Friday, May 25, 2007

Malnutrition stalks India’s children

AFP Release

Penny MacRae

Nearly a third of children are born underweight which means their mothers are underweight and undernourished. Many mothers do not have time to regularly nurse their baby’s as they must work as farm or manual labourers, domestic servants or in factories


KOLARAS, India: His wizened frame cradled in his mother’s arms, 18-month-old Nitish gazes listlessly at his surroundings in an Indian government feeding centre in this parched farming belt. The baby’s skin is so taut that each rib can be counted and his whispy hair is a rusty brown rather than glossy black, characteristic of malnutrition.

“He just got thinner and thinner after getting diarrhea,” said his mother Savitri, 24, a farm labourer’s wife. On the other side of the room, seven-month-old Niketa, being fed formula milk with a spoon by her grandmother, waves a stick-like arm. Her mother died two days after she was born following a difficult delivery.

“God is unjust — He took her mother away and her father doesn’t want her,” said her grandmother Soni, 55, rocking the tiny doll-like figure at the feeding centre in Kolaras in central Madhya Pradesh state.

These babies, lying in a room hung with pictures of roly-poly infants smiling down, are just two of the 46 per cent of all Indian children under three years old that the government says are malnourished. In the dust-bowl state of Madhya Pradesh, where monsoon rains have been scant for five years, the number is higher — a staggering 60 percent, the worst in the country.

“It’s the silent emergency — children are just fading away,” said Meital Rusdia, spokeswoman for the UN children’s agency Unicef. Malnutrition endures despite India’s booming economy, which grew by an average 8.5 per cent over the past four years.

“It’s shameful to have India become a trillion-dollar economy and to have nearly 50 per cent of the children hungry,” pediatrician Vandana Prasad, a member of the People’s Health Movement. Government investments in development are “insufficient,” Unicef says.

Figures for child mortality, underweight children and other basic health indicators have shown no significant improvement in seven years.

While India has banished the spectre of famine that plagued its history and overshadowed the early years of independence, “household level” food security has still not been achieved.

Millions subsist on the barest of basic foods — wheat, lentils and rice. Poor sanitation, under nourishment and haphazard immunisation makes them vulnerable to infection. Children suffer most in this cycle.

Just not enough feeding centres to care for all those in need. The “anganwadis” or village child care centres look after children under six and are the government’s first line of defence against malnutrition.

The Supreme Court has ordered free noon meals for all children under six. But the Citizens’ Initiative for the Rights of Children Under Six has highlighted lack of funds, poor staffing and corruption in providing meals that are often scanty and sometimes non-existent as the money has been pocketed.

At one centre visited by AFP, the children were served two small pieces of flat Indian bread and a tiny portion of potatoes. There was no protein.

“The government only gives two rupees (five cents) per child. What can you do with such small funds.

What they get is a disgrace,” said an aid worker who asked not to be identified.

To help severely malnourished babies, the government has set up intensive feeding centres but there just are not enough. “The babies’ mothers are often undernourished and they have low weight babies,” said Dr Nisar Ahmed, whose job it is at the Kolaras feeding centre to fatten up the children.

Nearly a third of children are born underweight which means their mothers are underweight and undernourished. “Some mothers just don’t produce enough breast milk,” he says.

Also, as pediatrician Prasad notes, many mothers do not have time to regularly breastfeed as they must work as farm or manual labourers, domestic servants or in factories.

“Some 97 per cent of working women in India work in the unorganised sector” — a catch-all phrase for casual workers — “and nobody makes time for them to breast-feed so their children suffer,” she says.

Some unlucky babies like Niketa lose their mothers in childbirth or soon after.

The maternal mortality ratio is 540 maternal deaths per 100,000 births, mainly due to lack of timely, proper health care. Malnutrition exacts a high cost.

“Their physical and mental development is stunted,” says Ahmed. With 40 per cent of India’s population under 18, the malnutrition figures are significant for India’s future.

Some studies suggest widespread malnutrition lops two to four percentage points off potential economic growth. Ahmed says for every baby who is saved, many go undetected. We do our best but we can’t reach everyone,” he said.

Wednesday, May 23, 2007

Workshop on water management begins

The Pioneer, May 24, 2007

A two-day workshop on 'wise water management' began here on Wednesday. The seminar was inaugurated by Bhopal division Commissioner BK Naidu.He stressed on the importance of the Jal Abhishek Abhiyan, effective water management and sanitation.

At the inuagural session Bhopal-Hoshangabad Divisional Commissioner BR Naidu said that the motive of the workshop is to target the 200 nirmal gram per district project in the divisions. He called on officials to engage community and Panchayati Raj members in their efforts.

