Institute for Indian Mother & Child (Calcutta, West Bengal, India)

“Inequitable distribution of food and malnourishment is one of the injustices. I think it is to the credit of the government that it is planning to bring about the Right to Food Act. Prime Minister Manmohan Singh and Sonia Gandhi are in the right territory. It is a step in the right direction. I [recently] found that there was a change in the administration even in the backward areas. A wider cross-section of people had access to food and it showed how change people’s initiative and a good leadership can bring about. No other country comes close to India. Most of the African nations have lower levels of child malnourishment. It is a situation of manifest injustice and we have the means to remove it but there is a certain level of smugness about India’s achievements. The most difficult and nasty thing about malnourishment is that incapacitates the mind and debilitates the body. One must recognize that poverty, lack of food, illnesses, and state of education in India are closely linked, and are of the same magnitude”.
~Dr. Amartya Sen, Nobel laureate, humanitarian, & one of India’s leading authorities on child development & human rights

“In our country and across the globe, the resistance to injustice and the fight for freedom, eradication of the poverty is an instinctive human response and it should be a continuous effort to all of us. Poverty, hunger, disease, death, and social injustice cannot be fought with weapons- they can only be truly challenged by our will force and values to the humanity.”
~Dr. Sujit Kumar Brahmachary, Founder & medical director of the Institute for Indian Mother & Child

I could not ask for any more perfectly aligned ending to my global health journey this past summer than the Indian government’s decision to pass the Right to Food (Guarantee of Safety and Security) Act the very day I departed from Calcutta (the final destination of my research project) to California. In addition to the legislative victory, Nobel laureate and one of India’s leading child nutrition activists, Dr. Amartya Sen, was stationed in Calcutta the same week I was there in order to praise the Indian government’s decision on the bill, as well as speak on the salience of contextualizing child undernutrition as a basic right for India’s future generations. What more could I ask for- a bill and an individual who exemplified the very ideals I kept close to my heart these past two months.

During one of his press conferences, Dr. Sen assessed, “The Right To Food Act is an integral component of the United Progressive Alliance’s proposed National Food Security Bill mentioned in the budget speech under which every poor family would get 25 kg of food grain per month at Rs. 3 (6 cents US) per kg. I think it is to the credit of the government that it is planning to bring about the Right to Food Act. Prime Minister Manmohan Singh and Sonia Gandhi are in the right territory. It is a step in the right direction. I [recently] found that there was a change in the administration even in the backward areas. A wider cross-section of people had access to food and it showed how change people’s initiative and a good leadership can bring about. Though the public distribution system has achieved something quite considerable, it still merited a depth of probe on how effective were the [food] distribution networks.” Dr. Sen’s West Bengal-based non-profit organization, the Pratichi Trust, is dedicated to researching the state of food security and child undernutrition across the country. His organization is currently investigating the Integrated Child Development Services (the government department that implemented the school Mid-day Meal Programme), and how it applies to children under below six years of age in six districts of West Bengal. Dr. Sen professed the importance of the non-profit sector to hold the Indian government accountable on social injustices such as child undernutrition and in describing his thoughts on the Mid-Day Meal Programme, he proclaimed, “What Europe introduced in the 19th century, India was getting it 200 years later.” His implications of governance and institutional violence as significant culprits of India’s child undernutrition epidemic ensured me that these contributing factors were not only recognized at a community level (as I found with my research), but on a national and international level as well.

India’s Prime Minister, Manmohan Singh, one of the most influential decision makers on India’s child nutrition policies. During his 2009 India Independence Day speech a few weeks ago, he included in his new promises for the “golden future” of India that no one should go hungry and that legislative action regarding food security would be a reality in the near future.

