January 24, 2007
Hungry children failed by state and marketHealth and Medicine
This is a week of good news and bad. The good news is that Goldman Sachs thinks the Indian economy is growing even faster than previously expected:
India could overtake Britain and have the world’s fifth largest economy within a decade as the country’s growth accelerates, a new report says… By 2050 India’s economy could be larger even than America’s, only China’s will be bigger, the bank predicts. [Link]
The bad news is that child malnutrition rates are still startling high in India. This week the PM felt a need to deal out thapars:
“Our prevalent rate of under-nutrition in the 0-6 age group remains one of the highest in the world,” Mr Singh said. “These are startling figures and the situation calls for urgent action.” [Link]
The situation remains astonishingly dire:
Last year the UN children’s agency, Unicef, said that the average malnutrition rate in some Indian states - such as densely populated Uttar Pradesh - was 40%. That is higher than sub-Saharan Africa where it is around 30%, Unicef said. [Link]… Unicef report said half of the world’s under-nourished children live in South Asia….”South Asia has higher levels of child under-nutrition than Sub-Saharan Africa, but Sub-Saharan Africa has higher rates of child mortality…” [Link]
Most striking is the fact that the economic growth of the past 15 years hasn’t necessarily translated into better child nutrition, and that malnutrition has actually risen in some places:
A recent health ministry survey said that the number of undernourished children below the age of three had actually risen in some states since the late 1990s, despite higher incomes and rapid economic growth. [Link]
At the same time, state efforts have also failed to significantly alleviate the problem:
In a strongly-worded letter sent to state chief ministers, Mr Singh said that a massive programme to improve health and nutrition had failed…The prime minister said that the country’s Integrated Child Development Services (ICDS) scheme had not sufficiently dented child malnourishment levels. “There is strong evidence that the programme has not led to any substantial improvement in the nutritional status of children under six,” Mr Singh said, urging strong action… The letter said that the programme had been “poorly implemented”.The ICDS scheme was established in 1975, and is one of the biggest childcare efforts in the world, providing immunisations, supplementary food and medical check-ups for pregnant women. The scheme is implemented by thousands of state-funded community workers in poor, rural areas with limited or no medical facilities. Correspondents say that efforts to provide nutritious food to children have been constantly marred by corruption in which food intended for the poor is stolen or sold to other people. [Link]
One place to start, according to the UNICEF report, is by improving the status of women:
“the low status of women in South Asian countries and their lack of nutritional knowledge are important determinants of high prevalence of underweight children in the region”. The report also blames “inadequate feeding and caring practices for young children” for the grim situation in South Asian countries. It says it is important that “in the interests of improving child nutrition, women’s status should be raised”. This need is very urgent in South Asia, including India, it adds. [Link]
I’m a pragmatist. Ideology is fine and good, but it doesn’t put food in a baby’s belly at the end of the day. In this case both the state and the market have failed to deliver calories to needy children. Clearly something different needs to be done, something where there is clear accountability and measurement of outcomes. What India’s doing today is simply not good enough.
ennis on January 24, 2007 05:26 PM in Economics, Health and Medicine, News · T·r·a·c·k·b·a·c·k address · Direct link · Email post
FYI - the photo of the weigh in is probably from Bangladesh and not India, but I can't be sure.
Clearly something different needs to be done, something where there is clear accountability and measurement of outcomes. What Indias doing today is simply not good enough.
Agreed.
It's an interesting problem, though. On one level, government action is the best way to address this type of problem, because the government presumably has the widest reach and the largest pool of committed resources. But, as must be the case in most democratic countries, the government is run by people with a vested interested in getting elected, which engenders corruption, etc.
Why not turn over the task of nourishing India to private (and preferably non-Indian) corporations? A corporate entity would have to bid for the project, and the Indian government could simply pay the entity agreeing to carry out the nourishment program. In reality, feeding the under-nourished is no different than building a road, or running a fiber optic line, right?
In this case both the state and the market have failed to deliver calories to needy children.
The small scale sectors have not been liberalised. Please see some of the studies at the bottom of this page. It is not the failure of the market since that has never reached them. They haven't overcome the license raj.
We have to examine this problem segment by segment, sector by sector, state by state. Studying India as a monolithic entity and making a generalized judgement on failure (of the govt or the market) is not very useful. (IMHO).
It is all right for the Unicef/BBC to make high-falutin pronouncements; "status of women should be raised" - not many people will dispute such statements. But what are the grassroots-level practical steps to be taken to do that? By whom? When it comes to solving these problems, suddenly one realises that it is darn complicated.
What makes it truly maddening is that India has the food - it has enough food so that it may even be exported in the near future!? Poor infrastructure which causes rot, ineffectual subsidies schemes, corrupt government babus and middle men (who sell off their good quality subsidized grain on the black market...while 'honoring' vouchers with mildewed product, has created a pathetic situation.
I hope India will one day wake up and understand that being a great power is not just about the size of your GDP, the number of nuclear missles you possess and the achievements of your space program, but should include, at a minimum, the deliverance of food, water and an enightened education to your citizens.
Ennis,
I think also also boils to a fragile infrastructure, and weak checks and balances in India.
To people aware of Tamil Nadu
Rather than mindless bashing in the comment section, let me ask people who are keenly follow Tamil Nadu politics. Years ago, TN Govt. (during MGR's time, I think) had instituted a free school lunch scheme. Some other states followed it too. Did those schemes made any difference? Were they more brouhaha? I dunno know.
Maybe, white revolution (milk cooperatives in villages) did more, obviously not enough. If so, a way to solving child hunger in India might closely linked to tying such programs to small businesses/ cooperatives.
"In this case both the state and the market have failed to deliver calories to needy children."
There is nothing surprising about government schemes failing to achieve their objective. It is expected and is the norm. India is not poor because of lack of good intentions. It is poor because policy makers bow down to populism and short-sightedness.
