It’s not every day that you would associate the words ‘food diary’ with children and young people living on the streets.  After all to maintain one they would need food to begin with. Child Rights and You (CRY) volunteers, in their many years of working with children in situations of poverty, realised that the general public don’t really understand what hunger means for children. So volunteers met with children from various backgrounds like those living on the street, young people involved in begging, tribal children and those commonly termed vagrants, to understand more about hunger in measurable terms, through a measurement of the calories they ingest on a daily basis. 

Chronically hungry

Two-and-half-year-old Surjo Basfore lives with his five-year-old sister on Platform No 4 of the Kalyani Railway Station in Kolkata. Their combined earnings -- about Rs 20 to 25 a day -- are handed over to their father, who also begs for a living. Breakfast is about half a puri, which brother and sister share. Lunch is about two handfuls of dal and rice. They usually don’t get an evening snack. Dinner is about two more handfuls of dal and rice or one chapati. Doing the math is easy. The total calorie intake for both children put together is about 1,000 calories. Surviving usually on food thrown away by railway passengers, they face chronic starvation.  
They are too young to understand irony. But both children live within shouting distance of Kalyani’s Food Corporation of India (FCI) godowns which have store about 11,000 metric tonnes of foodgrains.

More than eating

A few years ago the Supreme Court said that foodgrain left to rot in India should be distributed to the poor. Children like six-year-old Vishal will never know. He starts his day with half-a-cup of tea and two biscuits bought by his mother from a pavement stall. Breakfast is one samosa-pav. Lunch is khichdi from a local charity, half of which he saves to eat in the late-afternoon. By night he’s really hungry again, which is when a small packet of fries is bought for Rs 5 – the only amount his mother can spare. Vishal’s recommended dietary intake should be about 1,715 calories. He barely makes 800. Food might be scarce but Vishal’s address is a posh one. He stays in the backyard slums of Mumbai’s Khar area known for its schools, shopping malls, hospitals and steep residential property prices. All it lacks is an anganwadi, which would have gone a long way to keep children like him fed.

Tribal and neglected

Six-year-old Dharma Pahariya and Sani Paharin, from the Godda district of Jharkhand, called the Santhal Pargana, have been eating only rice and salt twice a day. Their total calorie intake is a meagre 440 calories or about one-fourth of the 1,715 calories they should be eating.

Hailing from the Pahariya tribal community they live in a parched forest that has not seen enough rain in the last few years. Food is scarce. Malaria and Kala-Azar are still dreaded threats, as they were 200 years ago. Earlier this year, media reports on the spurt of Kala-Azar cases in tribal-dominated Boyarizore and Sundar Paharia blocks in the district, prompted the Godda health department to push the panic button. But little has improved.

Food is so much more than just filling stomachs. Both doctors and people who work with children state that nourishment gaps at this age will result in lifelong poor health. Such severely malnourished children will not have age-appropriate levels of development in terms of height, weight and cognitive development. 

For such children the options are rather limited. A local nutrition rehabilitation centre (NRC) in Majhgaon, near Satna in Madhya Pradesh, a Government of India programme, runs a 15-day ‘course’ to bring near-death cases of malnourishment back from the brink of death with a two-week injection of essential food. The centre admits and gives food to only infants, and not to older children or parents, making the entire effort rather pointless, given that usually entire settlements are dying of hunger. Media reports say that 10 children have succumbed to hunger over the last year in this area.

“The condition here is so bad that the food distributed by the neighbourhood anganwadi is brought back home by the children and shared with the entire family,” says Sasmita Jena from CRY. “And since the infants are small they are the last priority and are only breastfed by the mother.”

It wasn’t easy for the volunteers working on the project to gather the data. Satyajit, the volunteer from Kolkata, who documented Surja’s food diary, says, “Extreme poverty, poor health and malnourishment made Surja’s parents reluctant to participate in the project.”

There was a time when Oliver asked for more and changed the way literature viewed orphans forever. Hunger stalks every child who is poor, whether from tribal areas or urban pockets of poverty. India’s children in poverty might not all be orphans but they certainly need more, especially in terms of nourishment.  After all. stable economic growth can’t be sustained on a future that’s so hungry today.

(Paromita Pain is a senior reporter and sub-editor with The Hindu and its feature supplements Young World and NXg) 

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 W hat people are talking about.
Avian flu

These days, the newspapers seem to have at least one story every day on avian or bird flu. Not just people but countries are frightened, and thousands of chickens all over the world have been slaughtered. What is bird flu, and why is it so troublesome? After all, the flu, or influenza to give it its full name, is a mild disease that nearly everyone gets and nearly everyone recovers from. At the most it’s a very bad cold, fever, body ache and a few days of bed rest and horrible medicines.   

