The word “cretin” has entered the English language to mean anything from a dim-wit to a simpleton to someone downright stupid. Or shall we say challenging – c’est très tendance! If you accept this definition, then cretins are people who throw banana peels, empty chocolate wrappers and peanut shells at hungry children and statistics at each other. Worse, this seems to be the genetic trait where each progeny is grateful that it has been passed on. The jury on whether this type of cretinism is contagious or not has been out for a long time, but it has not been empirically documented and presented as a paper or peer-reviewed in a journal by experts. Why self-destruct?
Cretinism is a medical condition. It can retard a child’s mental growth. Micronutrient malnutrition is India’s silent emergency stunting its children, slowing their mental growth and economic prosperity. Micronutrients are minerals and vitamins that our bodies don’t make. They have to be added to our diet – as in food we eat and not where Japanese lawmakers meet.
Observing, studying and researching malnutrition from all angles is a very nutritious business and comes with mouth-watering speaking tours and television interviews. In addition to being a perpetual also-ran at Cannes, it affords great opportunity to speak about purchasing power parity and public private partnerships (PPPPPP). Remember how international lending institutions told us some 30 years ago that poverty was feminine? Explains why it is Garibi and not Garibo hatao.
Some 18 months ago, Prime Minister Manmohan Singh said he was ashamed to learn that half of India’s children were malnourished and released a report – what else – with a very heavy heart. India is ashamed too wrote Venky Vembu inFirstpost, continuing to drag the horse to the water with his recent piece on why the Food Security Bill (FSB) is a dud. The article describes a ritual performed by Buddhist monks for universal good.
But what do you do when India itself has been turned into goods – our common, my wealth?
The reason why India has the largest population of malnourished children (almost one in two) below five years of age is because there isn’t enough money in it for any government to take to seriously. It would take as little as two paise to cure a child of a micronutrient deficiency. Food kitchens and mid-day meals that thrive on the corrupt Public Distribution System (PDS) would be starved. How would the smart cretins explain why aerated drinks and chips reach Jhumri Telaiya and Srikakulam while life-improving iodised salt cannot? Decimals are always a nuisance compared to nice round numbers. We invented the zero, might as well make good use of it.
Cretinism is a medical condition that arises out of iodine deficiency. It can lead to stunted growth and mental retardation and was one of the major public health challenges of the 19th and 20th centuries. Access to iodised salt has played a key role in eradicating the disease from most parts of the Western world. In Switzerland, for example, the derogatory phrase Cretins des Alps (Alpine cretin) was used to describe mountain people who lived in inaccessible parts of the country where transport and, therefore, iodised salt were difficult to reach. In other countries, mountain people are also wrongly and maliciously referred to as “slow”. It bears repetition that for a large part of the last century, food fortification has played a major role in the health of populations in developed countries where several nutritional deficiencies have been eliminated through dietary diversification, supplementation and fortification.
Unlike gnawing hunger that results from going without food or water, the hunger of micronutrient malnutrition often goes unnoticed even by those affected by it. Obese children could be as malnourished as skinny children and both can die prematurely, one from eating too much of the wrong thing and the other from not having any of the right thing.
Vitamin A, iron and iodine are crucial for a child’s growth as well as the growth of nations if you believe as most sane people do, that growth and development are connected. Iron deficiency places brain and social development among young children at risk and iodine deficiency leads to mental retardation.
Data from the World Health Organisation (WHO) and other multilateral agencies say 75% of Indian children under the age of three suffer from iron deficiency. Over 50% lack appropriate levels of vitamin A. Iodine deficiency is acute in all states and the country has the highest recorded level of folate deficiency.
In 2004, a panel of distinguished economists which included Nobel laureates was asked how they would advance global welfare if an additional $50 billion in resources was ploughed into the system. The panel listed 17 issues including malaria control, water, food production, health services, immigration, carbon tax etc. In what was called the Copenhagen Consensus, the experts said providing micronutrients ranked second as having the best cost-benefit ratio to achieve a major impact in the developing world. Control of HIV/AIDS ranked first.
If the human and economic impact is so severe, if food fortification is cost-effective why is nothing changing? For a start, there’s no perceived need to address the issue. Pitted against manufactured ignorance is a fiercely competitive food-subsidy industry which will die if diseases do. It’s all a question of priority or poverty. Yes, I know I am repeating myself. Not every repetition or recall is propaganda. Malnutrition is more than a public health problem in India. Don’t believe me. Ask the next cretin who says the problem is insurmountable – which mountain?
If we were serious, all sectors ranging from post offices and the packaging industry to telecommunication and agro business, media, entertainment could pitch in to ensure that malnutrition doesn’t stunt India’s development agenda. For that you need people with vision.
As India was born, malnutrition resulting from failing crops, lower yields and increasing demands for food tormented Dr Krishnaswami Ramiah, a plant breeder and India’s first geneticist. The father of India’s Green Revolution, he set up the Central Rice Research Institute near Cuttack (Orissa – not Connecticut) in 1946.
Providing food for a young and free nation was his dream and he developed the country’s first gene-bank. For Indians like him, right to food was not a slogan or a marketing strategy – it was a fundamental right. Sixty seven years later, 830 million Indians go to sleep on a hungry stomach. There is a moral argument for why all of us in India should be able to eat well. There’s probably a reason why the word cretinism has entered the popular imagination – people are generally ahead of governments.