I can bet that the current scheme of NREGA will also suffer the same consequences. 25 years and billions of dollars later GoI will realize how stupid these kind of schemes are. But then another politician will find the need to be elected on the basis of populist schemes and he/she will announce the same scheme with the name of the next generation of the Gandhi family and start the cycle again. After all, we have yet to see roads/bridges/airports/bus terminus/saving schemes/... named after Sonia Gandhi/Rahul gandhi/Priyanka Gandhi in India.
How did the market fail the children? Was the market ever given a chance? If given a chance, how does the market propose to alleviate child malnutrition? I am not quite sure. How does free market help in filling the bellies of hungry children and let them become stakeholders in the growth of India? I would appreciate some thoughts on that.
Regards,
Anindo
In 'The Strange Rise of Modern India', the author spends a considerable amount of time analyzing the failures of India's food delivery systems. Its actually an interesting book, which covers the Mandal-Mandir poles, the Deobandi Muslims and the Bajrang Dal, the Advaitists and the Atheists, the goondas of Bihar and the progessives of Tamil Nadu, charismatic TV yogis and Dalit Buddhists, Bollywood stars and Malyalee gulf-returned millionaires -the whole concoction that makes modern India a fascinating place.
What we need desperately is reforms. Esp, as Quizman pointed out, reforms - that will help liberalise the small scale sector.
On the other hand, we have been saddled with, quite possibly, one of the worst prime minister in Indian history. Being an eminent economist does not a good administrator make.
If Manmohan (glorified clerk) Singh, were truly an honest and caring man, he would resign his post.
Years ago, TN Govt. (during MGR's time, I think) had instituted a free school lunch scheme. Some other states followed it too. Did those schemes made any difference? Were they more brouhaha? I dunno know.
Right. I was actually thinking of MGR's "midday meal scheme" as I read Ennis's post. I think the plan itself was moderately successful. However, the program was also allegedly an administrative nightmare, and apparently led to a lot of graft, etc. But if the question is whether children who really needed the food got it, I'd have to say yes, some children did. So in that sense, maybe a smaller sector-by-sector (or regional/local) effort is the way to go.
FYI, the midday meal scheme did make for great political clout for MGR and the AIADMK though. An emotional plea of "it's for the children" is political gold.
FYI, the midday meal scheme did make for great political clout for MGR and the AIADMK though. An emotional plea of "it's for the children" is political gold.
I know. AIADMK milked it to the fullest. They were even huge debates on the menu for those lunches.
Does TN Govt. still have a midday meal scheme?
I know some schools in India on their own have it. It helps retention in schools.
And in case my above comment #9 seems overly cynical, I should add that Tamil Nadu's midday meal scheme is extant and remains very popular. In fact, other states have since adopted it, and in 2001, in response to a public interest litigation, the Supreme Court of India issued a directive requiring all states to provide cooked meals to students at government and government-assisted schools.
The main success of the Tamil Nadu program was not in reducing malnutrition, but in increasing enrollment and participation in education, particularly for female children.
Mid-day meal scheme's are alive and well, recently the Supreme court directed all states to have a functioning mid day meal scheme.
Sudha Murthy's, Infosys Foundation has put a lot of money into this:
http://www.akshayapatra.org/
as would expected it is mostly limited to Karnataka for now but they are expanding into Rajasthan, Orissa and UP. Seems to be a well run organization.
what does that say about us as a people? is it the corrupt government officials across the country?
or should we blame it on the caste system? i also hear so many stories of new money indians are getting their hands onto and then spending it on lavish weddings or preciaous art, but stories of giving back to the community are far and between.
this is interesting. you mean kind of like what yunus's organization does?
Yes, the TN govt realized the effectiveness of the Midday meal scheme and decided to enter into other domains; like giving free tvs. Oh, the joy of populism. Everytime I read an Indian publication, I get a justification of why I left India. :-P
It says it is important that in the interests of improving child nutrition, womens status should be raised. This need is very urgent in South Asia, including India, it adds.
"Women's status should be raised" is sort of vague and amorphous, and really provides no direction towards fixing the problem. However, there is an important underlying point. Malnourished pregnant mothers will invariably give birth to infants who will die of malnutrition (lack of sufficient nutrients in the breast milk, lack of sufficient nutrients in early solid food used to wean babies, etc).
So midday meal school meals only address part of the problem. The mothers need to be getting more to eat too.
As hideously brutal as this sounds: note that many children in India are malnourished, but most of these are not to the point of starving to death as in Subsaharan Africa. In other words, they are getting just enough food to survive from one day to the next. To some extent, this phenomenon probably is due to the success of anti-child mortality programs that fight infectious disease and other illnesses that used to decimate (or worse) the weak immune systems of the under-6 population. India is doing well enough that many of the children who used to die now are living, but without enough food to flourish.
Another point often implicit in vague references to "women's status" and "women's education" is birth control. Women who can access birth control, or demand that their husbands use it, will have fewer children and can devote the few resources they have to raising those children to be stronger and healthier (quality rather than quantity in offspring). Now that children are less likely to die young, to maintain the same number of working-age people there need to be fewer pregnancies.
I really think the mother's nutrition argument is a strong one, and I think folks are right on in generally "elevating women's status," even if that's a vague/nebulous idea. This happens in Sub Saharan African countries also, and one of the best ways to get mothers food is to tie nutrition programs to aid projects already happening (e.g. child immunization, or project evaluation surveys). While the midday meal is generally an effective intervention, it's just as open to corruption as the next project. I don't really think privatization would mitigate the impact of corruption on food reaching children. This is a pretty frustrating issue around the board; perhaps it is best carried out on the local level?
Talk about firing up the econ talk today. Nice topics, Ennis!
All democracies have officials with a vested interested in getting elected, but in India's case corruption, especially at the state and local level, is a huge problem. This post also illustrates the oft-described problem of how the economic gains in India are limited to a fairly small portion of the population.
