The lack of a scientific or a democratic approach to improving the state of nutrition with an attempt like rice fortification can lead to more distress scenarios in an already deficient population.
By Raj Shekhar
Dietary diversity is the foremost means of providing nutrition-rich food. The loss of diversity has resulted in much-talked miseries among young and old, women and men – marasmus, under-weight bodies and stunting. The list goes on. The best, often agreed upon nomenclature in government jargon is anaemia.
It is convenient to blame weakness on anaemia and describe weak, malnourished children as anaemic children. One obvious reason is that anaemia, measured as an incidence of the red blood corpuscles, can be conveniently blamed on the lack of iron in the body. It is also convenient because all it demands in return is to pump anaemic bodies with iron. It is economical and it helps camouflage the bare necessities of life.
Which is one reason why it is helpful to raise the decibels on anaemia. Not only is a valid concern raised when all forces on earth are moved to speak of anaemia, but it also conveniently shoves the lack of other nutrients and micronutrients under the carpet.
In return, a factory solution gets thrusted on a purely dietary issue – at the expense of diets and health.
Indeed, it suits the market as much as it suits the government. Because it all boils down to dismissing undernutrition in the first place. That perhaps explains why we see mention of anaemia in loads of government documents, discussions in Parliament, NITI Aayog seminars and even speeches of the Prime Minister, no less. The use of the word undernutrition is rare. Clandestinely, undernutrition is camouflaged. Even shunned.
Discomforting questions
That meeting space of markets and government decisions is a political one and the government has far too often had its way.
Why? Because addressing nutrition, or undernutrition can open a Pandora’s box. Because undernutrition cannot be blamed on poverty alone. There are other countries that mimic India’s historical and economic antecedents and yet, fare better on the various parameters on undernutrition.
It can raise the embarrassing question: Why is India home to such high number of undernourished children? Or, even more embarrassing: Why is India doing so poorly on the Global Hunger Index? Yet worse: Why isn’t anyone talking about rampant hidden hunger in India?
The best way of avoiding such embarrassing questions is to shove it all under the carpet. Talk of anaemia does exactly that.
An anaemia-dominated discourse on nutrition helps bypass the discussion on nutrition-rich food being the only cure for the growing incidence of hunger and malnutrition. It helps complete a cycle of dishing out carbohydrates by a less-than-perfect public distribution system (PDS).
These are tough questions posed to people in power by activists, sarcastically dismissed as andolanjeevis who have, for years demanded the expansion of the PDS to provide millets and other nutritious commodities such as oil and pulses procured at minimum support prices. Worse, activists like yours’ truly have even demanded the provision of eggs and other animal-origin products to the food basket. Activists have also pointed to the scope of improving the nutritional status of children and women on a priority basis with the revival of hot cooked meals as part of the ICDS and midday meal schemes. Activists have pointed out that implementing entitlements under the National Food Security Act can resolve many problems related to hunger and malnutrition. Some even link access to forests to nutrition.
Do also read: Halt Fortified Rice Distribution, Campaigners Tell Jharkhand Government
Policy dismisses people
The people’s choice and their right to eat nutritious, diverse food is being attacked on various fronts in today’s India. Serious violations of people’s choice of food and livelihood in the form of laws, bans and calls to boycott the sale and consumption of meat are now a norm. Besides social and economic, these attacks on food habits come with nutritional consequences.
The distribution of fortified rice through the mid-day meal, ICDS and PDS is one such issue. It raises serious public health and food security concerns. To fight anaemia, the government’s ambitious plan hinge on supplying fortified rice in all food schemes by the year 2024. The Prime Minister even mentioned this in his Independence Day speech in 2021.
A pilot scheme helming the distribution of fortified rice under the PDS was expected to unfold over three years in 15 districts across 15 states beginning 2019. Yet, the distribution of fortified rice was scaled up to 257 districts of India in 15 states rejecting crucial health and safety parameters even before the pilot scheme was analysed. This approach to tackle malnutrition needs to be questioned as it puts the lives of millions at risk without resolving the problems of hunger and malnutrition.
Adverse effects from the consumption of fortified rice have been reported from different parts of the country. Reports of people falling sick after fortified rice consumption have come in. The deteriorating impact of fortified rice on health is now documented. Community members have flagged issues around the quality of fortified rice – based on taste, appearance, flavour or smell and its cooking quality and customary issues too. Families complain the cooked rice cannot be kept by for a family member returning home late, because it goes stale very soon.
No participation
These reports also raise some serious questions of no information being given to the beneficiaries about the change in the distributed foodgrains and rejecting any scope of preference or liking by the community for whom such large scale transformations are being made. The information flow within the authorities from the centre to the state level is zero in the fortified rice distribution. State Governments and their machinery are only following the authoritarian order from the New Delhi without any level of intervention as a decentralised democratic structure. It is far too top-down, without even so much as some lip service for participation.
The Right to Food Campaign and ASHA-Kisan Swaraj conducted a fact-finding on the distribution of fortified rice in Jharkhand and exposed the irresponsible attempt of the government in the fortified rice distribution to already deprived communities. Fortified rice, in effect, a new rice, is being thrust on the communities without their prior consent. The right to informed choice and awareness about the entitlement is being violated. For example, there has been an absence of transparent sharing of information about fortified rice distribution from the government side and the mystery persists regarding the unethical distribution of fortified rice in the villages of Khunti district where people suffered some health-related complications after eating this rice while it has not been the pilot district for the fortified rice distribution.
Do also read: Greenpeace India Uses RTI to Debunk Government Claims On Fortified Rice
Even risky
Mass distribution ignores the FSSAI’s regulation that fortified rice must not be consumed by people with sickle cell anaemia or that thalassemia patients must consume it under medical supervision. In many cases observed in villages, fortified rice led to serious health risks.
It raises ethical questions: Are food insecure people being used as guinea pigs? Is the experimental pilot scheme of providing fortified rice being forced on communities that have no other option to access their basic staple diets?
The pilot scheme or its evaluation have yet to be shared in the public domain. The lack of a scientific or a democratic approach to improving the state of nutrition with an attempt like rice fortification can lead to more distress scenarios in an already deficient population. Fortified rice certainly is no magic bullet.
According to the recent NFHS report, 89.9 per cent of breastfed children between 6-23 months did not receive an adequate diet during 2019-20. The second Hunger Watch survey by the Right to Food Campaign also showed a staggering level of food insecurity across the country. Consumption of nutritious food including eggs, meat products, fruits, milk and green leafy vegetables have been considerably low in the majority of households. 41 per cent of household said their food consumption had deteriorated. The dietary diversity in terms of the quality and quantity of food intake has also been poorly affected.
This puts to question the accountability that is a sine qua non in a democracy. It also points to how official systems are being bulldozed to formulate a government policy without scientifically derived evidences.
Till then, Hippocrates’ quote, “Let food be thy medicine” seems abused, or, at best, forgotten by the powers that be.
Raj Shekhar is a researcher, currently working with the secretariat of the Right to Food Campaign.
