removed and pumped into a lake called Gorano Pond. This has opened up organic fish farming in the region.

Gorano is 35 KMs south of the Islamkot Taulka where an artificial reservoir of 1500 Acres was established, according to Business Recorder. Dewatering started in April 2017 from SECMC coal mine and so far, 600 Acres of the reservoir have been filled with water. More than 100,000 fish-seedlings (3-4inches in size) were initially released and within 8-9 months with full grown fish reaching more than 1Kg in weight only on natural feed (Zooplanktons, Phytoplanktons, Algae and other marine insects available in Pond) and were declared fit for consumption by an external laboratory.

Jobs For Locals:

Sindh Engro Coal Mining Company (SECMC), the largest contractor working in Thar desert coal project, has committed itself to hiring locals wherever possible.

When SECMC launched its Female Dump Truck Driver Program near the town of Islamkot in Thar, Kiran Sadhwani, a female engineer, visited several villages to motivate women to apply for the job and empower themselves, according to Express Tribune newspaper. “Not all women who are working as dumper drivers are poor or in dire need of money. It is just that they want to work and earn a living for themselves and improve the lives of their families,” she told the paper. SEMC is hiring 30 women truck drivers for its Thar projects, according to Dawn newspaper.

Private Sector's Role in Thar:

Most of the social sector improvement effort in Tharparkar is part of what is known as "Corporate Social Responsibility" (CSR). It is led by Sindh Engro Coal Mining Co (SECMC), and the Thar Foundation, funded by SECMC. SECMC is joint venture of Engro Corporation (Dawood Group) and Sindh government. The Thar Foundation is a special department under SECMC that serves as the CSR office of the Thar project, and handles all the CSR work in the entire Thar area on behalf of all the funding parties. Also helping out are Prince Sadruddin Aga Khan Fund & several universities in Sindh, including Karachi University, Aga Khan University and Tando Jam Agriculture University.

Sunday, January 31, 2021

Pakistani Universities Promoting Moringa to Fight Malnutrition

Moringa Flowers

There is high incidence of stunting and wasting among children in Tharparkar district and elsewhere in rural Sindh due mainly to their very limited diet of daal-roti (lentils and bread) which does not supply essential nutrients such as vitamins and minerals for good health and early development. Moringa tree packs 92 essential nutrients, 46 antioxidants, 36 anti-inflammatories and 18 amino acids which help your body heal and build muscle. Native to South Asia, the hardy and drought-resistant Moringa tree can contribute to everything from better vision and stronger immune system to healthier bones and skin. Moringa has 25 times more iron than spinach, 17 times more calcium than milk, 15 times more potassium than bananas and nine times more protein than yoghurt, according to Dr. Shahzad Basra of the University of Agriculture in Faisalabad, Pakistan. “It also has seven times more vitamin C compared to oranges, over 10 times more vitamin A compared to carrots and three times more vitamin E compared to almonds", he added. No wonder the powder made from Moringa leaves is sold as superfood in the West. Global market for Moringa products is estimated at $5 billion and growing at 8% CAGR.

Child Nutrition in Pakistan. Source: PDHS

Moringa tree is also known as Drumstick tree. In Pakistan, it is called Suhanjana (سھانجنا) or Mungay (مونگے) tree. Every part of this tree offers uses in nutritional or commercial applications. The leaves, bark, flowers, fruit, seeds, and root of the tree all have medicinal properties. Oil from Moringa seeds is used in foods, perfumes and hair care products, and as a machine lubricant. The seed cake remaining after oil extraction can be used as a green fertilizer and also to purify well water and to remove salt from seawater.

The Thar project supported by Aga Khan University goes beyond just planting and growing trees. Its goals include educating the people of its benefits and showing how its leaves and other parts of the tree can be cooked and eaten in the form of curries and sauces, according to a report by Voice of America.

In 2017, Sindh Agriculture University (SAU) Tandojam had planted 5,000 Moringa trees with 500 households for human and animal consumption. These drought-resistant fast growing trees have now matured. Their consumption is showing good results in terms of improving nutrition and health of these 5000 families.