Unless you build in accountability standards, you end up with very high levels of corruption that way too. Think about Halliburton and how they are getting paid for projects that they are not completing, or not performing within the agreed upon metrics. Infrastructure projects are rife with corruption, notorious for it, really.
The problem isn't private versus public sector. It's accountability and transparency.
The clearest picture of development versus health from the Human Development Report 2005 is at Gapminder.
While state might have failed, the market hasn't. A libralised market might have created more wealth in India in the past 10 years than in 100 before that.
Consider the amount of economic growth in the last 15 years. You would think that would have made a substantial impact on malnutrition - it hasn't, and in fact in some places it's even worse than it was before.
Wealth may be being created, but it's not affecting children's caloric intake, which is what I care about in this post.
Weren't you surprised to see some of the figures in the post?
You're framing this lamely.
Rapid industrialization in states such as UP leads to a influx of migrant workers from surrounding rural and agricultural areas. Besides the impacts on agriculture, and domestic food supplies, a large proportion of which is being exported (classic colonialism), the cities themselvers are vastly underprepared for the poulation boom.
I'm glad you're a pragmatist, but stop throwing around "accountability" and "outcomes". You're clearly aren't even aware of the basic context.
Maybe you could explain the context better yourself, "v for b"? What, for instance, might be a non-lame framework?
Ennis wrote,
Well there were no figures in the articles on which states were particularly affected, only UP was mentioned, which makes sense considering the only type of growth in that state has been in corrupt lefty parties, not economic.
Let's face it, in states like Bihar, UP, just giving them new and new programs will not solve anything. Perhaps it would work in industrialized states where there is some decent governance, but not those two, sorry. But whatever you try to do with those states is like a black hole. Liberalize those markets.
There is a food program. It is designed to feed children. It is not making a dent in childhood malnutrition according to the PM. I think that accountability and outcomes are precisely the words to use.
Secondly, the kinds of things you're talking about, migration and urbanization, are hardly unique to India. For example, they happened in China too. But these should make it easier to feed people, not harder. Cities have more jobs, and less distance to travel to a doctor or a health clinic.
The question you should be asking yourself is why has economic growth in India had such little impact on childhood malnutrition compared to what happened in other countries?
Why is everyone being so hard on Ennis lately? Ennis, just ignore it...you've been posting excellent, thought-provoking stuff.
I agree completely.
Most of the growth is impacting the top 10% of society. (I'm just throwing 10% out there as a cheap shot, the actual number could be somewhat higher...but it's not reaching the MAJORITY by any means.)
Ennis, centralised childhood nutritional schemes are bound to be rife with graft. Further, since the beneficiaries of these schemes are the poor and the marginalised, they have little leverage when it comes to demand accountability. Repeated checks by the government and NGOs are fine, but they hardly compensate for the lack of internal feedback.
Which brings us to why I think the benefits of economic development do not translate to more food for the kids. While the economy on the whole has grown, unfortunately the trickle down is yet to be seen. The difference in wealth between the middle-classes and the poor has widened to almost Brazil-like proportions. With galloping inflation and increasing wage disparity among urban and rural workers, real wages of India's rural poor are decreasing. While the government is doing its best to check inflation, rural wages have not increased due to the overdependence on agriculture using inferior techniques which lower productivity per agricultural worker.
Blaming industrialisation for drawing people out of agriculture is precisely the sort of romantic misconception that is hampering growth. Had there been a real shortage of agricultural products, prices of those would rise and farmers would stand to make more money, not less. Let farmers benefit from higher urban wages. However, this also requires the government to help educate farmers into semi-skilled work.
Setting up food banks is a noble proposition, however it does not scale well. What can be done in a county cannot be done over the whole nation.
Oops. I did not mean that you make those arguments. Some commenters here and commentators elsewhere have.
In 2003 India had 60 million tons of grain in public storage - according to Luce, a ton of rice or wheat for everyone below the poverty line and 1/5 of the world's grain stocks. Thanks to callous governance, much of the foodstuff allocated to these peple is "diverted" - a euphemism for "stolen." In the better run states (Luce cites TN and Kerala) less than 20% of the foodstuff allocated for the poor is diverted. In Bihar and UP, the figure is an astonishing 80%!
If you get a BPL card (Below Poverty Line) card you are entitled to rations of grain, kerosene, etc.. Government surveys show that 40% of those who have them don't need them. How did they get them? Bribery. But it may not mean much: The fair price shops, as I mentioned above, are invariably stocked with mildewed grain. The good stuff is on the black market. To be able to get away with this, you would need an entire nexus of corrupt officials complicit in the dealings.
i don't think this is a failure of globalization or "free markets" - it has much more to do with bad governance.
Risible - the "failure" of markets is that after 15 years of high growth, India still hasn't made a huge dent in childhood malnutrition.
Ennis, the obvious answer is that the profits generated by economic growth have not been prioritised to assist childhood malnutrition or its social or environmental causes.
Regarding educating women, I am a little divided on this issue. I think a lot of "women's education" convinces women to join the Westernised workforce, thus (as a general trend) giving them less time to have children. In a country like India, having lots of offspring, especially sons, is still socially desirable, so we see some contention between what "progress" delivers and what social standards dictate. I think that as long as a woman can afford to, she should be able to have as many children as she wants.
Perhaps the type of economic growth occuring in India is not allowing the most marginalised women -- those in rural areas -- opportunities to work in their local trades for fair wages. Instead, corporations are replacing local tradeswork and those higher wages are not being returned to the marginalised who are out of jobs.
Getting something progressive done through the government is typically the realm of those with money, and as previously argued, the most margainalised are losing work and wages to private interest.
Environmentally, India is a wreck. Lead-based paint is THE NORM for most houses, and LBP poisoning affects the neurological development of children. There are also tremendous issues with hazardous waste, PCBs, etc. All of these can affect the quality of mother's milk and therefore the health of a child.
Also, if international aid is contingent, then those who receive funds have an active interest in only intervening in communities where projects will be successful.