However, most essential to his speech with regards to my research in Calcutta, Dr. Sen stressed that the magnitude of undernourishment was especially devastating among woman, mothers, children, and infants. I decided to pursue my research project in Calcutta, a city that is infamous for its child poverty and exploitation, as well as gird-locked bureaucracy, because I felt that few other Indian non-profit organizations have done more to advocate for the proper nutrition of women and children in India than the Institute for Indian Mother & Child (IIMC). IIMC is a comprehensive, multidisciplinary health center located among the most neglected and disenfranchised villages in the rural outskirts of Calcutta. Its mission is to promote child and maternal health, literacy, and local and international peace by providing access to health care, education, and economic empowerment to Calcutta’s most impoverished communities. The activities and departments of IIMC include its medical program (20-bed maternal and pediatric hospital and five outreach clinics), a health education and promotion center, a Bengal NGO network program, a child scholarship & sponsorship program, 23 village-based schools, a socio-legal rights department for its patients, and integrated rural development project center, including a women’s microcredit banking system (six microfinance banks that were blessed two years ago by Nobel laureate Muhammad Yunus) and agricultural program.

Dr. Sujit and his wife, among some of their Nobel Peace Prize-winning mentors, Dr. Muhammad Yunus and Mother Teresa, who visited and blessed IIMC’s center.

IIMC was founded by Dr. Sujit Kumar Brahmachary, a pediatrician and the former medical director of Mother Teresa’s child orphanage Shishu Bhavan. Dr. Sujit has become one of my most inspiring teachers in the field of global health and in life; what he once envisioned and then built as a tiny health clinic in a cow shed has now become a heavenly oasis of hope and well-being amidst a back drop of destitution and vulnerability. The lives of 2,000 children and hundreds of women in IIMC’s surrounding villages have been uplifted physically, mentally, emotionally, economically, and spiritually due to Dr. Sujit and his wife’s tireless global health and human rights work.

IIMC’s acute care hospital includes numerous specialty units for its patients, such as ophthalmology, obstetrics and prenatal care, child nutrition, and rehabilitation for burn victims. I pursued my global health research in the child undernutrition residential child care center under the mentorship of the community health workers, nurses, mothers of the undernourished children, and IIMC physicians. This center treats children suffering from diseases directly caused by undernutrition, such as Marasmus, Marasmic Kwashiorkor, and Kwashiorkor.

IIMC child nutrition hospital unit

I also spent quality time in IIMC’s Tegharia Outdoor Centre, which focuses on health education and promotion services, in which approximately 700 patients visit the outdoor clinic twice a week. This micro-clinic provides severely malnourished children with nutritious food packets, as well as counsels mothers on proper breastfeeding practices and nutritious diets for children as they progress through the different stages of childhood.



IIMC’s kitchen for its child nutrition center IIMC’s child undernutrition feeding packet,
comprised of culturally appropriate foods

The growth and development of each child in the surrounding villages are consistently monitored using a weighing scale and growth charts.



At IIMC, a mother is taught the proper way to IIMC’s Intensive Care Programme child
feed her disabled child in the handicapped growth monitoring chart, which is crucial to children’s hospital unit. the individual and community monitoring of
child undernutrition in IIMC's surrounding
villages.

In terms of advocating for IIMC’s right to food among its pediatric patients, Dr. Sujit and other health professionals devote a substantial amount of their time in advocacy via print journalism and meeting with human rights groups to better understand how IIMC can integrate a human rights framework in their patient care. A book written about IIMC revealed that “in order to combat the dysfunctional education and health care systems, high birth rates, large-scale illiteracy, and shocking human rights record, the IMMC devised a multi-pronged program to empower women and children through holistic healthcare, education, and economic self-reliance.” Dr. Sujit stated that IIMC’s aims of patient empowerment and community development, and not charity, laid the foundation for its rights-based framework. He expressed that “women and children are the agents of change in any community; if these disenfranchised groups can be empowered today, they will usher in a brighter tomorrow.” Most prominently, IIMC created the Women’s Peace Council, which strives to address human rights and social justice through the ideal of peace in their communities. By training the mothers of IIMC’s undernourished child patients to become community-based rights activists, Dr. Sujit believed that they would take a vested interest in the demanding work that human rights activism requires. The purpose of the Women’s Peace Council is to educate villagers about their legal rights and responsibilities, including their children’s right to nutritious food, and to improve the social health of the community by encouraging cooperation of the community. At least once a week, council members are responsible for making home visits in the community, and at least once a month, the women organize a meeting with the villagers or organize a cultural program for the community.