Here's a BBC report on Moringa in Pakistan:

https://youtu.be/3Wc2Yw_VDFE

Monday, June 21, 2010

India Leads the World in Child Marriages

Over 40% of all child marriages in the world take place in India, making it the child marriage capital of the world. Nearly half of all the Indian marriages involve a child bride, ranking it at number 11 among 68 nations where child marriages are reported. Child marriages account for nearly a quarter of all marriages in Pakistan, according to UNICEF.

Earlier this year, the Hindu newspaper reported on an Indian study, prepared by the Population Council of India, which concluded that child marriage continues to be rampant in India with nearly one-fifth of Indian women being married off before turning 15 and around 50 per cent before reaching the legal marriageable age.

In April 2007, the International Center for Research on Women (ICRW) published the results of a study on child marriage in the world, "New Insights on Preventing Child Marriage: A Global Analysis of Factors and Programs" (pdf). The ranking included 68 countries. Topping the list was Niger, where 76.6% of women were found to have married before age 18, followed by Chad, at 71.5%. The proportion of child brides was above 60% in Bangladesh, Mali and Guinea, and above 50% in Nepal, Mozambique, Uganda, Burkina Faso and India. Pakistan, with 31.6% child marriages reported in 1991-92, is ranked at 32 in the middle of this list of 68 nations.

According to UNICEF, 47% of all Indian marriages from 2000-2008 were child marriages. Data collected from 2005 to 2006 by India's national family health survey revealed that 22.6 percent were married before they were 16, 44.5 percent were married when they were between 16 and 17, and 2.6 percent were married before they turned 13.

There are many socio-economic factors that play a role in the early marriage of girls in India. Widespread poverty is one of the major factors responsible for early marriage. The practice disproportionately affects little girls who are seen as an economic burden by their parents. A baby girl's marriage to a much older man is often a family survival strategy, and may even be seen as being in her best interest.

The child marriages take a severe toll on the little brides' lives. They are often abused by their husbands and in-laws. And they have more health problem on average than the rest of the female population. They are at greater risk of HIV infections, STDs and unwanted pregnancies and childbirth complications. "Women who were married as children remained significantly more likely to have had three or more childbirths, a repeat childbirth in less than 24 months, multiple unwanted pregnancies, pregnancy termination, and sterilization," wrote the researchers, led by Anita Raj at the Boston University School of Public Health. Raj also reported that infants and children in India born to mothers married as minors are more likely to suffer from malnutrition than those born to adult women.

Most of the problems affecting women in India have their roots in gender bias and the low social status given to them. While it is important to pass and ENFORCE legislation to stop the practice of female infanticide, bride burning and child marriages, what is required is a serious campaign to educate and incentivize the people to change their social attitudes.

Here's a video clip of a report on rampant girl child abuse in India:

Saturday, May 15, 2010

India's Hunger Far More Deadly Than Global Terror

In a recent article "The Distant Thunder of an Unexploded Bomb" discussing the failed terror attack in Times Square and its severe consequences in faraway places, author Ras Siddiqui invokes the memory of "a horrible famine in British India around the time of World War II" portrayed in a film “Distant Thunder” by celebrated Indian director Satyajit Ray. Several million Indians died in the Bengal famine of 1943.

Ray's film focuses on the famine during the British Raj when the colonial rulers diverted food from Bengali civilians to the British forces fighting the Axis powers in Asia and the Middle East. Unfortunately, there is no thunder, distant or otherwise, today when it comes to hunger in India. Most hunger deaths occur in silence, without making any headlines in the Indian and Western media. There is often denial of this unfolding tragedy that claims thousands of innocent, often young, lives every day in India and other parts of the world in Asia and Africa....many times more than the tragic deaths from terrorism in the entire world.

