The Vulnerable Population in India--It's a Big Crowd!

The theme of this year's World Population Day was vulnerable populations in emergencies, as I mentioned a couple of days ago. This referred especially to refugees and internally displaced persons, who are disproportionately women and children. But there are a lot of vulnerable people out there on a regular basis, even without having to be part of an emergency. Last week's Economist reminded us of this by highlighting the details of an Indian government/UNICEF nutrition study in India, the report from which the Indian government has seemingly been trying to hide. The report apparently shows substantial progress over time in reducing stunting in India, but there is still a long way to go to bring all Indian children up to the average for the world--right now they are worse off than children in sub-Saharan Africa. 

India’s government has been sitting on the report for months, though it has been ready since at least October. One rumour suggests official concern about the quality of the data, but Unicef has voiced no such worry. Another possible reason is the pride of India’s prime minister, Narendra Modi, who ruled Gujarat for a dozen years. The new data indicate his relatively prosperous state performed worse than many poorer ones.

The RSOC [Rapid Survey on Children] suggests that the proportion of children who are wasted fell from nearly 20% to 15%, and the stunting rate fell from 48% to nearly 39%. Yet still, more than half of children in Uttar Pradesh, a massive northern state, are below normal height. And amazingly, even among the wealthiest fifth of Indian households, more than a quarter of children are stunted. This may be because of sexism: mothers and girls get less food, health care and education than males. Over half of all girls aged 15-18 had a low body-mass index, meaning they were likelier to produce undernourished babies.

Related to these vulnerabilities is the poor sanitation in India--where there are more cell phones than toilets.

India’s age-old habit of defecating in the open—which distinguishes it from many other developing countries—makes matters worse. The proportion of Indians who do this has fallen from 55% a decade ago to 45%, but that is more than enough to help spread diseases, worms and other parasites that make it more difficult to absorb nutrients even when food is abundant. Poor public hygiene may account for much of India’s failure to make faster improvements in nutrition. There is a clear correlation between open defecation and hunger.

Health in India is not a top priority of the current government and despite progress this still means that nearly one in six humans lives in a country where their health is unnecessarily put at risk. That's an emergency of some kind or another.