New Delhi: “The COVID-19 pandemic has directly impacted child survival, health and nutrition significantly due to the breakdown in economic machinery worldwide,” says Soha Moitra, Regional Director of Child Rights and You (CRY). Ms Moitra says that the ongoing pandemic has completely disrupted immunisation services and delivery of nutritional supplements for over 18 months, making children more vulnerable to malnutrition among other illness.
CRY has been working across the country to help children meet their nutritional needs to improve India’s malnutrition status. Here are some on-ground stories of young children and their parents from Madhya Pradesh and Uttar Pradesh, as they continue to deal with the nutrition crisis amid the COVID-19 pandemic.
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A 4-Year-Old From Harhua’s Battle With Malnutrition
4-year-old, Ajay (name changed) who lives in Harhua developmental block of Varanasi district in Uttar Pradesh was identified as severely malnourished in October 2019, as he weighed only 9 kgs and 450 grams. The doctor had asked his parents for immediate admission in a Nutrition Rehabilitation Center (NRC). NRC has been launched under collaborative scheme of UNICEF and Government, for restoring severely acutely malnourished(SAM) children to good health, while educating their mothers about nutrition and childcare.
But Ajay’s parents refused, as they were afraid of who will take care of other children and the household needs of the family.
By February 2020 when COVID-19 hit the entire nation, Ajay’s condition deteriorated. His father Jitendra who used to work as a labourer and used to earn barely Rs 250 a day lost his work during the lockdown.
His mother Sarla (name changed) also left the house to visit her parents. Jitendra had previously also borrowed money from others which made the family’s financial condition extremely precarious.
Sarla urged her parents to extend some financial support, with the help of which Ajay’s health improved a bit, but it couldn’t persist for long.
CRY’s partner organization, Jan Mitra Nyas came to know about the critical situation of Ajay’s health. When the field members visited this family, they found the situation ‘extremely concerning.’
They neither had work nor money and ration. The child was in an extremely concerning state, a spokesperson from CRY told NDTV.
The team did advocacy at the block level and made Public Distribution System facilities available for the family.
However, it was not sufficient as the family didn’t even have the basic grocery items to cook food. Then the team reached out to the panchayat representative to seek their help, who arranged continuous supply of vegetables and other food items needed BY the family for weeks, the spokesperson added.
Apart from that, constant guidance was provided to the family to maintain sanitation at home, and techniques to take care of a malnourished child were also taught to them.
The team also did advocacy to start the supply of nutrition supplements for the child. Today, Ajay is doing considerably well, the spokesperson tells NDTV.
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Saharia Tribe From Madhya Pradesh’s Shivpuri District
Saharia Tribe who are mostly dependent on labour for their financial needs and migrate across the country in search of work, are considered under Particularly Vulnerable Tribal Group and have been badly affected by the pandemic.
Lack of employment leading to the poor financial situation has adversely affected the nutritional needs of children of Saharias, the spokesperson from Child Rights and You (CRY) tells NDTV.
Saharia dominant Jakhnod village of Pohari Block in Shivpuri district is one among such villages where malnutrition in children has become a major challenge.
After the lockdown in the state was removed a counsellor from CRY’s partner organisation visited Jakhnod village and found four malnourished children. The condition of all four was concerning and they were in need of immediate admission at the Nutrition Rehabilitation Centre (NRC).
Ramesh (name changed) who was 11 months old weighed only 3 kgs and his height was 52 cm, Rahul (name changed) who was 35-months-old weighed only 6.5 kgs and his height was 68 cms. The other 2 children who were 18 and 13 months old weighed 5.8 and 6.4 kgs. They were in urgent need of admission in NRC but the women in families were not keen to go the center as they were afraid of staying there all alone, said Ajay Yadav of Vikas Samvad Samiti- a partner organisation of CRY.
Witnessing the situation, the counsellor explained to the parents how their children are underweight considering their age and should be admitted to the NRC for treatment and proper care.
The mother of two children Bela (name changed) agreed to do it only if others in the village are ready to do so. Parents of other children were reluctant to go to the NRC and denied, Mr Yadav said.
Mr Yadav took charge and visited these homes with Anganwadi and ASHA workers and explained the situation of malnutrition they are dealing with.
After the entire process, all four children were admitted in NRC and the health of three children improved over time. Only Radha (name changed) daughter of Bela is still undergoing treatment at NRC.