*To learn more about IIMC and how you can become involved, please refer to:
http://www.iimcmissioncal.org/

Right to Food Campaign & Sambhavna Trust Clinic (Bhopal, Madhya Pradesh, India)

As the state with India’s highest rate of child undernutrition (50.09%), I continued my global health journey from central to northern India to Madhya Pradesh in its capital city of Bhopal. Despite the city’s ubiquitous conservative Muslim culture and resource-starved health facilities, I have read about or observed few cities in the United States that rival Bhopal’s impassioned, progressive grassroots health and human rights movement. I decided to continue my research project on child undernutrition and human rights in Bhopal through two leading non-profit organizations, the Sambhavna Trust Clinic and Right to Food Campaign. They are among the most successful models in holding the local and national Indian governments, as well as the international media and public spheres, accountable for the city’s health and associated human rights atrocities.



Sambhavna Trust Clinic

The Sambhavna Trust Clinic, a comprehensive health center founded by an eclectic cohort of renowned health professionals, scientists, writers, and social workers, is the clinical branch of the broad social justice coalition, the International Medical Commission on Bhopal. This campaign initiated the domestic and international environmental health justice campaign in 1994, which primarily advocates for the basic rights of the hundreds of thousands victims who lost their life or were disabled due to the American company’s Union Carbide gas leak in Bhopal in 1984. The mission of the Sambhavna Trust Clinic is to implement simple, safe, effective, ethical, and participatory ways of clinical treatment, monitoring, and research for the survivors of Bhopal. In addition to preventive and curative health care, the Sambhavna Clinic has initiated numerous local, national, and international human rights advocacy campaigns, protest demonstrations, court orders for the arrest of Union Carbide officials, and social media appeals. By keeping the Union Carbide tragedy fresh in the minds of government and corporate authorities a quarter century later, the Sambhavna Clinic has effectively delivered health care to tens of thousands of patients in slums in near proximity to the Union Carbide factory based on a model of social justice. In 1992, the Permanent Peoples’ Tribunal in Bhopal confirmed that the fundamental human rights of the Union Carbide victims had been grossly violated in terms of a series of articles in the various international declarations concerned with human rights. Although it was possible to sue with the International Tribunal for Human Rights in the Hague, it is often the case that transnational companies have more power than national governments, and as of now, none of these corporations have not signed any declarations on human rights.


Although Sambhavna does not focus on child undernutrition, I pursued my research specifically with the health center’s human rights activist and managing trustee Mr. Sathyu Sarangi, in order to understand Sambhavna’s methodology of approaching Bhopal’s health crisis through its world-reputed, successful rights-based approach, in which their tangible health outcomes are arguably India’s most well respected and cited. As a former engineer and now internationally recognized human rights activist, Mr. Sarangi has dedicated his life since the disaster in 1984 to seeking justice for the 25,000 individuals who have died since then, as well as 100,000 people who have suffered injuries. I have included below some of his inspiring thoughts on health and human rights below:



“Social activism among staff members is deeply ingrained into our daily work goals. Staff members participate in cycle rallies, poster exhibitions, and signature campaigns as part of their involvement with local and global social awareness and activism. More than half of its staff members are themselves survivors of the environmental disaster, and so they are social activists who are committed personally to the cause. I have suffered numerous death threats, I have received many beatings, as well as three prison sentences. But I refuse to allow these physical ailments from distracting me from my campaign. This is how deeply we are all committed to the human rights campaign we started. Along with raising issues of Bhopal and specific demands against Dow and the Indian government, the campaign has raised issues of corporate accountability, penalizing corporate crime, public access to information on industrial actions, inherently unsafe technologies and products, and the regulation of corporate activities.

