Combating Hunger, Malnutrition and National dishonour

Harsh Mander
The abiding disgrace of new India is that despite unprecedented quantities of wealth and the vulgar ostentation which has become customary in the gaudy glitter of city life, India is unable to overcome hunger and malnourishment. This is even more unconscionable when government warehouses are overflowing with stocks of rotting rice and wheat. The 2019 Global Hunger Index (GHI) report brings sombre tidings this year: India’s poorer neighbours — Bangladesh, Nepal, and even Pakistan — have overtaken India in the battle against hunger.

Hunger is the failure to access the calories that are necessary to sustain an active and healthy life. It results in intense human suffering and indignity, as parents are forced to helplessly watch their children ache as they sleep hungry, as their brains and bodies are unable to grow to full potential, and, as they fall ill too often and are snatched away too early.

This is a colossal national dishonour for two reasons. One, this suffering is entirely preventable. Given appropriate public policies — sensitively designed, adequately resourced and effectively implemented — the country has both the wealth and the food stocks many times over to end hunger entirely. The relative success of our neighbours in combating hunger — Nepal emerging from 15 years of civil war and Pakistan still torn by internal conflict — is a sobering reminder of what India has not accomplished. Two, this failure does not spur public outrage and the introspection that it should.

The GHI report ranks India at a lowly 102 out of 117 countries listed. The GHI scores are based on four indicators — undernourishment (the share of population with insufficient calorie intake); child wasting (children with low weight for height, indicating acute undernutrition); child stunting (children with low height for age, reflecting chronic undernutrition); and child mortality (death rate of children under five).

Among all the countries included in the report, India has the highest rate of child wasting (which rose from the 2008-2012 level of 16.5 per cent to 20.8 per cent). Its child stunting rate (at 37.9 per cent) also remains shockingly high.

The report is instructive as it explains why Bangladesh and Nepal have surged ahead of a much wealthier India. The Bangladesh success story is attributed to pro-poor economic growth raising household incomes as well as significant improvements in “nutrition-sensitive” sectors like education, sanitation and health. Nepal, likewise, shows increased household wealth, maternal education, sanitation, health and nutrition programmes.

What must India do better to at least keep pace with its South Asian neighbours in tackling hunger? This is the question that Dipa Sinha, Parth Shrimali and I seek to answer in our essay in the latest 2018-19 India Exclusion Report of the Centre for Equity Studies.

We observe the cruel irony of the largest population of food-insecure people being food producers — farm workers, tenants, marginal and small farmers, fish workers and forest gatherers. To end hunger, food producers must be supported to receive adequate remuneration. We recommend sound measures to protect farmer incomes, including income transfers to farmers, minimum support-price guarantees and crop insurance, and a massive expansion of farm credit. For farm workers, a refocus on land reforms is called for, and, a greatly expanded and effectively managed rural employment guarantee programme with attention to land and watershed development, small irrigation and afforestation. There must also be an urgent and comprehensive shift to sustainable agricultural technologies less dependent on irrigation, chemical fertilisers and pesticides, to reverse our agri-ecological crisis.

The other large food-vulnerable population comprises informal workers. Hunger can’t be combated without addressing the burgeoning job crisis. It also entails labour reforms which protect job security, fair work conditions and social security of all workers. We also argue that the time has come for an urban employment guarantee programme, to help build basic public services and infrastructure for the urban poor — especially slum and pavement residents, and the homeless. This should also include employment in the care economy, with services for child-care, children and adults with disability and older persons.

The Public Distribution System must be universalised (excluding income tax payees), and should distribute not just cereals but also pulses and edible oils. Further, we need to reimagine it as a decentralised system where a variety of crops are procured and distributed locally. Both pre-school feeding and school meals need adequate budgets, and the meals should be supplemented with nutrient-rich foods such as dairy products, eggs and fruits. Social protection also entails universal pension for persons not covered by formal schemes, universal maternity entitlements to enable all women in informal work to rest and breast-feed their children, a vastly expanded creche scheme, and residential schools for homeless children and child workers.

Malnourishment results not just from inadequate food intakes, but also because food is not absorbed due to frequent infections caused by bad drinking water, poor sanitation and lack of healthcare. India’s nutrition failures are also because of persisting gaps in securing potable water to all citizens, and continued open defecation despite optimistic official reporting. There is an urgent requirement for a legally enforceable right to healthcare, with universal and free out-patient and hospital-based care, free diagnostics and free medicines.

All of this is not unknown. Yet, India continues to fail children born in impoverished households, to homeless people and single mothers, and to oppressed castes and social groups. Our economic policy continues to be trapped in an elite capture, dominated by measures that support big businesses to the exclusion of farmers and workers. Social rights are broken and betrayed.

At its core, the reason for India’s continuing failures to end hunger and malnutrition of its millions is the indifference of people who have never known the agony of involuntary hunger. This is ultimately the result of our enormous cultural comfort with inequality, our gravest and most culpable civilisational flaw.

The writer is a human rights worker and writer