It's a long-term crime against humanity, and it will remain that way as long as we place all responsibility with either the government or private interest. Fundamental agendas rest on both sides of the fence.
One more thing -- India is no stranger to famine, and famine can be generated by any source -- the state, the market, the international community.
Amartya Sen's 1981 Poverty & Famine provides a wealth of information on how each of these parties can engender famine.
Risible - the "failure" of markets is that after 15 years of high growth, India still hasn't made a huge dent in childhood malnutrition.
I believe it was 70% in the 1970s, but your point is taken.
I don't think we can blame the privatization of industry or the reduction in tariffs and on roadblocks to foreign investment that facilitated the recent growth. Freeing markets alone isn't enough; the government still has a responsibility to deliver services.
Here's an interesting article I found while I was looking for more facts and figures. In it, the author, an economist argues that malnutrition is poorly correlated with income and inequality, but is instead determined by women's education and status.
From EPW:
Hidden Hunger: The Problem and Possible Interventions
http://www.epw.org.in/articles/2006/08/10475.pdf
The prevalence of hidden hunger caused by micronutrient
deficiency is widespread among Indias rural children, especially
in the age group of one to six. This articles examines possible
interventions to address the issue and the lessons learnt from
past experiences.
The Tamil Nadu Experience
http://www.epw.org.in/articles/2006/08/10478.pdf
Tamil Nadus noon meal programme has evolved via the
successful intervention of twin pressures political will that
ensured budgetary provision for the programme and the
widespread demand for it from below. Several nutrition-oriented
programmes have now expanded to cover groups such as pregnant
and nursing mothers, old age pensioners, widows and the destitute.
The need is now to create a nutrition literate populace, i e,
foster an awareness of non-food factors that in several ways
influence behaviours and attitudes related to food.
Forget private corporations or the public sector's miserable and ineffective attempts at feeding the hungry.
Check out Akshaya Patra:
http://www.akshayapatra.org/
and
http://en.wikipedia.org/wiki/Akshaya_Patra_Foundation
They do a lot of good. A LOT of good. If you want to see feet hitting the pavement, this is it. It's a pretty simple operation, really, and it doesn't require a lot of studies or reading up. It's food...for hungry kids. Not that complicated. I know, it's fun to furrow your brow and worry about cause and effect, but sometimes the solution is pretty simple. Distressingly simple, in this case.
Feel safe about donating to them. Spread the word.
Quite predictably, out come the excuse-makers for India's crimes against humanity. So Quizman, you really think it is more "darn complicated" to feed hungry women and children, when there is sufficient food rotting in godowns, than it is to put satellites into space and build nuclear bombs? Why do other nations not find it so hard to feed their citizens?
The difference is that Brazil doesn't have the massive hunger problem that India does. Even sub-saharan Africa is more successful than India in feeding its children.
Yes that is indeed "hideously brutal". The hunger problem in India is worse than that in subsaharan Africa. Africa has had a few massive famines in recent times while India has not, but the fatality rate from chronic hunger is far higher in India. Millions of indian children die every year from malnutrition related causes. Thats slow starvation. This is the shame of India that too many indians callously ignore, or try to cover up and deny, or even make excuses for. Amazingly there are many indians, in particular the BJP right-wing types, who keep insisting that India is "shining"......while half its children are starving!
What will it take to make indians grow a heart a conscience and a spine? Lets face it, India deserves the contempt of the world for this criminal neglect of its children.
i was stuck on this paragraph for bit. let's break it down.
okay
how is that bad? doesn't joing the workforce also lead to finanacial independence, confidence, knowledge of rights. thus not putting up with abusive husband that bring food home, and justifies domestic abuse that way?
educating women does not only means that their new knowledge will lead to jobs, it'll also teach them having sons is equally alright as having daughter. maybe the trend of killing young baby girls would slow down. education might also teach them that having kids is a choice, not a priority in life if it's not right for them.
if she wants. yeah of course it's fine. i hope you aren't encouraging. simply stating women's choice in the matter.
If you look at how the US went from a country where hunger was a big problem to where it was a smaller problem, it was a combiantion of allthree things. The government did a lot--not just paying for food and farms, but building railroads and then Interstates for delivering it and expending a lot of research in increasing yield,---food companies had a strong incentive to invest in infrastructure and delivery systems, and non profits and churches fed a lot of hungry people. When you look at America's historical civil society--which has been in decline---it was f---ing amazing. I mean, mind bogglingly amazing. So I have to back Salil and say that Akshay Patra seems like it's worth supporting, and social entrepreneurs who want to make a difference would be well advised to start more and more variations thereof, both non profit and for profit. More players means more competition.
When people tout the market they act like the market just happens and always exists. The market is built on a lot of assumptions that are simply rarely true. It's a great model, but it's only a model. Even the galaxies haven't had to time equilibrate to gravity in the lifetime of the universe. There is no reason to blindly believe that the market will equilibrate with the incredibly imperfect information and constricted movement usually had in a "free" market.
It seems like the real problem is corruption, b/c not only does that get in the way of governmental action, it gets in the way of more and better NGOs and more and better little companies. Historically, in America, the antidote to corruption was a combination of muckraking and easily ignited and powerful citizen outrage. But the two things need to feed each other. India has some awfully good muckraking, but considering how big it is it can always use more--and it has the additional problem of muckraking being fragmented by language, medium, and community. What I''d like to understand more of is what middle class outrage in India looks like. Where do the IIT students go marching? Where do the mandir congregations drive around activists? For what causes do the Bridge clubs raise money? Who sits on the neibhorhood committes and organizes homeowners to go harangue zoning boards and planning comissions? We're totally losing that here; in fact I'd say it's just about lost and will have to be recreated. But I'm guessing it takes other forms in India that I wouldn't recognize and I've always wondered what they are, exactly.
Markets don't solve hunger! I thought we all disproved Reagonomics and "trickle-down economic theory" back in the 1980's. I guess people just don't remember that idiocy.
