“There are people in the world so hungry that God can only appear to them in the form of a piece of bread.” Mahatma Gandhi
Gyota was born three-and-a-half months ago. She has spent half of her short life as a patient in the Malnutrition Intensive Care Unit, or MICU, that Médecins Sans Frontières (MSF) opened just over a year ago in the Darbhanga district of northern India.
Her name means “light” in Hindi.
The centre normally cares for children who are at least six months old, but Gyota’s condition was very serious, she was so weak that she couldn’t even cry so the MICU made an exception for her. She weighed less than two kilos when she arrived.
I look at her and notice that the shirt she’s wearing is far too big for her. Nineteen-year-old Jhuma Devi is Gyota’s mother and is dressed in a pink sari, with a ring in her nose and several bracelets on her wrists. Jhuma married at 16 and Gyota is her first and only child.
Gyota, has spent half of her short life as a patient in the Malnutrition Intensive Care Unit © Irene Núñez/MSF
Gyota had been vomiting and had diarrhoea for days. When the local doctor saw her, he sent her quickly to the Darbhanga hospital, where they referred her to the MICU. Gyota is very thin, with wrinkled skin that clings to her bones.
Mother and child occupy a bed near the door, from there they watch the days pass and see the mothers arriving at the centre carrying their babies in their arms, hoping for a miracle. The doctors say that they will have to spend at least another two weeks in the centre. No one has come to visit them.
“As I had no milk to breastfeed her and we don’t have a cow, I bought milk at the local market. But it’s very expensive. There are five of us who depend on my husband’s earnings: my husband’s mother, his two sisters, my daughter and I," says Jhuma.
"He earns 7,000 rupees per month (less than 100 euros), and he can’t get sick as they won’t pay him if he does. He hasn’t come to see us because he works far away in Delhi, in a mobile phone shop where he’s in charge of six people,” she says with great pride.
Darbhanga is in the state of Bihar, which is one of the poorest in India. Bihar exports cheap labour to the rest of India, and by extension, to the world.
Biharis do most of the menial jobs at the lowest pay, and many have left their families behind, sending money home from wherever they are.
“I’d like to have two more children, one of them to care for us when we’re old, if possible. When a girl marries, she leaves home to live with her husband’s family, but boys stay and work, and care for their parents,” explains Jhuma.
Anwori Khatoon’s situation is similar to Jhuma’s. She is 32-years-old and the mother of five children. Her husband works in another state, she says, “I think he’s in Calcutta. I’m not sure what he does, but he sends us money every month.” Anwori’s youngest child, eight-month-old Ajameti, is in the MICU. They arrived today together with her oldest child, a boy.
“The other three children stayed with my mother-in-law. I realised the baby wasn’t well because he was coughing, had trouble breathing and had a fever,” she says. “He’s now receiving oxygen, which seems to help him breathe.”
Ajameti’s birth was completely unexpected. Anwori had decided that she didn’t want another child and was going to visit the family planning service, but became pregnant during one of her husband’s visits. She was clear that she didn’t want more children, but her husband did.
“How will I feed them?” she asks me. “Have you seen how thin my daughter is?”
It’s true. Amajeti weighs less than four kilos and her arms hang limp next to her body. According to World Health Organization Growth Chart at eight months old she should weigh twice as much as she does.
Two children die every minute in India from malnutrition-related causes. That is just a statistic, a cold number. But last night in the MICU we had the horrible experience of watching a malnourished child die. Just one of the approximately 750 children who die every day from malnutrition or related causes in India.
Being born in Bihar, where one out of five children under the age of five is malnourished, most likely makes a child destined to be hungry. The more fortunate ones may survive, but throughout their lives they will suffer from severe development problems – they will only half-live their lives.