We’ve all seen the pictures. I vividly remember my mother telling me to “think of the starving Ethiopians” whenever I left food on my plate as a child. And I did think of the starving Ethiopians I had seen on the television, mostly with pity but also some curiosity as to why their bellies looked so rounded. Whether the cause is war, famine or natural disaster, it is these acute nutritional crises that tend to make it onto the television. Good for ratings I expect.
India has no “acute” crisis. As my boss astutely observed on the week he arrived, this is a nation capable of space travel and nuclear warfare. The rate at which the economy is growing makes the West envious and fearful in equal measure (although we’re a bit coy about the fearful bit). Naturally you might ask why is malnutrition a problem in a country such as this? A simple question which, unfortunately, does not yield a simple answer. Suffice it to say that there are multiple historical factors and geosociopolitical variables interacting in a complex fashion to produce dramatic inequalities of wealth and food security. That just came off the top of my head, so I would take it with a pinch of salt. I don’t think “geosociopolitical” is even a real word.
Whatever the causes, in practical terms, there is no quick fix for malnutrition in India. Neither I nor MSF nor anyone else can just click their fingers and make everything suddenly all better. I am optimistic for change, and things are changing, but in the interim, children are dying. So, if you can’t treat the cause, you are left with treating the consequence, which put simply, is really thin kids that can die if untreated.
But can you ‘treat’ malnutrition? You can’t really say it’s a disease in the same way that malaria or schistosomiasis are diseases, right? And maybe there is something strange about putting illnesses which are directly caused by very specific parasites in the same bracket as one with “geosociopolitical” causes. The facts are plain though. Malnutrition is associated with increased mortality and morbidity. It has diagnostic criteria. And it has evidence-based treatment. So whether you choose to label it as a disease or not (and MSF does), you can do something about it, and that is what really matters.
Luke's blog post was first published in Spanish in 20minutos.es