About 3000 Pakistanis died tragically in terrorist attacks last year in various parts of the country, according to government data. Putting it in perspective, however, hunger in India has proved far more deadly than terror in Pakistan. It claims as many Indian children's lives every day as all of the terror related deaths in Pakistan in a year, according World Bank HNP data. About 7000 Indians of all ages die of hunger every day, according bhookh.com.

Both tragedies are essentially man-made and preventable, and both need to be condemned and stopped by decisive action by all concerned.

Indian Nobel Laureate Amartya Sen who saw the Bengal famine in his childhood says as follows:

"When India achieved independence, more than 50 years ago, the people of India were much afflicted by endemic hunger. They still are."

As if to reinforce it, the BBC has a story today about little children in India eating mud to fight hunger.

"In Ganne, just off the main road about an hour south of the city of Allahabad, this is a simple fact of life.

It is home to members of a poor tribal community, who live in small huts clustered around a series of shallow quarries.

Inside one of the huts sits a little girl called Poonam. She is three years old, and in the early stages of kidney failure.

Like many children in Ganne she has become used to eating bits of dried mud and silica, which she finds in the quarry. Tiny children chew on the mud simply because they are hungry - but it is making them ill.

When reports first emerged of children eating mud here local officials delivered more food and warned the villagers not to speak to outsiders. But Poonam's father, Bhulli, is close to despair."

The only other country where I know children regularly eat "dirt cookies" is Haiti.

Related Links:

Right to Food

Ambassador Hussain Haroon on Failed Times Square Bombing

Indian Democracy Overrated

Theory and Practice of Right to Food

South Asia's War on Hunger Takes Back Seat

Food, Shelter and Clothing in India and Pakistan

Amartya Sen on Hunger in India

Haq's Musings

India's Rights Approach

Child Malnutrition India Video

Grinding Poverty in Resurgent India

Why is Democracy Failing in Pakistan?

Right to Food in India Campaign

Escape From India

Social Inequality Threatens India's Economic Stability

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

Wednesday, November 4, 2009

South Asians' Primary Duty to Children

Guest Post by Rakesh Mani

There has to be something wrong with Indian society for it to allow its children to be among the most deprived and malnourished in the world. Across castes and social classes, there is so little attention given to the inalienable right of a child to enjoy a childhood of good health, education and a nutritious diet. How can we get a society of adults to be accountable for the treatment of its youngest citizens?

Several reports from international organizations like UNICEF and the World Bank have been sharply critical of the abject failure of governance in health and education that has left Indian children way behind their counterparts in Sri Lanka, Nepal and even Bangladesh. According to some recent statistics, two million children below the age of five die every year in India. That’s one every fifteen seconds which, shamefully, is the highest figure in the world.

But let’s just focus on primary education for the moment. Through my own experiences of teaching in an under-resourced Bombay school for the last six months, some sights and sounds have become permanently etched in my mind – the family of five who cannot afford to send all their children to school, and therefore picked two, a girl and a boy; the beatings that a 3rd grade student can receive at home for scoring poorly on an exam that tests little more than memorization; young kids reciting poems in fluent English without understanding a word of what they’re saying.

Primary education here largely involves the teacher playing narrator in the classroom. Students are receptacles who must memorize and then mechanically parrot away the narrated content. The more meekly they reproduce what has been written on the blackboard onto pen and paper, the better students they are. For education here is little more than an elaborate ritual of filling student notebooks and issuing communiqués which students patiently receive, memorize and repeat.

But it’s quite apparent now that this factory-schooling model is not only dysfunctional but also destructive towards the myriad processes of human learning and growth. Pupils have to be encouraged to independently develop their own creative thinking processes. Curriculums have to be re-worked to foster a sense of competence, purpose and responsibility into students. And also equip them with a vital understanding of ethics and social responsibility.

As young kids are forced to submit to rote learning, they lose the critical consciousness they will need to intervene and transform their country in the years to come. As they embrace educational passivity, they will also more readily accept the imperfections and injustices their societies impose on them.

