In the first phase of lockdown amid the COVID-19 outbreak, Rinky, 30 relied on food being distributed by the Delhi government in a school near her accommodation in the capital’s Bhanwar Singh Camp. Despite the need to take care of her three-year-old daughter who is suffering from malnourishment, she could do little. The condition has not improved much since.
“Earlier, we would purchase three to four packets of milk per day. We cannot afford eggs, banana or Bournvita for the kids anymore. How will we take special care of our children at this point?” said Rinky, who is a homemaker and whose husband worked as a daily wage labourer before the lockdown. One of her four children Ankita* suffers from malnourishment, NGO Save the Children (STC) documented in a survey conducted prior to COVID-19 outbreak.
Antaryami Dash, head of nutrition at STC, said the survey found 44.5 per cent of children were already stunted, 14.6 per cent wasted and 30.7 per cent underweight before the pandemic. The survey sample size was of 343 children.
“COVID-19 and its indirect effects will worsen their health and nutrition through disrupted health and nutrition services, income losses and fragile food supply chains. Similar crisis in past had increased the prevalence of acute malnutrition by 50 per cent among poor children in other low and middle income countries,” said Dash.
According to the Global Nutrition Report 2020, 37.9 per cent of children under 5 years are stunted and 20.8 per cent are wasted in India. Besides, stunting prevalence is 10.1 per cent higher in rural areas as compared to the urban areas, according to the report.
Social activist Dr Abhay Bang, founder-director of Society for Education, Action and Research in Community Health, said, “The COVID-19 pandemic will worsen malnutrition because of several mechanisms. So far, the focus is on how the infection is spreading and the mortality rate. We now need to include what will be the effect on children in terms of malnutrition in terms of stunting and wasting.”
A World Bank spokesperson said that like the rest of the world, India is also vulnerable to shocks and impacts from a pandemic of the current scale and potency. “At a time of such an unprecedented crisis, the key is to ensure continuity of services,” said the spokesperson.
Multiple surveys pointed out that people struggled with less or no rations amid the pandemic. A recent Centre for Equity Studies report showed communities struggled with hunger with loss of livelihood. Surveys by Stranded Workers Action Network also documented workers who were in distress in the absence of access to rations throughout the lockdown period.
“This gets progressively worse. In the beginning, you can survive on savings and borrowings. As the situation persists, people run out of their savings, others are less willing to give and the employment opportunities do not pick up to the same extent. It will be difficult to lead the lives they led earlier, which includes their number of meals and the quality of those meals,” said economist Jayati Ghosh.
Niru whose daughter Naina* of one and a half years suffers from malnutrition said the family cannot afford health drinks any longer. “She has become weaker during the lockdown. It is not possible to take special measures when we are barely struggling with roti and chutney and black tea,” said Niru who worked as a domestic worker. Sources of livelihood have stalled amid the pandemic. Her husband who worked in the valet parking in a fitness centre in Hauz Khas has not been paid beyond March.
At this hour, ensuring food security of the vulnerable sections is the immediate need, said Arvind Singh, advisor, health and nutrition, NGO Matri Sudha.
Two-and-a-half-years old Neha* in Bhanwar Singh camp who suffers from malnutrition, also suffered from bouts of diarrhoea.
Reduced access to healthcare services and repeated bouts of infection can further aggravate cases of malnutrition, said Dr Bang. “If other forms of care suffer, the children will not only get less food from the family but also less care from the healthcare system. As a result, illnesses would increase resulting in increased malnutrition,” he said.
The Global Nutrition report 2020 had emphasised on the link between malnutrition and different forms of inequity, such as those based on geographic location, age, gender, ethnicity, education and wealth. Inequities in food and health systems increase inequalities in nutrition outcomes that in turn can lead to more inequity, it said.
*These names have been changed on request.