19 May 2009

Visiting the malnutrition project in Jhabhua

Before arriving in India, I had some idea of the poverty I would be faced with (particularly after the compulsory Slumdog Millionaire viewing before our departure) and the rapidly increasing disparity between the rich and the poor as the national economy develops. However when I think of malnutrition, Comic Relief images of Africa and Ethiopia come to mind from the news back in the 1980’s and 1990’s. But did you know that 40% of the world’s underweight children live in India?

As a result of malnourishment, a large proportion of India’s children under 5yrs old are massively susceptible to increased illness plus stunted physical and mental growth, which limits them for life. Of the 60million underweight children in India, an estimated 60% of them live in the State of Madhya Pradesh in the West of the country, which is why RMF has launched the malnutrition initiative there.

With the project at inception, Cait invited me to visit local nutrition centres and tribal villages in Jhabua District, the heart of the afflicted state with the hope of understanding the root causes of malnutrition there. The trip began with an overnight train from Delhi to Meghnagar – halfway from Delhi to Mumbai – where I was rocked to sleep in the silent sleeper carriage. I arrived the next morning to meet Cait and after a brief motorcycle ride to the hospital, we launched straight into a session with a group of regional NGO representatives who had gathered to hear about Cait’s Malnutrition project.

I was introduced as the Nutrition Expert (you make up your own job titles here!) but that was where my comprehension ended - the session was conducted entirely in Hindi. The meeting stimulated hearty debate, especially when the NGO’s were asked what they thought the cause of local malnutrition could be. Much to my surprise, the answer was not access to food, as I understand it to be in Africa. Here the answer lies in a complex web of issues including annual migration for work, a lack of dietary education, drought, failing crops and mothers working long hours in the fields. There is clearly no simple answer and much more to understand about the region.

Lunch was provided for all the delegates, and for me this was the beginning of an adventure called “I don’t know what I am eating” more of which in further posts. Whatever it was – some curried squash, a dal, rice, roti, papads and another curry – it was a delicious meal, home cooked by the a local worker and eaten with our hands off the thali it was served on.

The long, hot afternoon was spent in the Jeep dashing about the arid countryside of Jhabhua District seeing Nutrition Centres and meeting tribal villagers to check for signs of malnutrition amongst the children. The roads were narrow with thundering brightly decorated lorries, people carriers (jeeps with as many people crammed in and clinging to the outside as possible), pot holes and people walking for miles barefoot to who knows where.

Visiting the villages, it was an eye opening experience to see how wide scale malnutrition actually is, and how much help the state needs to address it. The Nutrition Rehabilitation Centres (NRC’s) we visited - many aided by Unicef –administered emergency care to just a handful of children. Compared to the number of kids we saw in need of nutrients, the centres should have been much busier. But as we discovered throughout the trip, life here is not that simple.

The biggest issue is making people aware of the signs of child malnutrition. The second is getting them to take the children to the NRC’s and stay long enough for the children to regain weight and health. It was the middle of the regions Wedding Season and many families opted to wait until after these extravagant and pivotal village events (more of which will be explained in a separate post) to admit the child to the centre. Just this alone demonstrates the barriers created by differences in culture and customs that Cait and the team are trying to understand, in order to prevent wide scale and long term malnutrition in the region.

It seems the situation is nearing emergency in Madhya Pradesh. Thankfully Cait and the Real Medicine Foundation are working collaboratively with existing field staff and NGO’s to tackle the issue from the ground, using insight and best practice from local NGO’s which will hopefully speed up the impact of this project.

For me, this project strikes a real chord. Education about food and nutrition is a subject very close to my heart, and is why I am here in India - to learn. It was baffling to see so many parents who didn’t understand that their own flesh and blood were in serious need of nutrition. Living here, having this Indian adventure, it’s too easy to be caught up in my own issues. But, thanks to Cait my eyes are now open wider to the issues being faced in this beautiful country full of contrast. But awareness is only the beginning...

For donations to this cause, and other work by the RMF – click here. To follow the projects progress read Cait's Blog

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