MALNUTRITION: The silent killer -- Malnutrition stalks urban poor

December 22, 2010
There is overwhelming evidence to establish a symbiotic relationship between malnutrition and children of migrant labourers living in urban slums. The recent death of 16 children, all of them less than six years old, from malnutrition and related illnesses in the last eight months in just one area of Mumbai serves to underscore urban poverty and the non-existence of even rudimentary healthcare system for the poor in our cities. These tragic deaths also highlight deep-rooted problems afflicting urban slums, where children are exposed to unhygienic condition, pollution and contamination due to overcrowding and lack of basic civic amenities. What should concern authorities is that malnutrition in urban slums remains neglected by policy-makers. Studies have shown that the nutritional status of slum children is even lower than the rural average. It is primarily because families living in urban slums do not qualify for the 'below poverty line' category. Moreover, the maternal and child health services that occupy an important place in socio-economic development programmes have failed to address the problems in urban slums because they follow the rural model. These services have failed to take into account that with both parents working, children are usually left unattended and neglected; that they are born with nutritional disadvantage because their mothers are malnourished and not in the best of health; and that they are more vulnerable to communicable diseases. Slum-dwellers are often ignorant of the fact that malnutrition is a silent killer.
Since migration from rural to urban areas will continue to happen, Government must work on providing better living conditions, access to clean water and healthcare for migrant workers. If Mumbai has only 183 public health posts and 162 public healthcare centres for over 82 lakh slum-dwellers, the situation in other smaller cities and towns can well be imagined. There is no denying that Integrated Child Development Services in cities is in a shambles with inadequate staff and thus fails to provide the necessary services, including vaccinating children, and monitor their health. What we need is a separate set of services for urban areas, especially urban slums. A point that often gets ignored is that there has been a steep rise in the level of urban poverty over the past few years. This is primarily because of increased migration to urban areas by those seeking jobs as workers on construction sites or in factories. This in turn has led to a steep rise in the number of people living in already crowded urban slums. The results, understandably, are sufficiently scary to make authorities worry about the future. The solution does not lie in regulating migration, but in ensuring migrants do not pay for absence of policy
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