It really isn't that complicated. If people are starving, give them food. All this "teach a man to fish" crap is fine, but first things first! Feed the children who can't feed themselves. There is plenty of food in India, but it's not reaching the people who need it.
Do your part: support the organizations that DO JUST THAT! Give money to the NGO's who help solve problems, rather than write goddamn whitepapers about potential logistical models to use if and when a distribution network is created.
And stop with the endless moralizing, while you're at it! It's beyond annoying to read otherwise educated browns tout the failures of education, the problems with lead-based-paint, their personal issues with Bihar or UP, when the real cause is so simple it's absurd:
INACTION.
Some problems require a great deal of thought and planning. Others require immediate and drastic action. This would be one of the latter.
risible
I agree completely. There is also a tendency to underestimate the negative effect the corrupt and bloated bureaucracy has on the country. The bureaucratic establishment is given huge powers and massive amounts of cash with little or no oversight. Apart from their sheer ineffectiveness, they also play the crucial role in enabling small time crooks to flourish in local and state level politics.
Definitely the callousness of indians towards the massive human suffering in India has some basis in hindu casteism. Sikhs feed everyone in their Gurdwara langars, muslims have charitable contributions as one of the pillars of their religion, christians are known for their charitable organizations, as are buddhists. Hindus OTOH are the worst offenders in the world when it comes to lack of charity and compassion. Of course there are some notable exceptions, the most outstanding being Sathya Sai Baba, but as a rule wealthy hindus, in particular the baniyas, would rather compete with each other in obscenely lavish weddings for their spoilt children or building fancy temples than in creating charitable foundations.
Here's Nobel Laureate Amartya Sen on India's astounding failure in feeding its children:
http://www.littlemag.com/hunger/aks.html
"we observe the continued barbarity of old problems with new and added dimensions, in the distressing world in which we live. Nowhere, perhaps, is this as exasperating as in the terrible continuation of massive hunger and undernourishment in India."
"How can things be changed? The first thing to get rid of is the astonishing smugness about Indias food record and the widespread ignorance that supports it. India has not, we must recognise unambiguously, done well in tackling the pervasive presence of persistent hunger. Not only are there persistent recurrences of severe hunger in particular regions (the fact that they dont grow into full-fledged famines does not arrest their local brutality), but there is also a gigantic prevalence of endemic hunger across much of India. Indeed, India does much worse in this respect than even Sub-Saharan Africa.[2] Calculations of general undernourishment what is sometimes called "protein-energy malnutrition" is nearly twice as high in India as in Sub-Saharan Africa. It is astonishing that despite the intermittent occurrence of famine in Africa, it too manages to ensure a much higher level of regular nourishment than does India. About half of all Indian children are, it appears, chronically undernourished, and more than half of all adult women suffer from anaemia. In maternal undernourishment as well as the incidence of underweight babies, and also in the frequency of cardiovascular diseases in later life (to which adults are particularly prone if nutritionally deprived in the womb), Indias record is among the very worst in the world."
"So low incomes, relatively higher prices, bad healthcare and neglect of basic education can all be influential in causing and sustaining the extraordinary level of undernutrition in India. Yet, as Siddiq Osmani has shown, even after taking note of low levels of these variables, "one would have expected a much higher level of nutritional achievement than what actually obtains" in India in particular, and in South Asia in general.[5]
So something else must be brought in. Osmani suggests plausibly enough the lasting influence of maternal undernourishment, working its way via underweight babies (India and South Asia lead the world in this field), who grow into children and adults more prone to illnesses of various kinds. This is in line with findings that have been identified by others, such as Ramalingaswami and his colleagues.[6] Recent medical research has brought out the long-run effects of foetal deprivation, reflected in low birth weight, which appear to cause immunological deficiencies and other health vulnerabilities. The health and nutritional adversity related to maternal undernutrition and low birth weight children is almost certainly a significant factor in explaining the terrible nutritional state of India.
Since maternal undernourishment is causally linked with gender bias against women in general in India, it appears that the penalty India pays by being unfair to women hits all Indians, boys as well as girls, and men as well as women. Even though there is ambiguous empirical evidence regarding the relative nutritional backwardness of girls vis-à-vis boys (as Svedberg discusses in his paper in this number), there is no dearth of definitive evidence of the neglect of pregnant women. For example, the proportion of pregnant women who suffer from anaemia three quarters of all is astoundingly higher in India than in the rest of the world."
Just asking again if anybody has any links/sources outlining the malnutrition rates state by state?
At least this article doesn't blame the problem on America.
The fact is India is a country with one foot in the 21st century, and one foot in the 11th. It has a population of 200 million more people than Africa in about 1/10th the area. Given this, and the fact that it is still in theory possible for India to feed it's millions, it really is a matter of "ideology". Sheer cultural inertia will prevent market or government from turning the country upside down on the time scale of decades as some here seem to expect.
>http://www.akshayapatra.org/
http://en.wikipedia.org/wiki/Akshaya_Patra_Foundation
They do a lot of good. A LOT of good. If you want to see feet hitting the pavement, this is it. It's a pretty simple operation, really, and it doesn't require a lot of studies or reading up. It's food...for hungry kids. Not that complicated. I know, it's fun to furrow your brow and worry about cause and effect, but sometimes the solution is pretty simple. Distressingly simple, in this case.i>
Salil i agree with you people on this site and most of the places are never short of ideas they can take discussions from hunger straight to caste, which makes great drawing room discussion. Irony, nobody wants to get his/her hand dirty all they do is just plane talking.
Apart from akshaypatra I also support Naandi foundation which is tackling same problem in andhra pradesh with big support from corporate india in just 4 years they have seen a massive success, which includes operating world's biggest kitchen proving food to underpriviledged children.
Why is everyone being so hard on Ennis lately? Ennis, just ignore it...you've been posting excellent, thought-provoking stuff.
