Fast-growing India can’t outpace woes

Subelal Choudhury’s two daughters show classic signs of malnourishment: their close-cropped black hair is tinged orange, and their stick-thin arms and legs, protruding from dirty orange-and-yellow sailor suits, are covered in a mild skin rash.

But when the father looks at the pinched faces of his 8- and 5-year-olds, he sees nothing worrisome.

“If my children are underweight, then all children are underweight,” he said, waiting with the girls outside the government-run Safdarjung Hospital in New Delhi, where his wife had gone to visit a friend.

Choudhury isn’t entirely wrong.

Figures from India’s National Family Health Survey this year show that despite the nation’s fast-growing economy and growing gains against poverty, about 43% of Indian children younger than 5 are underweight and 48% of children in the same age group are stunted in height.

While malnourishment is worst in rural areas, the study shows that it remains a major problem in cities as well, with 33% of urban children underweight and 40% stunted.

“Progress on child health and nutrition has been painfully slow,” the government said in a presentation of new figures, noting that the country’s record on child malnutrition remains among the worst.

According to the report, based on a nationwide survey of families in 2005-06, 79% of children younger than 3 also suffer from anemia, as do 58% of pregnant women. Those percentages have risen since the last national survey five years ago.

The problem crosses all income levels, with more than half of rich children also suffering from lack of iron in the blood, the report said.

“It’s a vicious circle,” said Dr. Priyanka Verma, a doctor at Safdarjung, a government-subsidized hospital serving primarily poorer patients.

Because about a third of Indian women are underweight and many are anemic, they tend to give birth to infants with low birth weights and anemia, she said.

Then, because many families are poor and struggle to give their children adequate and nutritional food, the children remain underweight.

Malnutrition in turn makes the children vulnerable to a host of infections and other problems.

“People are mostly malnourished because of poverty,” Verma said.

Sarla Devi, a mother waiting outside Safdarjung hospital, ascribed 4-year-old daughter Rinki’s waif-like figure to a possible heart condition. But the child, she said, generally ate little but tea and bread.

The girl, dressed in nothing but an oversized T-shirt that revealed bony legs and knobby knees, weighed just 18 pounds, her mother said, and hadn’t yet been able to start preschool because she was often weak and sick.

“If she gets better, we might send her next session,” said Devi, who with her husband has four other children.

The government survey showed that while India’s birthrate is falling, from 2.9 children per woman in 1998-99 to 2.7 in the new study, the rate of population growth remains well above the government’s goal of a fertility rate of 2.1 children per woman by 2010.

The highest birth rates are among India’s poorest and least educated women, the survey showed, and knowledge of modern contraception remains poor, with most couples relying on female sterilization as their main birth control method, if any is used. Altogether, just 56% of married women practice birth control.

“We need a smaller population and more resources for each child,” said Verma, the Safdarjung doctor. “We’re educating people to adopt a two-child family but it doesn’t always work.”

In an indication of India’s growing divide between rich and poor, the study also found that obesity is a growing national problem, particularly in wealthier urban families. Altogether, 13% of Indian women and 9% of men are overweight, the figures showed.

The study was based on a door-to-door survey, accompanied by measurements and blood testing, of 125,000 women and 75,000 men across India.