Ever since Jawaharlal Nehru decided in the early 50s to develop India’s higher education platform to compete technologically in the Cold War era, the importance of primary education in the country has been largely ignored. Instead the nation focused on building institutions that could produce more engineers, doctors and scientists. But how can we sustain these specialized programs without building sturdy foundations at school? Or rather, what quality of engineers and scientists must we be producing at these institutes of excellence? Excluding the IITs, what percentage of Indian graduates are able to compete effectively in the global economy?

As the Indian educational debate remains sharply focused on colleges and universities, it is worth remembering that elementary education is the foundation on which the promise of equal opportunity exists. Much work needs to be done towards making the primary education system accountable to the child for what she learns, and how she learns it. And we’re possibly in the worst of situations at the moment – more than 1 in 3 children who begin primary school will drop out before 5th grade and World Bank statistics show that less than 40% of Indian adolescents are attending secondary school. In this context, the new Right to Education Bill is being hailed as India’s great solution but alas, it is only a sketchy blueprint that has yet to be implemented effectively.

And then again, the bill only caters to children above the age of six. Meeting the nutritional and developmental needs of children under the age of six is critical for the educational journey they will undertake. But there is not enough public attention to this omission in the new bill.

For India’s children, things will clearly not change by themselves. If it takes a village to raise a child, it might take the whole nation to raise the ten million children born annually in India. There is a serious need for much more material that can be used for playful learning, and a need for more simple storybooks, which affluent children have easy access to. Urban slum children have no such resource, either at school or at home.

For a country like India, where almost 40% of the population is under the age of fifteen, this paints a highly disturbing long-term trend. And talking globally, 25% of the entire global workforce will be Indian in about twenty years – so be sure that the quality of education these kids receive is going to impact us all.

But perhaps this is not about numbers, or about economics. Maybe the harshness of the statistics tells us that there is something more sinister at play – that the dialog shouldn’t be about resources or economics at all but instead a debate on our values.

Author Rakesh Mani is a 2009 Teach for India fellow, working with low-income schools in Mumbai. He is also a New York-based investment banker, freelance writer and commentator who contributes to a variety of publications.

As a volunteer for "Teach For India", Mr. Mani is inspiring others by personal example. Teach For India is a nationwide movement of outstanding college graduates and young professionals who will commit two-years to teach full-time in under resourced schools and who will become lifelong leaders working from within various sectors toward the pursuit of equity in education.

While there is no Pakistani equivalent of "Teach For India", there are a number of organizations such Human Development Foundation (HDF) and Development in Literacy (DIL), and Greg Mortenson's Central Asia Institute, which are focusing on improving primary education and promoting literacy in Pakistan.

Riaz Haq's Note: This article focuses on the state of India's children, and raises fundamental questions about society's values. However, I find Mr. Mani's thoughts to be equally, if not more, applicable to Pakistan as well.

Under former President Musharraf, Pakistan followed India's lead by focusing on tertiary education with the higher education budget rising 10-15 fold in a short period of time.

Unfortunately, there was no commensurate increase or focus on primary or secondary education. As a result of the long neglect, Pakistan's primary and secondary public education is in shambles with insufficient funds, rampant corruption and ghost schools that exist only on paper with fictitious staff drawing salaries and perks.

This lack of focus on access and quality of children's education has resulted in the proliferation of madrassahs, some of which are highly radicalized, that fill the vacuum by offering a one-stop shop for poor children needing food, clothing, shelter, healthcare and basic education. Parents simply drop their children off at these madrassas, and essentially let these institutions raise their children, and brainwash the children in some cases.

As Pakistan now fights an existential battle against extremely violent radicals, many from the radical madrassas, the nation is now paying a heavy price for years of neglect.

Upon the urging of saner elements in Pakistan, and pressure from the alarmed world, a new education policy has recently been announced that will more than double education spending in Pakistan from about 3% of the GDP to 7%. If it is done correctly, instills proper values, and with transparency, then there can be hope for light be at end of the tunnel for Pakistan's younger generation.

Here's a video report about Pakistan's decrepit public education:

Sunday, September 20, 2009

Is India a Nutritional Weakling?