However, community-driven activism is what drives most of our local and global human rights advocacy work. For instance, in 1994, about 350 women from the communities affected by groundwater contamination occupied the director’s Bhopal Gas Tragedy Relief & Rehabilitation Office for three-and-a-half hours, demanding the supply of safe water. The protestors left only after the director gave them a written statement promising immediate action on the matter. Each of the communities has a group of women representing it. These women keep track of the quantity and quality of water supplied every day. This facilitates prompt response. The data collected by them is used to nail government’s lies in the Supreme Court. All decisions are taken at open meetings, in which representatives from different communities participate. Over 2,000 people, mostly women, are expected to travel to New Delhi to protest against the delay in distribution of compensation. Community leaders have mobilized people for this campaign, visiting the communities and speaking to people. Local supporters carried out house-to-house visits. In terms of a recent example, there will actually be a rally taking place on August 5, 2009, which marks this year’s Hindu celebration of Rakhi [a day in which sisters tie rakhis, or decorated string, around their brothers’ wrists as a sign of sibling affection and appreciation of their protection and love]. The Sambhavna Trust Clinic will transform an ancient religious ritual that is deeply ingrained in the hearts and minds of Indian families throughout the Indian subcontinent into a day of addressing the health and human rights of this community. The Sambhavna Clinic staff will march alongside 100 women up to the Madhya Pradesh government offices with rakhis on their wrists, and demand that the government officials, or their “brothers,” live up to their duty, or dharma, by protecting their communities from further political and financial neglect. In another example, health education by Sambhavna’s community health workers led to collective action by residents of the communities affected by groundwater contamination.”

Some of the most prevalent human rights issues in our community are:

a) Child undernutrition: The breast milk of local women has been found to be toxic and children born to exposed parents of the 1984 gas leak are also affected by poison leaked into the air, soil, and water by the Union Carbide Corporation, all which influence their nutritional status.

b) Inequality in the populations affected: The poorest, who lived closest to the chemical plant, were hit the hardest. In addition, the shortest in stature [children] inhaled the most fumes since they were closest to the ground where the gas mostly resided.

c) Poor governance: The Government of India retains the exclusive right, according to the Act of Parliament, to represent the survivors of Union Carbide. The government must be the people’s own lawyer, but since they are not playing this role, the people have to fight for their ‘natural lawyer’ [the Government of India].”



*For further information about the Sambhavna Clinic & Union Carbide disaster,
please refer to:

1) Bhopal Express (Bollywood movie, 1999)
http://www.bhopal.fm/bhopalexpress.html

2) Bhopal Medical Appeal/ Sambhavna Trust Clinic website:
http://www.bhopal.org/


Right to Food Campaign

The Madhya Pradesh Media for Rights/ Right to Food Campaign, or Vikas Samvad, is a state partner of the national Right to Food Campaign and its headquarters are located in Bhopal. Its campaign is grounded in the belief that the main responsibility for guaranteeing the basic entitlement to food lies with the state, and the national Right to Food campaign focuses on the following food security issues: the national Employment Guarantee Act, the universal Mid-day Meal Programme in all primary schools, universalization of the Integrated Child Development Services (ICDS) for children under the age of six, effective implementation of all nutrition-related schemes, revival of the public distribution system, and equitable land and forest rights. On the state level, the Right to Food Campaign’s mission is to engage in research and advocacy initiatives in order to address the following human rights issues in India: poverty, food security, livelihood, disability, women’s rights, globalization, health, social exclusion, education, child rights, environment, and right to information and governance.

I pursued my research project specifically under its child undernutrition and human rights campaign, which engages in multiple local and national activities, including public hearings, rallies, conventions, action-oriented research, policy recommendation reports, media advocacy, and lobbying of Members of Parliament. I was fortunate to interview the lead investigator and director of the Right to Food Campaign, Mr. Sachin Jain, who was one of the most insightful and experienced public health leaders I have ever had the pleasure of interacting with. Excerpts of my interview with him are included below:



“Child undernutrition is only an outcome, not the process that breeds inequality and injustice. We must create linkages with this issue to other fields, such as law and human rights and education. The Indian health departments can only play a small role in this multifaceted issue. When a child is brought to a health facility, we see more and more how the role of public health in addressing the root causes and cures is very limited. We must focus on how the issue of child undernutrition evolves- that is the important question, not on the outcomes…Child undernutrition is an issue of household food security and of livelihood and of a control over natural resources and of drought and unemployment. There are too many macro-issues to name.

