How scales were tipped against malnutrition

MUMBAI: Malnourishment has two sets of data. One, released by the government. The other, computed by the Unicef. One, which says there’s nothing to worry. And the other, which describes a horror story.

On Saturday, the horror story was evident. A team comprising medical experts from Unicef and MPs, which visited three anganwadis in Wada, Thane district, found the scales used to weigh children to check for malnutrition were faulty and, hence, sent up wrong readings.

Two-year-old Krutik M was recorded to have weighed 11.5 kg in September of this year. On Saturday, when medical experts re-weighed him using Unicef scales, he weighed 9.5 kg.

Medical expert Sameer Dalvi, who weighed Krutik, said: “According to the faulty scales, the child weighed 2 kg more, giving the impression that he was suffering from a less severe case of malnutrition. This can cause problems as the child is shown to be a healthy one, when in fact he is malnourished.”

When questioned, the anganwadi workers produced another weighing scale, which

they claimed was the one they used to weigh Krutik. The scale was a local brand — not the ones donated to the anganwadis by Unicef, and which they were required to use. When the child was re-weighed using the local scales, he weighed 12 kg.

These findings came to light during a fact-finding mission conducted by Unicef on Saturday. Raji Nair, a nutritionist for Unicef, said: “The weighing is a simple method but, if not done with accuracy, can cause mistakes which can be drastic. The kid who is malnourished can fall into a safer group due to faults either in the weighing methods or the weighing scale.”

It wasn’t just the weighing scales that came under scrutiny either. Medical experts who accompanied the team stated that children who suffered grade 4 malnutrition (the most serious form and defined as being life-threatening), were termed as “lost records” by anganwadi workers, which meant they had no information about their current whereabouts..

The records showed 13 children from three anganwadis were suffering from grade 3 and grade 4 malnutrition, and when the medical team questioned the workers as to the whereabouts of the 13 children, the workers claimed they didn’t know.

During the trip Sachin Pilot, MP, was surprised to find that the weight and height records of children maintained by the anganwadi workers were written in pencil, and could, hence, be “forged”.

Subhash Hazari, a district collector, revealed records which showed that out of the 382,341 children at anganwadis in Maharastra, 157,991 suffered from grade 1 malnutrition, 55,037 were grade 2, 692 were grade 3 and 106 were grade 4.

In 2004 the Maharastra government announced these very same regions have no malnourished children. Later, the chief justice set up a committee to evaluate child mortality rates in Maharastra. From April 2005 to April 2006, 1,700 children have died due to malnutrition in Maharashtra.

Even though Unicef experts claim that every one of the four grades suggests malnutrition - the only difference being the level of severity -anganwadi workers state that only grade 3 and grade 4 can count as malnourished.

Nair says India may soon have new standards to judge the severity of malnutrition, which would help get a better perspective of the situation: “WHO standards have been discussed with the government, and if these are implemented, it will help get a better view of the malnutrition levels in India.

Till date, we have been following the US-based National Family Health Survey (NFHS) standards, which are usually meant for Hispanics and mothers who bottle-feed children; but Indian mothers breast-feed their children. With the government implementing WHO’s standards, we’ll have a more realistic way to check malnutrition among children in anganwadis.”

Also present on the visit were MPs Supriya Sule, Shanawaz Hussain, and Jay Panda along with celebrities Rahul Bose and Gauri Karnik.