Friday, February 27, 2009

Weight watching

The infant, brought out screaming, is placed on weighing scales. The reading is 5.5 pounds. Birth weight has not gone metric in India. Calls are made to relatives and friends across the city, the country, the world. The message goes out: she's healthy, 6.5 pounds, almost 7. Back in the delivery room, the new mother is told nothing till she recovers from the strain of giving birth. Eventually, the sex of her new born is revealed. If the woman is lucky, it is her first child, and she has a few more attempts left at a male heir.
That's the way thousands of lives begin each day in India. With silence about gender and lies about birth weight. The two are more intimately connected than one might suppose. Today's Times of India carries a large feature about malnutrition in India. The writer, Kounteya Sinha, has published similar articles more than once in the past. The news remains the same. Despite concentrated efforts by this government, and by all the administrations that preceded it, levels of malnourishment in Indian children exceed those in sub-Saharan Africa. How can this be, one wonders. Sure, the bureaucracy is corrupt, sure most of the rations meant for the poor never reach the people targetted, but even so, how can all that outlay, all that effort undertaken by a nation experiencing unprecendented economic growth fail to raise nutrition levels above those of states bereft of even rudimentary governmental oversight, states whose economies are sustained largely by foreign aid. India's population has a higher per capita income, better access to sanitation and substantially better literacy rates than that of sub-saharan Africa, yet one in every three Indian children is born underweight compared with only one in every six in that part of Africa.
It's a huge puzzle, and the Times article provides no answers, just more gruesome figures. Half the child deaths in India are caused by malnutrition; 27% of the world's undernourished children live in India; 43% of children under 5 are underweight, and more than 70% are anaemic. High food prices are making the problem worse.
A few years ago, researchers isolated the cause of India's failure to improve nutrition levels among children. It lies in the extremely low position of Indian women in society. Their status is so low that the nation has an abysmal female to male ratio; so low that a girl's birth is greeted with sombre silence as often as joyous celebration. Women cook for their husbands, but eat after their men are done. They consume whatever little is left, and it is often very little indeed because the husbands have been brought up to consider only their own stomachs, and women trained to think of other people before themselves. The ideal Indian woman is defined by her self-sacrifice. All this is well-known, so it should be no surprise that over 80% of India's women are anaemic.
In Africa, they say, the social mores are different. It is shameful for men not to ensure their wives are well fed. Whatever little there is to eat is shared more equitably between the sexes.
As it happens, the nutrition levels of women are crucial to the birth weight of their babies. An undernourished female will, likelier than not, produce underweight babies, and birth weight is, in turn, a crucial determinant of future health.
The point, then, is not just to provide more food to the poor, but to ensure it is distributed more equally within households. But prejudice is bound to be a massive stumbling block in any educational campaign. The solution, in my opinion, is to fight prejudice by pandering to it. Men ought to be taught that, should they want healthy male children, they need to keep their wives well fed, and not just once a pregnancy is discovered. Women, similarly, must learn that their sacrifices are often counterproductive. By denying themselves, they are denying their children.
We may not be able to break through the disappointed silence that greets the birth of girls, but we might do better when it comes to the weighing scales.


Anonymous said...

Girish Shahane said...

Ouch, speak of the other extreme...

DS said...

It really is a distressing situation. The slum health project that the Missionaries of Charity ran in a Worli slum and a Mazagaon one where I helped out was mainly to triage out malnutrition in women and children and get them across to hospitals for a full check up , basic ed and supplements. Never worked for many reasons.

One of the reasons which was the most distressing to me was the fact that young women in their 20s were mothers several times over with barely a recovery period betw their pregnancies as the quest for a male child continued. Some had a male child but we couldnt talk re birth control as the Sisters would not allow it. That really wd piss me off.

None would turn up at the hosp for a follow up so the whole exercise became futile and I advised the NGO that their money was better spent improving the sanitation of the slum than doling out medicines for a diarrhoea that wd recur and chronic diarrhoea as one of the causes of malnutrition was huge.

The other discriminatory aspect of birth control is when it is so much easier to have a vasectomy done (rather than a tubal ligation ) why do so few men have it done ? Just think their kid could get an extra 5 marks at the med entrance ! Serious! At least in our time.