But first and foremost, we must examine the public health and biological issues associated with child undernutrition. We witnessed that child undernutrition was a direct and indirect cause of child death in Bhopal, and this is the reason why we have the highest double burden of child deaths and child undernutrition in the country. The irony of the situation is that the period of growth between 6 and 24 months is the most crucial period of physical and mental development for a child, and since this period falls after the exclusive breastfeeding period of 0 to 6 months, the highest number of undernourished children lie within this age range in India.

Second, there is no specialized national or local food program that exists for children suffering from tuberculosis, HIV/AIDS, leprosy, and other physically taxing diseases. Because these children are already stigmatized by their disease, they face a double burden of exclusion since the absence of a tailored food program for them leaves them vulnerable to child undernourishment as well. Most disabling, however, has been the public health community’s narrow purview of child undernutrition and neglect of the social determinants of the condition. Public health professionals have focused too much on which macro- and micro-nutrients are lacking among children, as well as hygiene quality of the meals served in schools. But right now, the priority is fighting for the mere survival of government schemes and political will, and not on the quality of food delivered. If we cannot even allocate even the most basic food rations to all children in India, how can we even focus on these smaller issues? I have realized that we cannot fight all these issues from all different angles at one time. We must unite as a public health community and fight an organized, streamlined campaign to garner the attention of the Indian government and navigate the already chaotic political environment efficiently.

Third, we must understand how international food policy influences our domestic right to food policy decisions. By opening our country’s issue of child undernutrition to a worldwide audience, we are able to contextualize how our undernutrition rates compare with that of other developing countries. When the Indian government and society hears that Madhya Pradesh possesses a child undernutrition rate similar to that of Ethiopia and Chad, they can gain a better picture of the gravity of our situation. We cannot approach our problem in isolation, and international food policies allow us to study what worked for other countries and what failed.

Finally, governance is of utmost importance when looking at the issue macroscopically. Governance must provide a basic environment for the right to basic survival, and this is the most basic indicator of good governance. So what else can we expect from the government than their assurance to the basic amenities of food, water, shelter, health, and education? But good governance in India is stifled by development politics, especially since India is the second fastest growing economy in the world and possesses the largest number of consumers. Thus, the root problem is that the Indian government places all their resources and attention on approaching the country’s development through economic growth indicators, rather than on human development indicators. We have damaged our health care delivery system for the last 60 years, and it will only take the humility of the Indian government to accept this fact and take action. We must implement a strong monitoring system, and genuinely engage the community to get involved in these health and human rights issues. Good governance means creating a decentralized system of leadership for service systems such as health. In addition, the government must have the humility and integrity to admit to the severity of the problem. Nine children died in duration of a week in three villages of the Satna district of Madhya Pradesh. The issue came to light when someone got wind of it. The health department issued a report that the deaths were owing to undernutrition. However, the Women and Child Development Department immediately denied the report, implicating that the children had succumbed to various other diseases, and so the department was not responsible for the deaths. No responsible officer visited Satna and the WCD Department managed to alter the report mentioning that the children were above six years of age and thus outside the purview of the government’s care.”



*For further information about the Right to Food Campaign, please visit:
http://www.mediaforrights.org/foodsecurity/food_security.html

Community Rural Health Project (Jamkhed, Maharashtra, India)

"At Jamkhed, the Aroles nurtured a process unique in community action in one of the best primary health care projects in the world. It is unique in truly getting people's involvement. They believed that the very poor have a great capacity for change and can effecitively take positions of leadership if given a chance and some support. As in other social changes, they are turning the customary academic order upside down. Rather than starting with what is considered academic excellence, they are starting with the ultimate truth, which is that the future belongs to the people."

