Child malnutrition, or rather child malnourishment, has always been a sore spot for India. The unacceptably high incidence of stunted growth and protein-energy malnutrition diseases like kwashiorkor and marasmus in children below 5 years in the country have held international attention for long now. There finally seems to be some real understanding of the problem in the policymaking circles of late. India has very recently made the vaccine against rotavirus—the pathogen responsible for most of the cases of dehydration and diarrhoea in children—free for distribution, along with three other vaccines. Rotavirus-caused diarrhoea kills over 80,000 children in India annually while putting millions of others in the hospital. But this shocking bit of statistics reveals only a part of the havoc the pathogen wreaks. Princeton researcher Dean Spears found that poor sanitation—rotavirus spreads through the fecal-oral route, via contaminated water or food—affected nutrient-absorption in children adversely, leading to stunted growth and a host of deficiencies.
Thus, in India, where there are more households with mobile phones than those with access to sanitary toilets, rotavirus causes a problem larger than children dying of diarrhoea—it creates survivors whose growth and development is sub-par, leading to the shamefully high figures of malnutrition/malnourishment. So, while India pours millions into programmes of questionable efficiency in addressing problems such as PDS and free meals in government schools, the approach should have been to control rotavirus spread through improving access to sanitation and safe drinking water while vaccination mitigates the problem in the interim. Thankfully, the government has taken care of the vaccination part. Now, it is time to focus more on sanitary toilets for schools and households than on leaky and ineffective mid-day meal schemes and PDS.