The flu is a common enough disease that’s caused by various types of related viruses. Usually it causes nothing more than an annoyingly painful short-term illness. But the flu is especially dangerous because it seems to be able to change or ‘mutate’ very rapidly. So the normal resistance that people have to the flu, the resistance that allows them to fight it and get better after a few days, may not work with mutated varieties of the flu, even though the parent virus itself may be very common. It is usually the very young or the old who are most at risk since their resistance is lower. Sometimes the mutated strains are so severe that they can turn into international disasters: between 1917 and 1918 a variety of the flu, known as the Spanish flu, killed nearly 50 million people as it spread all over the world. Incidentally, an international flu epidemic seems to happen three or four times every century.

Bird flu, as you would expect, is found in birds, which, like humans, are very susceptible to the flu. In fact, there are 15 types of bird flu of which the most contagious are H5 and H7. The type that is worrying doctors right now is the H5N1 strain. Migratory wild birds, such as ducks, are natural carriers of the virus, but are unlikely to actually develop an infection. But they can pass it on to domestic chickens that, because of the way they are reared in close proximity to each other, are much more susceptible to the virus than are wild birds. Because the virus is carried by wild birds, which obviously do not recognise national borders as they migrate, there is no way of preventing its spread.

It was thought that bird flu only infected birds until the first human cases were discovered in Hong Kong in 1997. In humans it can be fatal. Humans catch the disease through close contact with live infected birds. The usual infection route is by inhaling the virus from dry airborne bird faeces. The symptoms are the same as other types of flu: fever, tiredness, body ache, a sore throat and cough. This similarity could mean that many illnesses, even deaths, thought to have been caused by something else may have been due to the bird flu virus.

As of January 9, 2006, the World Health Organisation confirmed 146 cases of H5N1 in people in Indonesia, Vietnam, Thailand, Cambodia, China and Turkey. Of these infections 76 were fatal. In countries that have recorded large numbers of infected birds, most of which are in South East Asia, all the infected birds are being killed to try and prevent the spread of the disease to other birds.

Yet, the number of cases seems to be increasing and one explanation for this increase is that H5N1 has mutated into a form that can jump more easily between chickens and humans. If true, this also means that it could genetically mix with human influenza viruses, making its spread quicker. This is what experts fear the most. If the double infection happens it could create a new virus that can pass from person to person. Once the virus gains the ability to pass easily between humans the results could be catastrophic. Right now the only people who have got the bird flu are those who have been in close contact with sick birds. In fact, some researchers believe that the virus that caused the 1918 international epidemic was an avian flu virus that changed in precisely this way.

There is no vaccine yet that prevents people from catching the virus. Anti-viral drugs, especially one called Tamiflu, are being made and stocked by countries. Though Tamiflu helps limit the symptoms and slow the spread of the virus, it does not actually cure it. In fact, if there is a universal epidemic (called a pandemic) it will be of a mutated strain of the H5N1 virus, so scientists don’t actually know if Tamiflu will actually work.

One positive sign is the way countries of the world came together to fight the SARS epidemic a few years ago. That could have been a very bad pandemic, killing thousands if not millions of people, but proper identification of the infected and their isolation in hospitals was enough to halt the SARS epidemic. The bad news is that SARS patients were not infectious during the early stages of their illness; flu patients tend to be very infectious even before they actually begin to feel sick. So, diagnosing and identifying infected people will not be easy; people can have and spread the flu before showing any symptoms.

But there are people who think that bird flu is not a serious worry; that it’s a money-making scare made up by the rich developed countries, especially the USA, and the huge pharmaceutical companies based in them.

Tamiflu (Oseltamivir phosphate) was developed and patented in 1996 by a US company called Gilead Sciences, which then sold it to the Swiss-US pharmaceutical giant Roche. This is one of the world’s largest and most powerful corporations, and they are making a lot of money from the fear of avian flu as people and governments rush to buy and stock the drug. Roche does not allow other drug manufacturers to produce Tamiflu. 

Gilead Sciences still also makes money from every dose of the drug sold. US Defence Secretary Donald H Rumsfeld not only used to work for Gilead Sciences he is also a major stockholder in the company. Other people in the US government or close to it also own shares in the company. All these people stand to make a lot of money from bird flu, and the scare surrounding the virus. Many development workers think this is more than just a coincidence.

-- Manoj Nadkarni

Kids For Change, February 2006
 
 
   
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