No food security without sanitation

Debate has been raging on the Food Security Bill in India for quite a while now, at least in the English press and online commentary. Until recently, the role of sanitation in malnutrition (and by extension, in food security) was largely missing from the public discourse. This prompted me to write an article in Pragati back in May:

While the National Food Security Bill proponents have been looking at nutrition as a ‘gross’ problem which requires more input in the form of cheaper food, the reality is that it is largely a ‘net’ problem. Far too much nutrition is lost to recurring diarrhoea, dysentery, persistent worm infestations and chronic environmental enteropathy linked to open defecation and a lack of sanitation. People in 69 percent of rural Indian households continue to defecate in the open. While most of the urban population uses toilets, little human waste gets collected and treated properly.

It is ludicrous that sanitation has not been made a priority in development policies addressing malnutrition. While the official government of India position has always been that malnutrition is ‘complex, multidimensional and inter-generational’, the interventions have largely been about targeted and non-targeted nutritional interventions, subsidized healthcare, and with token mention of clean drinking water supply and sanitation. This is like giving dysentery patients subsidized food and medicine, and asking them to eat more, and stopping the medical advice there. In the absence of focus on sanitation, what we have is taxpayer-funded diarrhea and little else. [Think Sanitation, Not Food Security | Pragati – May 2013 PDF]

It has been encouraging to see that the popular discourse has changed significantly in the last month, with sanitation and clean water getting  due recognition for their role in nutrition and food security. Several excellent articles have been written on the subject in that time.

Business Standard published an editorial early in June, questioning the assumptions behind the food security bill and arguing against rushing it through, while citing a lack of sanitation as one of several important reasons behind malnutrition.

Arvind Virmani wrote in the Times of India on how we need a ‘hunger elimitation’ act coupled with a strong policy focus on clean water, sanitation and communication about good nutrition instead of a gargantuan food security bill. Dr. Virmani, a former advisor to the Planning Commission and a Chief Economic Advisor to the Government of India, has written extensively on the topic even in the past as well.

Adi Narayan wrote a well-researched piece in Bloomberg on how extra food means nothing to stunted kids with bad water.

Robert Chambers (most famous for his development of Participatory Rural Appraisals) co-authored an article with Gregor von Medeazza in the Economic & Political Weekly on sanitation and stunting in India, on the link between sanitation and undernutrition in the country.

And most recently, Sadanand Dhume also critiqued the ‘hunger games’ in India, calling instead for a fix of the woeful public sanitation in the country.

Much of the credit for this goes to some excellent research done by Dean Spears, currently heading a start-up RICE Institute in Uttar Pradesh. While there is a whole body of research on sanitation and health, Spears catalysed the field with original analyses of large, disparate datasets.

All said, it is unlikely that anything will stop the current government from their pursuit of this ill-considered bill. One can but hope that in the long run, sanitation occupies a larger portion of the public mindspace when it comes to matters of nutrition, health and food security.

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