Arguing the conclusions made by a poster isn't the same as being hard on the person who made them. This isn't personal [1]. I think people have objected to certain - I'm afraid, this is blunt - lazy characterizations. His research is very good. His conclusions could be better. :-) [IMHO, of course]
[1] why is it that we Indians confuse professional discourse and personal loyalty almost all the time? This has happened in companies, non-profits, college meetings and everywhere else I've been. Interactions with Westerners (i.e. people with Western attitudes - of all races) on the other hand are quite clinical. The personal is separated from the professional.
Okay, it is time to get off my high "uncleji" horse. :-)
TN program: I've heard that it improved retention. All my school textbooks had the words சத்துனவில் முட்டை புத்துணர்வு அளிக்கும்! written on the backside, meaning "An egg adds extra zing to the nutritious meal scheme!". I think it was the DMK that added the egg in as part of their election promise. This Wiki page (cool picture of MGR in it) says that Kamaraj's introduction of the program also brought big social change (maybe because of kids of all castes eating together?).
Other stuff on our textbooks, this in english - Untouchability is a sin, untouchability is a crime, untouchability is inhuman. Although this stuff was written inside the books too, I think people tended to notice it better when on the outside.
Quizman -- you agree with the facts but not the conclusions, fine. But instead of saying that these are lazy characterizations, break it down - where do you have a problem with the logic. Were you not surprised to see how hight malnutrition was? Were you not surprised to see that economic development has not made a huge dent in it (excuse the double negative but I'm running late) ?
http://www.littlemag.com/hunger/shiv.html
"Some 47 per cent of Indias children below the age of three years are malnourished (underweight). In Sub-Saharan Africa, the proportion is, on an average, 30 per cent."
"Bihar (54 per cent), Orissa (54 per cent) and Madhya Pradesh (55 per cent) report child malnutrition rates higher than the maximum reported in Sub-Saharan Africa by Angola (51 per cent)"
"Manipur reported a per capita income of Rs 8,114 (in 1997-98) and a child malnutrition rate of 28 per cent. Gujarat, on the other hand, reported a per capita income of Rs 16,251 and a child malnutrition rate of 45 per cent."
"Orissa (50 per cent[or is it 54%?]) and Maharashtra (51 per cent) report similar levels of malnutrition, but Maharashtras per capita income is almost three times higher than that of Orissa."
"Kerala and Karnataka report similar levels of per capita income. Yet 27 per cent of children under the age of three are malnourished in Kerala. The figure is 44 per cent in Karnataka."
"In 1993-94, Tamil Nadu and West Bengal reported similar levels of income poverty (35-36 per cent living below the poverty line), and yet in 1998-99, only 37 per cent of Tamil Nadus children below three years were malnourished as against 49 per cent in West Bengal"
"Haryana (35 per cent) and Assam (36 per cent) reported similar levels of child malnutrition despite the fact that in 1993-94, only 25 per cent of Haryanas population lived below the poverty line as against 41 per cent in Assam."
Note that Gujarat and Maharashtra have very high malnutrition rates (so much for the trickle down effect).While Kerala and Manipur have the lowest rates of malnutrition among the states mentioned. I expect that Punjab and Kashmir must also have malnutrition rates lower than the Indian average.
i'm wondering what the scale is used to measure malnutrition when comparing the data above. i was looking to find the details of how they determined the % but couldnt find anything. my biais is that the scales/ methods are different when comparing africa and india numbers. thresholds indicating malnutrition can be set differently. i am not saying that children aren't malnourished in india, but i think the info needs to be assessed.
one thing that is very different in approaching food distribution between african countries and india is the quality of food... this may have been mentioned already. the fact is that there isn't enough to go around, so the servings people really need will never get delivered. therefore they need to distribute fortified foods, which deliver better calories and nutrients per serving. this does happen in some places in africa, i have not come across this much in india. india HAS the technology and the know-how to deliver this, but i am not aware that such fortified foods (milk, grains, potatoes, nutrition powders being key) are being produced or distributed at the scope required.
the inaction and corruption at state and downstream levels are major issues as mentioned already... and for those who see it there is a sense of apathy and 'what's going to happen even if we try'. where lies the responsibility of the citizens in questioning this, esp among those that are far above the poverty line. no one really addresses specific issues as far as i can tell from local news programs, it's basically the goverment vs social sector. and those who aren't affected just go about their own business.
providing food and resources is an imminent answer, but not a permanent one... systems still need to be implemented to provide financial opportunity and independance. i find that lack of consistency in overseeing program progress is a problem here... suggestions have been made by governments and money has been provided but the authorities don't follow up or account for anything. the cycle keeps continuing. i think proper regulating authorities/ systems that mediate between government and citizens, holding them both accountable, need to be created
I agree with Ennis' conclusions about the lack of accountability and transparency in India's food programs. This world bank report highlights the gravity of the situation.
The chart on page 89 of the report shows the effects of rising incomes on Malnutrition rates.
If almost 50% of the kids are mal-nourished in India, than how come the "Indian"s are genetically predisposed to have coronary heart disease?? Ok, I am being coy. Main point is that I disagree with the "scientific studies" in the west that proclaim "Indians are predisposed to heart disease"...
Well, 50% of these "Indians" have other kind of worries in life :-) Again main point is that "genetic predisposition" is a bunch of bullshit masquerading as science. Besides it only applies to the tiny fraction of a group called "Indians".
As far as market liberalization goes, I honestly don't see how that could help anything at all. The market, by definition, assumes that some will "win" and some will "lose." There are not many equilibrium solutions where demand is fully satisfied. I think Saheli summed it up best - it's not a useful model/ideal, and there are other major factors going into this. As was also mentioned, Sen has done extensive coverage on the "man made" drivers of famine. There is more than enough food to feed the hungry, we simply do not choose to do it. Studies have shown that this kind of disregard for child health not only leads to high levels of child mortality (slow starvation, as I think others mentioned), but it also takes away from a child's capacity to gain human capital. Talk about furthering (one aspect of) a circle of poverty.
