Somini Sengupta has discovered child malnutrition

Somini Sengupta has discovered child malnutrition in India.

From the New York Times March 12: "As Indian Growth Soars, Child Hunger Persists"

“Small, sick, listless children have long been India’s scourge” she writes, “even after a decade of galloping economic growth, child malnutrition rates are worse here than in many sub-Saharan African countries, and they stand out as a paradox in a proud democracy.”

Apparently this is not a paradox in America, the worlds richest and most powerful country.

She compares India to China “China, that other Asian economic powerhouse, sharply reduced child malnutrition, and now just 7 percent of its children under 5 are underweight, a critical gauge of malnutrition. In India, by contrast, despite robust growth and good government intentions, the comparable number is 42.5 percent.”

She laments that “There are no simple explanations.” Then goes on to make the incredulous claims that “Economists and public health experts say stubborn malnutrition rates point to a central failing in this democracy of the poor.” And that “Amartya Sen, the Nobel prize-winning economist, lamented that hunger was not enough of a political priority here.”

She acknowledges that India runs the largest child feeding program in the world but then eviserarates it by saying that “experts agree it is inadequately designed”.

She makes a trip to a slum in Delhi to make these journalistic observations:

“A tour of Jahangirpuri, a slum in this richest of Indian cities, put the challenge on stark display. Shortly after daybreak, in a rented room along a narrow alley, an all-female crew prepared giant vats of savory rice and lentil porridge.

Purnima Menon, a public health researcher with the International Food Policy Research Institute, was relieved to see it was not just starch; there were even flecks of carrots thrown in. The porridge was loaded onto bicycle carts and ferried to nurseries that vet and help at-risk children and their mothers throughout the neighborhood. “

First of all khichdi – a traditional Indian dish all over the north is not “all strarch” as every Indian knows – the lentils are added to provide protein and it provides a nutritious meal if vegetables are thrown in for the vitamins.

So she deliberately misleads – its not porridge nor is it all starch.

She then provides more anecdotal evidence of how, horror or horrors, some the left over food is given to women.

Somini Sengupta then provides more recycled and some questionable statistics collected from the internet.

She observes there are beggars in Delhi: “A few blocks from the Indian Parliament, tiny, ill-fed children turn somersaults for spare change at traffic signals.”

She also seems amazed that there are rats in slums, there are open drains and malaria. I guess if you move about the five star hotel circuit this could come as a shock.

Here she makes an observation that a more astute journalist would have followed through on: “Neighborhood shops carried small bags of potato chips and soda, evidence that its residents were far from destitute.”

Yes, thanks to globalization, multinationals like Coke and Pepsi, and Indian companies too sell non-nutritious snacks and sugary water drinks. These are consumed by poor under-nourished slum dwellers as a luxury thanks to the constant advertising barrage. This further erodes their finances, which could be better used to buy fresh vegetables or meat.

But instead she moves blithely on ….
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Many of the observations she makes are not new for example here is quote from a World Bank report on the subject:

The South Asian Enigma: Why is undernutrition in South Asia so much higher than in Sub Saharan Africa?

In 1997, Ramalingaswami et al. wrote, “In the public imagination, the home of the malnourished child is Sub-Saharan Africa…but … the worst affected region is not Africa but South Asia”. These statements were met with incredulity. However, undernutrition rates in South Asia, including and especially in India, are nearly double those in Sub-Saharan Africa today. This is not an artifact of different measurement standards or differing growth potential among ethnic groups: several studies have repeatedly shown that given similar opportunities, children across most ethnic groups, including Indian children, can grow to the same levels, and that the same internationally recognized growth references can be used across countries to assess the prevalence of malnutrition. This phenomenon, referred to as the “South Asian Enigma”, is real.

The “South Asian Enigma” can be explained by three key differences between South Asia and Sub-Saharan Africa:
- Low birth weight is the single largest predictor of undernutrition; and over 30% Indian babies are born with low birth weights, compared to approximately 16% in Sub-Saharan Africa.
- Women in South Asia tend to have lower status and less decision-making power than women in Sub-Saharan Africa. This limits women’s ability to access the resources needed for their own and their children’s health and nutrition, and has been shown to be strongly associated with low birth weight, as well as poor child feeding behaviors in the first twelve months of life
- Hygiene and sanitation standards in South Asia are well below those in Africa, and have a major role to play in causing the infections that lead to undernutrition in the first two years of life/


Ramalingaswami V, U. Jonson and J. Rohde. 1997 “The Asian Enigma”. In, The
Progress of Nations. New York: UNICEF.

