What to do with hidden and apparent hunger

The International Food Policy Research Institute (IFPRI) managed to get together about a thousand politicians, scientists and activists to attend a conference it organised recently in Delhi on the subject of nutrition --- both hidden and apparent ---- and how best to address it. The Economist of March 26, 2011, covered it in its inimitable fashion, beginning its report with a word-picture of vitamin-A fortified sweet potatoes selling in southern Uganda at a price 10 per cent higher than ordinary tubers, because 'they're better'. Half a million farmers in Uganda and Mozambique have already started planting the 'biofortified' rootcrop, distributed since 2007 by a company called HarvestPlus, says the paper. It seems to be commending the intervention and goes on to say that, 'Nutrition has long been the Cinderella of development. Lack of calories --- hunger --- is a headline grabber, particularly as rising food prices push more people towards starvation. But the hidden hunger of micronutrient deficiencies harms even more people and inflicts lasting damage on them and their societies...... ...... .' This isn't new knowledge. A 1960's textbook 'Health Science and Physiology for Tropical Schools' by F Daniel, published by Oxford University Press, London, gives enough information to young adults about the role of various macro and micro nutrients in 'the proper enjoyment of full health with a keen mind and a vigorous body .................... hence the need for intelligent planning of balanced diets.' Otherwise, diseases of poor nutrition are bound to trap individuals and whole societies in a vicious circle of poor nutrition- poor health- low productivity- low education- entrenched poverty. [Unfortunately, the national education curriculum in Bangladesh hardly offers anything that is even remotely close to such a comprehensively written text book for high school. The author rightly claims his aim 'is to help with a very important part of your education for life (and not merely to help you pass a written examination), because you cannot make full use of your life either as an individual or as a member of your community if you do not enjoy full health.' If only our policy makers would heed such wisdom. ] Bengal's two Nobel laureates, Dr Amartya Sen and Dr Mohammad Yunus, had come together last year for a 'Dialogue on Health and Education' in Dhaka, organized jointly by the Centre for Policy Dialogue (CPD), Prochiti Trust and UNICEF. While conceding that the crisis in human health is a worldwide problem and that there is no easy solution to it, both shared their thoughts and experiences on how the deep crisis, particularly in South Asia, might be addressed. Dr Amaryta Sen believed compulsory general education and health should be packaged together, with school meals, as a first step, beginning to address malnutrition among children and keeping them from dropping out. All enlightened school education systems worldwide in fact include one nutritious meal. Britain discovered the benefit of adding a glass of milk to primary school meals over a century ago ---- which resulted in healthier pupils and better grades. Indeed, balanced nutrition is something which Dr Bernarr MacFadden, of 'The Home Doctor' fame, keeps insisting on, as a pre-requisite for building a robust human resource. 'One should understand the subject of diet so completely that it becomes second nature merely to accept only healthful foods and in proper combination, and to ignore those that are detrimental,' says the doctor, wondering, why the subject of diet has been ignored to such a great extent by the leading schools of healing, regardless of the fact that the connections between diet and disease have long been established. More than 80 per cent of the disease burden in developing countries is said to be due to mal-nourishment and poor hygiene and sanitation. Coordinated and complementary efforts by government, non-government and other stakeholders in the health and education sectors, should certainly be able to address these core problems in right earnest ----- if the will is there. Enough income-earning activities must be generated and enough essential foodstuffs made available at affordable prices ---- not only grain but fruits, vegetables, pulses, milk, meat, eggs and fish ---- to meet the macro and micro nutrient requirements of all. But people need to know most importantly what a good diet means, what are the combinations, qualities and quantities of food items that constitute a balanced diet for different age groups. Unfortunately, even otherwise educated people in Bangladesh seem to be unaware ! The Delhi conference, interestingly, mentioned Bangladesh as a success story that is 'instructive'. Helen Keller International, which in 1990 started encouraging kitchen gardens in Bangladesh, earns credit for providing 'women (mostly) with seeds and advice. By 2003 (the year of the latest available research), four-fifths of families in the target area had gardens, against 15 per cent in the whole country. Almost all women and children were eating green vegetables three times a week, compared with only a third beforehand. And Vitamin A intake had soared. Projects like this work because they improve what people like to eat anyway,' says The Economist. Dr Mohammad Yunus also had similar illustrations from his lifetime's work to share at the Education and Health Dialogue. Hundreds of thousands of landless women have been mobilised through micro-credit and a common sense approach to self-reliance, such as raising poultry and growing their own vegetables. This intervention has helped the target group overcome night blindness, a Vitamin A-deficiency disease still quite common among Bangladesh's poor. Grameen's joint venture with the French food giant Danone, through which it has been selling packaged 'Shakti' yogurt in Bangladesh, is another nutritional project Dr Yunus doesn't forget to mention. At Taka ten, his detractors say, it is 'cheap' only for the well-fed minority. But to be fair, Shakti is made of milk, an A-class protein, not a concoction of harmful 'empty calories' that are sold aggressively as 'soft' or 'energy' drinks, by dozens of franchisees and independent companies in Bangladesh ! Couldn't the beverage companies profit by bottling nutrients instead? An incredible array of harmful substances get packaged and sold in the name of food and beverage the world over, not just Bangladesh. Health food activists have been trying to stop the entry of all kinds of toxins in the food chain, such as saccharine, aspartame and nutrasweet in 'sugar-free' goodies; monosodium glutamate/tasting salt in noodles and other edibles ; pesticides in pulses and grain, and food colours and flavours. They have been campaigning for decades to get the UN to play a pro-active role in curbing such health-destroying commerce. And they have also been asking governments to formulate policies to discourage so-called 'food and beverage' businesses that do more harm than good to human health, specially in countries like ours where most people cannot even meet their basic nutrition needs. So insidious is the power of 'brands' that even the poorest villagers in the remotest corners are found serving coke or fanta or whatever rather than the once-upon-a-time 'lebur shorbot'! It is indeed worth repeating the warning of the old sage : 'When a people's diet takes a vicious path of its own impoverishment, it causes a graver mischief than an act of cruelty inflicted by an alien power.' Decision-makers must wake up and apply their minds seriously to this crucial aspect of human resource development. As The Economist puts it : Famines lay waste to countries; bad diets cripple them silently.