Assistant Commissioner (Tribal) Jassu spoke on the need to scale up the water and sanitation efforts in Ashram schools. HN Gupta, superintending engineer of Bhopal division also spoke at the meeting. Project officer of water and environmental sanitation of UNICEF Sam Godfrey said that aim of the workshop is to orient district level officials on global techniques for solving water scarcity (such as water reuse/recycling) with the objective of scaling up the wise water management approach to Ashram schools throughout the Bhopal division. He spoke on UNICEF experiences in Dhar and Jhabua. Wise water management was initially implemented in 26 Ashram schools of Dhar and Jhabua districts and construction in Ashram schools of Bhopal division to be undertaken in May, 2007. Tribal Welfare Department has already allocated Rs three crore for construction of 100 wise water management systems in addition to funds allocation by PHED for 300 systems in Madhya Pradesh. UNICEF's Pawan Kumar, HB Dwivedi of National Centre for Human Settlement and Environment (NCHSE) were also present. Officials of Public Health Engineering Department and Tribal Welfare Department from eight districts of Bhopal Division are participating in the same.

Friday, May 4, 2007

A sanitation revolution sweeps across Madhya Pradesh

By Anil Gulati

May 2007: Jabarha village in Dhar district of Madhya Pradesh is gripped with lliteracy poverty. Yet amidst all the grim socio-economic scenario, aray of hope shines.

A robust improvement in sanitation has metamorphosed the basic look of the village.

The central government has set a target of constructing a latrine in every house in all villages by 2012.With the implementation of the Total Sanitation Campaign, this tribal dominated hamlet nearly 100 kms from Dhar district headquarters, has gradually started learning the ABCs of sanitation. The first revolutionary step in this direction was the construction of a latrine in each of the 310 households of the village.

Like many traditional Indian villages Jabarha was almost untouched by modern infrastructural development. Open air defecation, uncontrolled movement of cattle, littering adjacent to water reservoirs---all the standard unhygienic characteristics were prevalent in the village.

But in the last four months the village has spruced up its 'hygiene quotient' and the residents have acquired a new sanitation vocabulary, all without any coercion. Each of the 310 houses has a latrine, a container has been kept outside each house to accumulate the garbage, the streets are without any stray cattle and the drains impeccably clean without overflow on the roads.

The campaign's reach was 8 percent in Dhar district in 2005 and has risen to 23 percent in 2007

In Indore district more than 75 percent of Below-Poverty-Line dwellers have constructed a latrine in their homes. In Seoni, Hoshangabad and Sehore this figure has touched between 50 to 75 percent.Sarpanch Ms Rajkunwar Jatav Jat maintains: "To bring such a change in four months time was an arduous task. The veterans of the village in particular had to be coaxed to give up the 'loti' habit and take to the new method."

Jatav Jat says that she took the help of children and UNICEF supported NGO Vasudha Vikas Sansthan to accomplish this mission. Enumerating the steps taken she said films were shown to the villagers highlighting the benefits of sanitation. "The school teachers were also roped in to make the parents and grandparents realise
the virtues of having a latrine at home. Even we – the village leaders - took up the broom and did not shy away from cleaning the roads. This motivated the villagers to follow suit."

UNICEF's Dr Sam Godfrey says it is nothing less than a revolution for social change.

Five village panchayats had been chosen in the Badnawar Janpad of Dhar District for the Nirmal Gram Puruskar this year.

Thursday, May 3, 2007

'Anganwadi calendar', a communication tool

Bhopal, May 2:

At a first look it may look like a typical monthly Indian calendar available in the nearby market place. But on a second look, it is not!

It is an 'anganwadi calendar' published by the State Women and Child Development Department of the central Indian state, Madhya Pradesh in India. Anganwadi centre is a child care centre in villages of the state which provides services to help improve the nutritional and health status of children below the age of six years and pregnant and lactating mothers. It is set up by the state with the support from Government of India under its Integrated Child Development Scheme. It includes package of services like supplementary nutrition, immunisation, health check-up, referral services, pre-school non-formal education and nutrition & health education for children below the age of six years and pregnant and lactating mothers. The said calendar probably has all the information which one Anganwadi worker needs to provide it to mothers, pregnant women who visit the centre along with their children.

As in all the calendars it has month wise dates in a 'week wise' format duly stapled on to the calendar. In this calendar the month slips could be removed after the month gets over and rest of the portion of the calendar for that month could be used as a poster. It could be stuck on to the wall of an 'anganwadi centre'. It becomes an IEC (information education and communication) tool and helps provide the much needed 'right' information to the families visiting the centre. The information on the calendar is provided both in written and pictorial format, keeping the literacy levels in mind the rural areas of the state.

The calendar has information on the various services available in the anganwadi centre, (very importantly) full child's immunization chart and information about care of pregnant women. It also talks about right age of marriage i.e. 21 years for boys and 18 years for girls and motivates parents to marry their children especially girls at the right age. That's not all it also has key messages on gender equality, importance of exclusive breast feeding till six months and complimentary feeding, which is important in the state which has high rates of infant mortality and low rates of exclusive breastfeeding.

The calendar also relays importance of institutional delivery and has key messages which probably ever family should know and understand. No doubt an effort worth praise, but it may be important to evaluate its effective distribution and use.

By Anil Gulati