“There is no better joy than laying the foundations of a strong future for these little children,” Narendra Modi wrote in a blog for the Times of India in 2013.
Children are the future of the world, but some children don't make the cut. Take the case of four-year-old, Ayush, who also has a legitimate claim to a bright future, but has been living as an emaciated child. Compared to his elder and stronger siblings, Ayush spent his formative years indisposed. Instead of playing outside, like his peers, Ayush spent his day indoors, his bones bent with rickets, caused by a severe vitamin deficiency.
Stuck at home with a broken foot, Barkha, Ayush’s mother who lives in Prem Nagar, at the Delhi-Haryana border couldn’t register herself at an anganwadi for a government-funded meal. Consequently, for lack of care, Ayush weighed only 1.5 kilograms at birth – a weight gap that hasn’t been addressed yet.
Barkha says the Accredited Social Health Activists (ASHAs), by the government of India's Ministry of Health and Family Welfare (MoHFW), somehow failed to identify her as a pregnant woman.
The onus is not on any one person but the system as a whole, which failed to monitor these government-funded nourishment programmes.
If malnutrition is perceived as a mere health issue, it can turn into an epidemic for generations of a family. In many cases, malnourishment turns into a vicious cycle. A weak mother gives birth to a weak child, who in turn will produce weak children. That aside, it also stunts social growth.
In 2013, a study carried out by charity Child Rights and You (CRY) in 2013 found that despite Delhi’s relatively high GDP, 36 percent of 3,650 children surveyed in Delhi’s urban slums were recorded to be malnourished as a result of the unequal division of wealth.
Malnutrition in all its forms increases the risk of disease and early death. India accounts for 22 percent of the total deaths of children under five worldwide, according to a UNICEF report.
The dismal truth is that India’s capital alone accounted for 135 deaths of children under the age of five in 2012.
The Performance Audit Report of the Integrated Child Development Services (2012-13) submitted by the CAG named Delhi among the nine states, where the percentage of malnourished children are above 50.
In an anganwadi located at an urban slum in Lal Kuan along Delhi-Haryana border, close to where Ayush lives, a chart paper is pinned to the wall, with a time-table of sorts, detailing what food is to be served through the week.
At first look, it does appear that the government has arranged for proper meals to feed malnourished children. A fixed budget of Rs 6 for every child, Rs 7 for pregnant women, and Rs 9 for malnourished children in anganwadis with a calculated intake of protein and calories for each category. However, there is no weighing scale in sight to track the children’s growth.
“We don’t have weighing scales because the ones provided by the governments are all faulty,” says the anganwadi worker dispassionately.
Between 2013-14, 1,126 weighing machines were found in working order for the 10,987 operational anganwadis.
On paper, the government spends Rs 9 per malnourished child. However, anganwadis in and around Delhi don’t have any special direction from the government. Extra care for weaker children generally means extra helping of the same food.
A five-year-old girl, Dipanshi, walks into the anganwadi and seats herself between two children. She is visibly smaller and thinner than the others.
Dipanshi has been identified as one of the cases of malnourishment by Matri Sudha, an NGO that works for children, as per the WHO standard of age-weight proportion.
For the lack of any special government guidelines on malnutrition, Dipanshi walks out with the same portion of chana (gram) and halva (sweet dish) as her peers.
“We need to understand how malnourishment affects children and hold counseling programmes for mothers so that we can arrest the deficiencies at an early stage,” says Arvind, head of Matri Sudha.
For the lack of a government initiative, the NGO works in tandem with ASHA workers and anganwadis to identify cases of malnourishment before it becomes critical beyond cure.
“In urban slums, junk food is a flexible replacement of proper food (given that it’s cheap),” Arvind explains. “So we need to tell the parents how to find the best diet in a tight budget.”
In 2016, Arvind wrote to the Chief Minister of Delhi, Arvind Kejriwal, intimating him about the 1,038 children who were found to be severely underweight in the capital in 2015, urging him to improve the nutrition level among children at community level.
Read the letter below:
On receiving no reply from the government, he had nowhere else to go but seek help from the judiciary.
In 2016, he filed a PIL at Delhi High Court demanding the appointment of the Food Commission in Delhi as mandated under the National Food Security Act, 2013, to monitor the functioning of these government-funded schemes.
A little intervention and evaluation of the situation of malnutrition in Delhi will help ensure that each child receives his/her entitlement to nutritious food – thereby arresting malnutrition at an early phase.
Even Ayush, who is still struggling to gain the same amount of physical strength as his peers, can catch up, with a monitored diet and adequate medical care.
His weight is slowly picking up and he wants to go out to play. What’s more, the four-year-old, who has just started going to school, is also an ace at taking selfies whenever he chances upon a phone.
(This story has been published in collaboration with Child Rights and You, an NGO in India that works for the upliftment of underprivileged children.)
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