~Dr. Carl E. Taylor, a professor emeritus at the John Hopkins Bloomberg School of Public Health, father of the modern-day community, & mentor to Drs. Aroles

"When I started, I had no support from anyone, no education, no money. I was like a stone with no soul. When I came here they gave me shape, life. I learned courage and boldness. I became a human being."
~Sathe, CRHP Village health worker

One of the most coveted desires of the Government of India is its abandonment of its third world label. As increasing media attention on the country’s child undernutrition crisis prevents this from occurring anytime in the near future, the Community Rural Health Project’s (CRHP) rights-based approach to child hunger may be the country’s most promising solution to curbing the epidemic. I decided to first journey to the rural villages of Jamkhed, Maharashtra for one month in order to tangibly learn how to effectively address child undernutrition through the lens of human rights from true global heroes, CRHP’s village health workers (VHWs). Due to the VHWs’ tireless public health, clinical, and child rights advocacy work, they have succeeded in reducing their villages’ child undernutrition rates from 46% in 1971 to less than 0.1% today. These VHWs are women who at one time experienced gross human rights violations on their own personal accord: some were former leprosy patients who were denied the right to health care; most were once young girls who were stripped of their right to a primary education; and then others were wives who experienced gender-based discrimination through domestic abuse and lack of land rights. And yet, their resilient spirits brought them to CRHP in order to advocate for the rights of future generations of villagers, in an attempt to cease, or at least slow down, the vicious trajectory of poverty, disempowerment, and social injustice in their villages. As Dr. Carl E. Taylor assessed, "Illiterate and outcaste women could become leaders who would address international conferences and advise India's Prime Minister."

A group of CRHP village health workers and I during a focus group session on child undernutrition and human rights. I was fortunate to share their cultural, linguistic, and religious background, which provided me the opportunity to establish relationships with them based on mutual trust and interest in each other's lives. They began to treat me like their daughter, and each moment that I spent with them was filled with love and inspiration!

Since 1971, CRHP’s mission has been to approach community-based primary health care as a universal human right by eliminating cultural, social, and economic injustices which deny all people access to this right. By mobilizing and building the capacity of communities, CRHP’s primary goal is to ensure the access to health care and freedom from poverty, hunger, and violence for all Jamkhed citizens through a value-based approach to health and justice. Serving over 250 rural villages and 500,000 individuals for the past four decades, CRHP has partnered with village communities in order to elevate local knowledge and resources, and to effectively meet the immediate and long-term social and health needs of India’s most vulnerable populations: women, children, impoverished families, indigenous tribes, and low-caste individuals. Furthermore, CRHP specifically focuses on addressing human rights violations that are rooted in harmful cultural and religious traditional practices, such as dowry deaths and female infanticide. CRHP was founded by world-renown physicians and global health experts Dr. Raj Arole and Dr. Mabelle Arole, and is now directed by their surgeon daughter Dr. Shobha Arole. CRHP engages in primary and preventive health care for its target villages through its village health workers, provides secondary medical care at its comprehensive hospital managed by physicians and surgeons, and engages in social and economic transformation of its villages through the formation of Farmer’s Clubs, Women’s Clubs, and its Girls Adolescent Program.

Since CRHP’s renowned reputation among the global health community has attracted the attention of students all over the world, I was fortunate to be accepted into its one-month student course along with 14 other public health and medical students from the U.S. and Bhutan. We were blessed with the opportunity to participate in application-based lectures by the Aroles and VHWs, village visits, leadership development workshops, and group presentations. My research project focused on interviewing its village health workers by leading focus groups, as well as documenting my experiences in government schools, CRHP’s schools, and village-based nutritional rehabilitation feeding centers. I was able to witness first-hand the processes, successes, and challenges faced by government-sponsored child nutrition programs, such as the Integrated Child Development Scheme’s Midday-Meal Programme. During my village visits, I observed how CRHP’s nurse tests for anemia among adolescent girls, a ubiquitous sign of micronutrient deficiency among India’s young female population.