While researching the causes of the sugar crisis in Pakistan earlier this month, I found that, on a per capita basis, Pakistanis consume significantly more of almost everything they eat than their neighbors, including wheat, dairy, meat, poultry and sugar. The only comparable category between Indians and Pakistanis are fruits and vegetables, of which both use less than 100 grams a day.

This was before the shameful deaths of several destitute Karachi women scrambling to grab free wheat bags stole the headlines.

In spite of the fact that there is about 22% malnutrition in Pakistan and the child malnutrition being much higher at 40% (versus India's 46%), the average per capita calorie intake of about 2500 calories is within normal range. But the nutritional balance necessary for good health appears to be lacking in Pakistanis' dietary habits. One way to alleviate the sugar crisis in Pakistan is to reduce sugar consumption and substitute it with greater intake of fruits and vegetables. There is an urgent need for better health and nutritional education through strong public-private partnership to promote healthier eating in Pakistan.

Among other basic food commodities, per million population wheat consumption in Pakistan is 115,000 metric tons versus 63,000 metric tons in India, according to published data.

Pakistanis consume over 25 Kg of sugar per person versus India's 20Kg.

According to the FAO, the average dairy consumption of the developing countries is still very low (45 kg of all dairy products in liquid milk equivalent), compared with the average of 220 kg in the industrial countries. Few developing countries have per capita consumption exceeding 150 kg (Argentina, Uruguay and some pastoral countries in the Sudano-Sahelian zone of Africa). Among the most populous countries, only Pakistan, at 153 kg per capita, has such a level. In South Asia, where milk and dairy products are preferred foods, India has only 64 kg and Bangladesh 14 kg. East Asia has only 10 kg.

While it remains very low by world standards, meat and poultry consumption has also increased significantly in Pakistan over the last decade. Per capita availability of eggs went from 23 in 1991 to 43 in 2005, according to research by N. Daghir. Per capita meat consumption in Pakistan now stands at 12.4 Kg versus India's 4.6 Kg.

In addition to relatively large per capita wheat and sugar consumption, Pakistanis also consume significantly higher amounts of meat, poultry and milk products than other South Asian nations, getting more protein and almost half their daily, per capita calorie intake from non-food-grain sources.

About two weeks after the widely reported wheat deaths in Karachi, there is a new damning British report about the serious malnutrition affecting Indian children.

The new British government report on child hunger and malnutrition in India says the nation is an "economic powerhouse" but a "nutritional weakling". Here is an excerpt from Times online story:

India is condemning another generation to brain damage, poor education and early death by failing to meet its targets for tackling the malnutrition that affects almost half of its children, a study backed by the British Government concluded yesterday.

The country is an “economic powerhouse but a nutritional weakling”, said the report by the British-based Institute of Development Studies (IDS), which incorporated papers by more than 20 India analysts. It said that despite India’s recent economic boom, at least 46 per cent of children up to the age of 3 still suffer from malnutrition, making the country home to a third of the world’s malnourished children. The UN defines malnutrition as a state in which an individual can no longer maintain natural bodily capacities such as growth, pregnancy, lactation, learning abilities, physical work and resisting and recovering from disease.

In 2001, India committed to the UN Millennium Development Goal of halving its number of hungry by 2015. China has already met its target. India, though, will not meet its goal until 2043, based on its current rate of progress, the IDS report concluded.

“It’s the contrast between India’s fantastic economic growth and its persistent malnutrition which is so shocking,” Lawrence Haddad, director of the IDS, told The Times. He said that an average of 6,000 children died every day in India; 2,000-3,000 of them from malnutrition.

Related Links:

FAO Statistics

Grinding Poverty in Resurgent India

Pakistan's Sugar Crisis

Agricultural Diversification in South Asia

Nutrition in Pakistan

FAO Report on Food Consumption Patterns

Global Hunger Index Report 2009

Wheat Consumption in India and Pakistan

World of Sugar

Pakistan's Livestock Farming