Double Malnutrition Worries Young Mothers in Musahar Villages

It is well known that Covid directly affected child survival, health and nutrition due to the breakdown of economic and government machinery.

Children of the Musahar community, the most marginalised among Dalit castes, in the post-covid period in Annai village, Badagaon block of Varanasi eat unhealthy packaged foods like Kurkure, chips and cream biscuits which have a high salt, sugar and fat content. Regular consumption of these unregulated and ultra-processed foods has pushed them into a double burden of malnutrition, leaving them susceptible to non-communicable disease.

In the Musahar hamlet of Annai, mothers are worried as their children’s addiction to packaged foods is making them suffer from liver ailments, affecting their cognitive function, and leading to muteness, frustration and depression.

The 56 families here used to work in brick kilns in conditions of servitude but now work as sharecroppers. Due to interventions by social action groups, those who were derided as rat catchers and had all-pervasive untouchability perpetrated on them have now seen perceptible change, as they own 4 biswa (5400 sq. ft.) of land.

25 year old Savita, who has a 2 year old son and 5 year old daughter named Anshika says, “My daughter used to cry and throw tantrums when she was not given crunchies. To stop her incessant crying, her grandmothers would feed her with 14 Crunchy packets a day. Doctors at the PHC advised me to stop feeding her crunchies. Now she can’t even talk and always clings to the lap of her grandmother.”

Anshika was severely malnourished and developed chronic fever. Addiction to crunchies affected her deeply, while she used to talk she now suffers from muteness and cries throughout the day.

Her grandmother Shama confirms, “She was severely malnourished when she was little, and being fed too much crunchy has physically and mentally incapacitated her. She cries throughout the day and never gets down from my lap, only when I give her biscuit or toffee. I know it’s not good but what to do?”

Seeing Anshika’s condition, Savita has kept her 2 year old son away from packaged foods. “My son needs protein and fat so I give him one egg a day. He was also born underweight but now he has recovered.”

21 year old Anita, who also has a 2 year old son, shows a chips packet saying, “My son suffers from a liver ailment so he should stop eating potato chips, which the doctors advised. As my son was born malnourished he should not take chips as they are high in salt. He also cries for crunchy, which we avoid giving him.”

23 year old Rinka has done the same. “I have stopped giving my son and daughter crunchy and chips. Rather I try to give my children an egg a day. I keep them away from packaged foods. I know that crunchy contains plastic and seeing Anshika’s plight I never encourage my children to take crunchy. Sandhya didi and Mangala bhai had been making us aware about the harmful effects of packed foods so we follow them thoroughly.”

According to Santara, 27, “My younger sister-in-law would daily feed 10 packets of crunchy to her one and a half year old son Akash. His daily consumption of crunchy damaged his liver. He suffered from chronic diarrhoea and he died.”

According to a Lancet report published in December 2019, “The double burden of malnutrition is the coexistence of overnutrition (overweight and obesity) alongside undernutrition (stunting and wasting) at all levels of the population—country, city, community, household, and individual.” The report explores how double malnutrition is affecting low- and middle-income countries.

Sandhya Jatav, a Dalit activist of the People’s Vigilance Committee for Human Rights (PVCHR) who works among the young mothers of this Musahar village says, “Most of the women living in this hamlet are anaemic so the risk factors are high. During their pregnancies, blood transfusion is a necessary factor. As these women are financially too poor to bear that expenditure our organisation mobilises support for them. As their children are born severely malnourished we start advising them not to feed their kids with kurkure, chips or biscuits. Rinka’s husband is 8th class pass so he followed what we asked him to do.”

The Musahar hamlets in Annai and neighbouring Koeripur, Lakhapur and Dallipur villages of Badagaon fall within Prime Minister Narendra Modi’s parliamentary constituency and have long been the most neglected part of the Varanasi district. In 2007 Jigar, an infant boy living in Annai was severely malnourished, along with 16 other children. Jigar’s condition became precarious and he became susceptible to infections. The PVCHR intervened and got Jigar admitted to the Pandit Deendayal Chikatsalaya. After a thorough check-up at the hospital, the doctors wrote in his prescription that he was suffering from malnutrition.

Mangala Rajbhar, a postgraduate in chemistry who works among the Musahar for the PVCHR says, “Earlier, there have cases of severe malnutrition among the Musahars but the brazen practice of untouchability kept them away from hospitals and PHCs.

“In 2007 when it came to the fore, Mayawati was Uttar Pradesh’s Chief Minister. NDTV was first to report it and interviewed Jigar’s mother Gangajali, who gave the statement that ‘governments come and go but our condition remains the same: rather we are further pushed to worse conditions.’

“When the UP CM saw the report she sent her team to investigate the matter. When it proved factually correct, immediately the 16 families were disbursed agricultural land for livelihood purpose and to build their huts. The Lion’s Club working in Jaunpur sent a team of doctors to Annai and nearby villages for treating the malnourished children. Jigar’s life was saved and now he goes to school.”

Asked about packaged foods and their effects on children, Dr Arvind Pratap, a medical practitioner specialising in child health and nutrition says “None of the packaged foods has a description of the quantity of sugar, salt, fat or calories in it. Children in the Musahar villages of Badagaon block which I visit regularly suffer from severe malnutrition. Children here consume crunchy, chips or cream biscuits packed in locally manufactured transparent polybags, which are more dangerous… They are pushing themselves in the double burden of malnutrition.”

The Union Ministry of Health and Family Welfare found that the contribution of non-communicable diseases nearly doubled from 30% of the total disease burden (in disability adjusted life years) in 1990 to 55% in 2016. There was also an increase in the proportion of deaths due to NCDs from 37% in 1990 to 61% in 2016. This shows a rapid epidemiological transition with a shift in the disease burden to NCDs. This trend is expected to continue in the years ahead.

Malnourished children receive inadequate nutrition early in their life, and illness for them is more pronounced than for children who receive adequate nutrition, due to their weak immune system. If stunted children later in life regularly consume unregulated ultra-processed foods and drinks laced with high fat, salt and sugar, as a replacement for nutritious cooked food, they become more susceptible to obesity and later may suffer from cardiovascular disease, diabetes and other ailments.

“In this situation, there should be urgent policy action on Front of Packet Labelling (FOPL) regulations, which facilitate and in fact empower consumers taking healthier choices while purchasing package food products from the store. Often a consumer takes less than 10 seconds to select package food products from the store, not enough time to read and interpret many complicated nutrition facts panels,” adds Dr Arvind Pratap.

“During the pandemic, doctors, health experts and nurses recommended that people eat healthy nutritious and homemade food. We moved in with a medical team to the Musahar hamlets and advised them to eat healthy food, green vegetables and proteins like egg. They say they cannot afford it,” says Shruti Nagvanshi, convenor of the Savitri Bai Phule Mahila Panchayat.

“We have found that they spend Rs 20-30 daily on packed food items. They are spending on things like crunchy, chips, cream biscuits, mixtures, packed items manufactured locally. Let’s persuade the government to implement FOPL, otherwise an army of diseased people would emerge consuming packed foods. Let a new beginning start with FOPL regulations as it happened in Chile, Brazil, Mexico or Peru.”