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Last Updated: Tuesday, 2 May 2006, 08:52 GMT 09:52 UK
Spotlight on India's malnourished children

By Geeta Pandey
BBC News, Shivpuri

One and a half year old Barsa cries incessantly. Thrashing her frail limbs around in agony, she appears upset at all the attention she's getting.

Mother Rukma with baby Barsa
Mother Rukma says she has little time to feed her daughter

Her mother Rukma, no more than a child herself, unsuccessfully tries to soothe her.

Barsa is severely malnourished. Doctors say her condition demands urgent medical attention.

She's been brought to a Nutrition Rehabilitation Centre in Shivpuri in the central Indian state of Madhya Pradesh, where health authorities are working hard to improve her condition.

Her emaciated arms and legs are no thicker than my thumb and under her stretched skin, her ribs are clearly visible.

Health officials say she's been on a saline drip for two days now.

Her mother says her condition has improved a lot in the four days since she's been here.

People have few concepts about breast-feeding or weaning
Manohar Agnani
local official
In her family of 14 everyone has to work in the field to earn their bread. And feeding the infant is obviously not a priority here.

"We have a small land-holding, but that's not enough to feed everyone. So I work from the morning till late evening as a farm labourer. I feed her when I get the time. But where is the time?" Rukma asks.


Barsa is among millions of children in India who are underweight.

A volunteer nurse administers vitamin A to a child
A volunteer nurse administers vitamin A to a child

A report by the UN's children's agency, Unicef, on child nutrition found that out of 146 million children under the age of five who are underweight in the developing world, 57 million are in India, giving it by far the biggest share of the problem.

Doctors say every year almost eight million babies in India are born weighing less than 2,500gm (5.125 lbs) and that millions of underweight babies die in the country annually.

The dubious distinction of having the largest number of malnourished children in India goes to the state of Madhya Pradesh.

In the tribal district of Shivpuri alone, more than 4,500 children suffer from acute malnourishment.

Unicef officials say close to 1,000 have been classified into Grade 4 - which means they are critical.

Crippling poverty and illiteracy have joined hands in this backward region and children are falling prey to malnutrition like nine-pins.

Local official Manohar Agnani admits the situation is grim.

"Almost 50% of the zero to six-year population here is malnourished. People have few concepts about breast-feeding or weaning," he says.

Mr Agnani says the problem is not confined to his state, "but definitely the more remote you are, the more marginalised you are, you'll have less access to information, less access to supplies," he says.

To deal with the problem, the Madhya Pradesh government has set up detection and nutrition rehabilitation centres across the state, supported by Unicef.

At one such centre in Chandarpur village, dozens of children below the age of five are being checked.

Screaming babies are hung in a cloth sling and weighed on a scale. They are graded according to their age and weight.

The ones seriously underweight are recommended to the rehabilitation centres.

Lack of awareness

At the rehab centre in Shivpuri town, the dormitory is teeming with babies.

Doctor Gupta (right) on his rounds
Doctor Gupta (right) says there are simple solutions to malnutrition

The four-month-old Goswami twins - Prince and Ansh, have arrived here just an hour ago and their mother Jyoti is bewildered.

"I had no idea that I wasn't feeding them properly. Everyone said dilute the milk with water so I mixed them half and half and fed the babies with a bottle."

Jyoti looks on with concern at Ansh who weighs only 1.8kg (4 lbs), the normal weight for his age is 6kg.

Doctor Ram Sarup Gupta is the paediatrician at the rehabilitation centre and it's his job to nurse Ansh and Barsa back to health.

Today alone, his clinic has received 10 underweight babies and Dr Gupta is rushing from bed to bed, checking them, ordering drips for some, prescribing medicines or a special diet for another.

"A little bit of awareness on the parent's part could have prevented these babies from getting so grossly underweight," he says. "This is preventable by simple measures."

At these centres, the children are kept anywhere from seven to 14 days.

And to ensure that there are no relapses once they are discharged, Unicef is also holding training classes for mothers - they are told what to feed their babies, when to feed them and how much to feed them.

Unicef officials say that the biggest reason for malnutrition is not a lack of food.

They say the main reasons are social - like the low social status of women, early marriage and little gap between birth of children.

"We are trying our level best," says Unicef's Vandana Agarwal, "but the number of affected children is very high. It will take us five years to deal with the problem."

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