I also observed how the VHWs monitored the status of their villages’ child nutritional status through their UNICEF weighing scales, community growth charts, and individual child growth monitoring graphs. In terms of the assiduous human rights work that the VHWs engage in, no other form of insight is better than the words of CRHP’s VHWs themselves, and I have included some of their thoughts from my focus group sessions below:

“In our village, we are giving them [villagers] knowledge about the
human rights. For example, we educate them that each child should go to school, and if their families are below the poverty line, they must receive free housing from the government. We also give education to the young women in the Adolescent Girls’ Program, the Farmer’s Club men, and the Women’s Groups about human rights. We advise the government that our villages must be given clean water. All the village health workers come together to contact the government officer that is in charge of the issue we are fighting for.”

“Through the national and [local] Maharashtra government, taking care of children’s health and education is very important for us. But we believe we first must empower parents at home so that they can be educated and fight for their rights with their own voice. We teach parents that education is free for girls from the 1st to 10th standard [grade]. We also visit schools regularly and check the children’s blood, hemoglobin levels [for girls], height, and weight. We educate children about nutrition and personal hygiene using flashcards in the 1st standard, and we give health education to all children up to the 10th standard. We have excellent coordination and good relationship with the government and CRHP mobile health team workers. If the teacher or nurse of a school or nutrition rehabilitation center does not come regularly, we will report their absence to the village officer. Most importantly, people listen to VHWs more than government officials since we are one of them. The government is coming from the outside, and so they spend less time and attention on their relationships with these people. This is the reason why the VHW’s role is very important.”

“When we were young, we were very poor, so there was no food to eat… so forget about nutrition. When I was a young girl, no one gave special attention to me because I was a girl. So for me, human rights meant I had no rights because I was a girl, and so I was the last to be given food. I received no education either because everything went to my brothers. ‘Just let her die,’ my parents said. ‘Do not give milk to her since she is a girl; her birth has no purpose.’ My parents never thought about human rights because they were never informed about them. I married at 11 years of age, and no one was there to tell my parents about all these things like child rights until CRHP came, then I understood human rights.”

“The Indian government has organized programs for child nutrition in primary schools, so that two meals are given to children daily. But the quality of the food is very poor because they are giving food without much care. Many times, the food is finished before all children are fed, and if the local government runs out of money, the food stops coming into the schools for 3 or 4 days at a time. There are many drawbacks to these government schemes. When we started our work at CRHP 20 years ago, we saw the benefits of these government programs. Children were given milk, wheat, oil, halva [semolina-like grain porridge], and other foods that were good for their health. But that was 9 or 10 years ago. I would say that only 50 percent of the child undernutrition problems today benefit from these government programs. In some places, where government funding is sufficient and there are good doctors, nutrition will be good. Voluntary agencies, the Indian media, newspapers, parents, and children understand the importance of nutritious food. The VHWs are the most important people in the village and they talk regularly about nutritious food to families. Everyone [in the CRHP target villages] now has enough money for grains, vegetables, and eggs, due to the social transformation CRHP started. So now, in all the project villages, almost no malnourished children exist.”

*Suggested readings:

1) Community Rural Health Project website:
http://www.jamkhed.org/index.htm

2) “Necessary Angels” (National Geographic, 2008):
http://ngm.nationalgeographic.com/2008/12/community-doctors/rosenberg-text/9

India's Child Undernutrition Crisis in the Context of Human Rights, Structural Violence, & Governance

“There is no trust more sacred than the one the world holds with children. There is no duty more important than ensuring that their rights are respected, that their welfare is protected, that their lives are free from fear and want and that they can grow up in peace.”
~United Nations Former Secretary-General Kofi Annan

“The problem of malnutrition is a curse that we must remove.”
~Indian Prime Minister Manmohan Singh,
2008 Indian Independence Day Speech