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Here are some interesting comments to the NYT Article:

Comment 1 one of my favorites reporduced in full below
Comment 2
Comment 3
Comment 4
Comment 5
Comment 6
Comment 7

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240. March 13, 2009 3:22 pm

I will try to write this in the kindest least offensive manner. I worked five years in India (99-2004) managing Unicef's supply operation. Unicef is the UN childrens fund and has been working in India over 60 years; it was the first UN agency to startup in the then newly independent country. It has worked with governments, community groups, large ngo's, religious leaderships, universities, foriegn experts, you name it, anyone and everyone who wants to help nourish India's future, her beautiful children.

We (unicef) had some of the best nutrition and child development experts on our staff and advising us. Amartya Sen, nobel winner from his work on famine in Bangladesh; arguably the world leader in these issues regularly offered assistance. I am not a nutrition or development expert, I managed the spending of money, we spent about $130 million yearly, most of that went for vaccines, most of that for polio eradication. In nutrition unicef mostly offered training and meetings called 'advocacy' a nice way of saying, trying to convince people to nourish their children better. So my naive gleanings and reactions to comments here I've just read.

1. India has plenty of food, in fact large surpluses that are a financial/market stability problem; food is not lacking; its in the wrong spots at the wrong time. Teen girls & their babies need good food now.

2. India knows more about child feeding than most; they have received the world's most dedicated specialists in this area for many years.

3. 'Corruption' in government is not nearly the issue westerners blurt out whenever they use the word India. I worked with senior, middle and lower level officials, in tendering, ajudication and contracting of all sorts of local and international contracts for five years. I worked with government donor agencies, World Bank and well intended groups with money. I'm a typical middle class American male business fellow, with years in the US drug industry before Unicef. I've worked in Europe, Africa, Latin America, former Soviet, most south and east asian govt's managing contracts that spent your hard earned donations. India is no worse, and on balance better than some in the realm of corrupted contracting. They have corruption, but so do we (America)--it seems to be part of life. But, resistance to changing how things are always done is a bigger than the usual small time grifters trying to get over. India has active anti fraud teams, and a more agressive press than we do now in America.

4. 'Government' is not the problem. All comments seem to blame govt, but India's govt is a large complex group criticized from so many sides I wonder how they carry on. India is over six hundred districts, equivalent to US counties, only these have power. Nothing affects people through govt without the district. There are 600,000 towns & villages, each with elected vested interests--sound familiar? There are 26 states, each remarkably different; each zealous in its authorities. There are at least 10 powerful 'learned societies' of nutrition and child development in India, who field real experts in all subjects of child nutrition. They gather as often as someone will pay for their visit to Delhi or Mumbai and present learned papers. In my experience they disagree more over every aspect of nutrition than I thought was possible. In hindsight I found the gov't people trying to manage this 'nutrition' process to be powerless peons caught in the middle of angry partisans.

5. 'Caste', I love how westerners write about caste. In five years of very concentrated effort in all sorts of health programs with the smartest people I ever worked with, the word & concept of caste never entered the discussions. The only people who say things like 'untouchables' are westerners. Caste is a nice conception from watching films like Gandhi--who was high caste, but not part of the educated governance culture of the country. There is caste, it is illegal, there are exceptions who make it to the top, but caste is not causing this alone, and it is taboo to discuss--no one admits they have it.

6. Religion; to my surprise none of the comments I saw mentioned what is a measurable; muslim children and mothers in India suffer, and they are the largest 'minority' group. They are also the largest muslim population within a nation excepting Indonesia, over 100 million Indians are Muslim; most of them are poor hungry and fed up--call it a security risk, these teenage moms and babies need vitamins minerals and real food now.

'India's problem' in my view? It's similar to ours in America; selfishness. When we (the well off in America), and the same 'we' in India feel the pain of our poor, we will move forward. Thank you NYT for these opportunities, John Gilmartin

— John Gilmartin, Rhode Island, USA

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