Nearly half of country's children malnourished

Policies and political compulsion fail to provide relief to marginal

Even before he got his name, the one-month-old came to the nutritional rehabilitation centre (NRC) of Khammam town, the only institution out of seven in the state still functioning. His mother, Soni, 18, a resident of a hamlet in the nearby forest, could hardly speak about her child’s health, except her wish for him to survive.

Reports show nearly half the children in India suffer from malnutrition. But the policies and political compulsions are unable to provide relief to people on the margins, like the internally displaced people (IDPs) occupying land in the reserved forest areas. IDPs of Khammam are a testimony to this.

With a body in which one can literally see bones through the skin, Soni's son will survive, said the in-charge of NRC, with a rider, “only if the child, after leaving the NRC 15 days later, is given nutritious food for at least some months to come.”

The 70-bedded NRC has two wards – one for the locals and the other for the IDPs, in which Soni stays. Out of the 24 beds, 14 are occupied. Cultural and linguistic differences have forced the authorities to separate wards for different communities.   The in-charge added that nutrition levels among local tribes have improved, but condition among IDPs have gone worse. In the health centres of Andhra Pradesh, the recommendation of World Health Organisation to use Mid-Upper Arm Circumference (MUAC) as an indicator, is used in addition to other criteria. It is a measuring tape with different colours along its length. Circumference less than 11 cm for under-6 children indicates severe acute malnutrition. Circumference between 11 and 12.5 cm indicates moderate acute malnutrition.

 “This is a much easier indicator to teach and apply and it should be promoted,” said Dr Isha Prasad Bhagwat, national health manager, Save the Children, an NGO working among the IDPs. Register after register in which data for malnutrition is recorded among IDP hamlets, is marked in yellow, indicating the acuteness of the crisis. In one hamlet, connected by a road which can be travelled only by seasoned bikers, Venkatamma said they know about malnutrition among children through their thin hands and legs.

She moved along with other 37 families within Dandakaranya forest from Chhattisgarh to Andhra Pradesh due to fighting between the state and the Maoists. NGOs like Society for Integrated Rural Improvement (SIRI) and Save the Children say it is tough to get help from the government as the citizen rights of the IDPs are not well defined.

“We have to really push for opening anganwadis and nutrition centres because these people stay on reserved land and government is reluctant to recognise them,” said K Ranganathan, project coordinator with Save the Children.

But against the lack of overall infrastructure development, things like institutional delivery and regular visits to a health centre are matters of luxury.   (This is first part of a five-part series on child malnutrition. The series is the result of a fellowship jointly awarded by Save The Children and Deccan Herald. To know more about Save The Children, click on: www.savethechildren.in)

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