Then there's that little matter of political will. India could feed all its children if it really wanted to, just as every American could have government-sponsored health insurance. No one likes poor people, they don't matter, and India is no different from anywhere else in the world.
Ennis,
I haven't had the time to read through all the comments, so I might be repeating what others have said already -- it's a mistake to blame the market because the market has not been given a chance. Although food production appears to be in control of small farmers, a lot of price controls and subsidies are in effect and there's heavy distortion. The ration depots run by the state for food distribtion are a huge failure and they adversely affects distribution. The production and distribution of electricity( a lot of farming is electricity intensive) is still under state control and the populist parties come up with schemes like free power to farmers and low-income population and then failing to deliver it. Case in point is the government of Andhra Pradesh where the congress party promised free power to come in to the government and now struggling to meet the demand.
All the growth you notice in India is predominantly in the sectors where the markets have been given somewhat a free reign. The telecom sector, for example, reached the poor amazingly well in very little time of opening up. I agree with you that the state has failed in feeding children( or for that matter everybody) for a number of years, but the markets are still waiting to get there.
ut instead of saying that these are lazy characterizations, break it down -
I did, in my first comment. As I mentioned, your statement "In this case both the state and the market have failed to deliver calories to needy children." was not true, since both have in certain segments. I also mentioned that poorest segments of society in India are still under license Raj. Ergo, the market hasn't reached them. This is especially true of farmers. As we all know, farmers cannot sell their land for commercial purposes (can sell for agro purposes to individual farmers). However, the govt can usurp their land and sell it to companies. Thus, leaving the poorest sections marginalized and displaced.
My point was that we cannot make a global claim about "state" or "market" and link it to malnutrition in India. We have to break it down to regions, segments, religions, and so on ad infinitum.
There is also a personal responsibility aspect that bears consideration. I'm sure you saw Oprah's Roots last night, where individuals went above and beyond limitations imposed by the state and the market.
Half of indian children are starving and you have the nerve to claim that the state and the market have worked "in certain segments"?? I guess that makes India a "shining" success to your ilk. In normal nations such a sorry state of affairs would be considered a crisis. But not in callous India. Its too "darn complicated" for indians to solve the chronic hunger problem, says you!
The states with the most entrepreneurs/capitalists, Gujarat and Maharashtra, have 45% and 51% malnutrition rates respectively. OTOH Manipur and Kerala, which aren't home to that many baniyas, have rates of 28% and 27%. What conclusion do you draw from that?
More to the point, average income in state isn't correlated with levels of hunger.
http://www.littlemag.com/hunger/shiv.html
"It was argued that biologically and genetically, Indian children do not normally grow as fast or as large as children in other countries. This is simply not true. Extensive studies by the Nutrition Foundation of India have established that global standards of height and weight apply to all Indian children as well. And the growth patterns of Indian children who are well-fed and well looked after are similar to those of adequately nourished children in other parts of the world, no matter where they are born in New York, New Delhi or New Zealand."
Following that logic, could the market EVER be "given a chance" so long as an elected government is involved? Price controls and subsidies enjoy tremendous popularity among first world nations as well.
True, but in plenty of other ways, their lives have been changed by liberalization in significant ways. In any case, the bigger point is that GDP increase across India has not been sufficient to alleviate dire malnutrition.
I linked to state by state analyses in the comments. Again, it's still noteworthy that such major transformations have been unleashed in India's economy and yet the aggregate numbers remain relatively poor. Breaking it down is helpful, but is hardly a whole answer especially since the richer states don't have less malnutrition than the poorer ones.
Sure. But when we're talking about that many numbers, it's not likely to be an individual issue.
Assuming children living below poverty levels are the ones left behind. 24%(22% from todays Dr. Kalams Republic day speech) of Indian population are Below Poverty Line. And around 50% are children. That would be 12% are children. Of that 50% are malnourished. Which is 6% of the population. So are you telling, the other 6% were not fed by the government or NGOs?
Doordarshan,
Fine, shed your tears. These problems cannot be solved at a marco level with grandiose 5 or 10 year plans or slogans. There is no universal panacea to such issues. The lesson that we learn is to find out why the state or the private sector have succeeded in certain segments and try to replicate those in other areas - if applicable. Else, a creative solution needs to be created specifically for that area/community/ etc.
Making normative statements that the "state has failed" or that the "market has failed" (within this context) just shows intellectual laziness. Think of it this way; if a doctor gives the same medicine to 6 patients and 3 of them get better, he has to examine what was it about the 3 successes and the 3 failures that contributed to the %age of success of the medicine. Is there some other condition that was specific to each of the 3 failures that need to be rectified, to living conditions, to eating habits etc. What you're saying is that the medicine failed! Let us throw it away. That ensures that the 3 guys who got better get shafted. [It is akin to the idiot above who blamed it all on Hinduism.]
India's population increased from roughly 300 million to 1 billion in 60 years. Life expectancy has increased across the board (from roughly 32 from 1820 to 1947, t went about 60 in 2000). How did that happen? What can be done in those regions which fall short of the average? etc. So it was not like 100% of Indian govt workers are corrupt or that the entire private sector is ruthless. Clearly, some folks in some places got it right.
Here's an interesting stat:
==
Dis-aggregation of underweight statistics (NFHS-II) by socioeconomic and demographic
group reveals that weight-for-age underweight prevalence is higher in rural areas (50 percent)
than in urban areas (38 percent); higher among girls (48.9 percent) than among boys (45.5
percent); higher among scheduled castes (53.2 percent) and scheduled tribes (56.2 percent)
than among other castes (44.1 percent).
There is also large inter-state variation in patterns and trends in underweight. In six
States, at least one in two children are still underweight, namely Maharashtra, Orissa,
Bihar, Madhya Pradesh, Uttar Pradesh, and Rajasthan. The four latter states account for
more than 43 percent of all underweight children in India.