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Harhua’s 2-Year-old Dinesh Looked Barely 8 Months Old Due To Malnutrition
Dinesh (name changed), who is almost 2 years old now, was one among 17 malnourished children of Tola Kakrahi Basti of Harhua block in Varanasi district of Uttar Pradesh. Dinesh was the sixth child in the family and was suffering FROM severe malnutrition. Due to poor financial backgrounds, children in this settlement did not get proper food. These families do not have land to perform agricultural activities so they are completely dependent on labour for their earning. Unavailability of proper meals everyday makes these children vulnerable to various infections and illnesses and even a simple cold deteriorates their health.
Dinesh who was barely 6.4 kgs either sleeps on his bed or on his mother’s lap all the time. Unable to stand on the ground, the eyelids often dip and the eyes are white, the child cannot see at night, apart from this, when he speaks, the sound does not come out properly.
Though he is turning 2 years old but by looking at him, it appears as if he is only 8 months old. His hair turned completely brown and he used to keep crying constantly.
His mother Mamta tells NDTV,
My husband used to work at construction sites but lost his job during the pandemic. We could barely manage meals for the family every day. Providing nutritious food to children is a distant dream. We live in a hut. We have a ration card but the ration provided is not sufficient for the entire family.
A community mobiliser of Jan Mitra Nyas (JMN) a CRY partner organisation identified the family, provided nutritional advice, and insisted they maintain sanitation at home.
On September 7, 2020 Dinesh’s treatment for Severely Acute Malnutrition (SAM) was started by the JMN mobilizer, under which they took him to Community Health Center, Puri Kala.
The child was referred for NRC (Nutritional rehabilitation Centre). Gradually, there was a change in the behaviour of the parents, they showed readiness for proper care and cleanliness of the child. The community had an active role in this case as Dinesh’s father lost work due to the pandemic. People in the community started donating grains and food to support the family, due to which the health of the child started improving, the CRY spokesperson told NDTV.
On February 3, 2021 a health camp was organised in the settlement so that other malnourished kids can be identified and treatment can be provided to them as well.
Today, Dinesh is in a good state, weighs 8 kgs, he is healthy, and is progressing well.
Also Read: Opinion: Public Health Nutrition Priorities- Disrupted But Not Defeated By COVID-19
The Issue Of Malnutrition And The Challenges Due To The COVID-19 Pandemic
Ms Moitra says that food and nutritional insecurity were prevalent much before COVID-19 in Uttar Pradesh, Madhya Pradesh, and Rajasthan. However, the current pandemic has made it severe.
As per the National Family Health Survey-4, the combined average of UP, MP and Rajasthan is at 75 per cent death rate attributable to malnutrition in children younger than five years, compared to the national average of 69.2 per cent.
She further asserts that the COVID-19 pandemic has brought massive challenges for every segment of the society but the worst of it is being faced by the socially backward vulnerable who were already on the margin and thus living on a bare minimum.
The loss of daily wages due to the lockdown and the inability to meet the basic needs of food and nutrition led thousands and hundreds of migrant workers to return to their villages. As they migrated back to their villages, the added burden of feeding an extra person further increased the existing food insecurity. Rise in cases of acute malnutrition are an inevitable consequence of pandemic especially in vulnerable communities like Musahar in Uttar Pradesh and Saharias in Madhya Pradesh where rates of acute malnutrition were already substantially higher even before the pandemic.
Ms Moitra also explains that with limited access to the health care facilities, nutritional meals in the form of Midday Meal (MDM), and delivery of nutritional supplements, it was observed by the CRY field team members that the nutritional requirement and growth of children was compromised the most during the pandemic. Thus, making children more vulnerable to malnutrition and also to other preventable diseases.
Amidst the pandemic children and their needs were the prime focus of CRY and its partner organisations. When health services were disrupted, schools were shut, Anganwadi centres were closed and entire focus and resources were dedicated to combating COVID-19, we encouraged community support and ensured management of acute malnutrition with the support of Accredited Social Health Activists (ASHA), Anganwadi workers and Auxiliary Nurse cum Midwives (ANM), our Counselling and Monitoring Centres (CMCs) and the team of community mobilisers. They not only identified vulnerable families and malnourished children but also assisted them to combat it, Ms Moitra said.
Lastly, Ms Moitra says that the pandemic has taught us how important it is to allocate an adequate budget for public health, and it holds true for child healthcare as well.
To be precise, child healthcare should be given more priority in terms of budgetary provisions, now more than ever, Ms Moitra concluded.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.
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