Where will you find the highest rates of undernourished children in the world? In Somalian refugee feeding camps set up by Doctors Without Borders? In the drought-prone and resource-deprived war zones of Afghanistan? No, instead it is India, the nation with the second fastest rising economy in the world, a country with the world’s highest surging millionaire population. As the daughter of Indian-born immigrants, this year’s endlessly glowing spotlight on India as home to the Oscar-winning Slumdog Millionaire, selected host to the 2010 Commonwealth Games, and home to this past spring’s largest democratic elections in human history, my family has been celebrating the international acclaim their mother country has received lately. However, these successes translated in my mind as points of confusion rather than cultural pride. This was the same India that boasted humanity’s largest democracy, and yet social justice was no where to be found when it comes to the nutritional status of its 391 million children. After spending the past few summers engaged in child health work in the rural Himalayan villages of India, I became accustomed to weekly reportings of child starvation deaths in the news, children too weak to learn their daily lessons at school, and youth dying not from malaria and HIV/AIDS, but simply from a lack of basic nutrients to sustain their growing bodies. I could not justify conceptually or experientially how a country abundant with newfound wealth could at the same time engender 47% of its children undernourished. If China possessed similar child undernutrition rates as India in the 1970s and managed to reduce its incidence to 7% today, while experiencing a comparable economic growth rate as India, why did India continue to fail in achieving the public health successes of its next-door neighbor? Maybe the epidemic extended beyond a solely economic purview and was rooted in the multilayered, clandestine forces of governance, human rights, structural violence, and politics.

The discrepancy between what is and what should be impassioned me to return to my ancestral lands this past summer to three regions of India that inherited among the highest rates of child undernutrition in the country, with the support of the USC Institute for Global Health. My practicum research project, which focused on the contextualization of India’s child undernutrition crisis within a human rights-based framework, became for me a cause to advocate for rather than a practicum requirement to fulfill. I was fortunate to pursue my research question at four non-profit, community-based comprehensive health centers that are renowned locally and internationally for its health and human rights work. Following this blog post, I have chronicled my life-transforming experiences at each of these global health institutions: the Community Rural Health Project in Jamkhed, Maharashtra; the Right to Food Campaign in Bhopal, Madhya Pradesh; the Sambhavna Trust Clinic in Bhopal, Madhya Pradesh; and the Institute for Indian Mother & Child in the southern rural outskirts of Calcutta, West Bengal. In addition, I have listed below a recent article that includes an interactive audio slideshow that greatly inspired me during my initial research work on India's child undernutrition crisis. It provides profound insight into the multi-faceted sociopolitical, economic, and human rights issues surrounding India's child undernutrition epidemic.

Suggested reading:
"As Indian Growth Soars, Child Hunger Persists" (New York Times; March 13, 2009)
http://www.nytimes.com/2009/03/13/world/asia/13malnutrition.html

Fondue, Swiss chocolate, and tobacco - My experiences at the WHO - Geneva, Switzerland

I had the amazing opportunity to intern at the World Health Organization headquarters in Geneva Switzerland. I interned with the Tobacco Free Initiative (TFI) with their Communications Team, which mainly worked to develop strategies to implement and promote the Framework Convention on Tobacco Control through with their Report on the Global Tobacco Epidemic, MPOWER, funded by the Bloomberg Initiative. My scope of work included assisting the Communications Team with regular communication work (e.g. drafting PowerPoint presentations, preparing press and advocacy kits for important events, help with photo and video footage selections, contributing to new ideas for promotion and advertising), drafting letters and articles for the director of TFI, doing internet searches to determine the breadth of press coverage of WHO's advocacy and media outreach effort in the area of tobacco control, as well as assisting with the development of the World No Tobacco Day 2009 campaign. My supervisor was a former well-accomplished journalists who graciously allowed me to attend meetings and interact with other departments within the organization. My internship at the WHO was an incredible experience that not only allowed me to meet remarkable leaders in global health, but also has tremendously help to shape my future career and endeavors.