==
See what I mean by regional trends etc?
Yes, I too feel sorry for our malnourished brethren, which is why I feel that this has to be taken seriously by intellectuals.
You said:
But that wording comes from the PM:
Is he lazy too? I realize that "failed" is not a quote from him but from the BBC, but he's staying that the programme has not worked, and it was the major state effort.
Seems like the state is failing to me.
Quizman,
I would like to invite you to become chief economics adviser to the new Normaltarian party, where rational thought and analysis actually trump slogans and emotional appeals.
Gazsi
Ennis,
That's my point. The PM spoke specifically of children under six with regard to the ICDS programme. In fact, I have linked to that report in my previous post to cite regional stats.
Well, I'll concede that the failure of ICDS is synonymous with the failure of the state. But somehow, I get the feeling that I am taking the easy way out. [Possibly, it is the engineer in me who likes to view defect-counts rather than talk about macro failures. :-)]
Amartya Sen went ballistic about the pathetic malnutrition numbers which in turn incited the PM to speak out on it - ultimately its an embarassment for his UPA government, which is holding the baton at the moment. Unfortunately, other anti-poor schemes floated by Congress will likely go down to corruption to.
I am told that several thousand non-existent people have been conjured up to receive wages from the 100-day guaranteed work scheme, for the benefit of India's upstanding bureacrats, no doubt.
Its pro-labor union stance has the effect of limiting hirings in the 'organized' sector, which keeps business small, so as to avoid grasp by the multi-tentacled state monster, which leads to abuse because workers (90% of whom are in the unorganized sector) have little protection. And that limits tax collections.
The poor are subsidizing the rich's consumption of water as well. The water delivery stystem in the metros is pathetic, and the poor wind up paying money to the water mafia to obtain their daily fill, while the rich pay subsidized rates to a failed system whose workers enjoy maximum union protection!?
And then its leaders look for the jobs which give them maximum leverage as crony rajas. Why do you think Lalu wanted railways? Because he has thousands of jobs to dole out. He, who the All-India Yadav Samaj believes (along with Mulayam Singh Yadav) is an incarnation of Lord Krishna. He too believes it, and is a pious cow-protecting vegetarian as a result.
And its intellectuals go on about "neo-liberalism" ... hehe. I have a feeling the South (well some southern states)will clean up before the North - though cronyism - by world standards - is bad there too.
These problems have already been solved by many other nations. What resources are indians lacking that make this problem so "darn complicated" to you? Are indians just too dumb or what?
You just refuse to accept that India's massive hunger problem is a national failure.
You seem to think that half of indian children starving is not a national failure. That says a lot about you. It should be considered a national crisis.
Its people like you, making excuses, the chalta hai attitude, that are the root cause of India's problems. Population has increased worldwide. Why are other nations able to feed their children but not India? Your reasoning seems to be that half of indian children are not starving, so India has not been a failure. That is so....contemptible.
All regions of India are severely malnourished. Some more than others. Why are Gujarat and Maharashtra more malnourished than Manipur and Kerala?
I would really like to see some proof that half of Indian children are starving. Which report gives this information.
The numbers are from UNICEF:
I can't find the report - it came out last year. I suspect the GOI also has similar numbers of its own, otherwise they would be disagreeing.
Doordarshan: Its people like you, making excuses, the chalta hai attitude, that are the root cause of India's problems. Population has increased worldwide. Why are other nations able to feed their children but not India? Your reasoning seems to be that half of indian children are not starving, so India has not been a failure. That is so....contemptible.
Where did that come from? You don't know me at all.
My angst is because of the fact that I have spent many hours working on grassroots education as a volunteer with a NGO. I've realized that every school in every village has to be tackled differently. That there is no magic wand, as you seem to want. So fine, you feel sorry. You get angry and shout slogans and accuse others like me of making excuses. I haven't seen any creative solutions from you on this forum either.
Doordarshan is right though, India has totally failed in this regard to alleviate chronic hunger and the worst forms of poverty. However, he is totally wrong in assigning the blame . . . just like a typical lefty. Like the CCR song "FOrtunate Son" . . . and when you ask them, how much should we give, oooh the only answer is more MORE MORE! his/her solution will only be more communism/socialism, ensuring another good 50 years of economic and social stagnation. And then, when things get worse, he will have more talking points to blame everything on casteism and markets and capitalism and not enough collectivization.
That came from your opinions expressed here, where else? Why do we need to know you personally to know where you stand on this issue? Thats just silly.
You seem to be more interested in excuses than in creative solutions. A solution to this crime against humanity is too "darn complicated" for indians, according to you. That sort of attitude is the reason why India remains so hungry and impoverished. What "creative solution" to the distribution of food, water, electricity etc to all citizens have other nations successfully employed that India is unable to duplicate? This is not rocket science. Its a failure of will.
At least you recognize that India has failed. So many indians just refuse to accept that. Whats "typical lefty" about blaming the corrupt, incompetent government, the cruel, heartless culture, the apathetic media and so on about this failure?
Since you are a proud right-winger explain why right wing and entrepreneurial Gujarat is more malnourished than left wing Kerala despite being far more industrialized?
The stubborn ideologues of both left and right are wrong. Every developed nation on earth has found some balance between capitalism and socialism. Every civilized nation has a safety net for its citizens.
You dont starve in Japan, Sweden or America if you you lose your job. India to its shame abandons its citizens to hunger, beggary, illiteracy, lack of sanitation, clean water and so on. Thats criminal negligence. It makes India a failed state.
Break it up guys. Focus on your disagreements, but don't make it personal. And that goes for both of you, Quizman too.
Ennis #74,
Although not the Unicef report you are talking about, here is a world bank report that I linked above that provides some good statistics.
I only see statistics for children under 5. Not half the children in India.
I think the statement is usually that half the children under 5 or under 6 in India are malnourished. That's the age at which it tends to be measured. You're right, perhaps they're magically more nourished by 12, I dunno.