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No time for school: Why lakhs of children are missing the bus

With no proper hygiene habits, kids are increasingly suffering from stunting or malnourishment that impedes their learning capacity.

brand stories Updated: Apr 16, 2018 12:25 IST
malnutrition,HUL,Swachh Bharat
The solution to India’s sanitation crisis lies in following the simple hygiene practices(HUL)

Swati* is 8 years old and the youngest amongst her siblings. She studies in class III at a government primary school in Hamirpur. When Swati’s teacher told her parents that she was one of the most intelligent children in her class, they felt like the proudest parents in the village. Having dropped out early from school, Swati’s parents wanted her to achieve a life that they could only dream of. They wanted her to finish schooling and attend college in the city. Apart from studies, Swati liked playing cricket and learnt classical singing.

However, Swati’s tendency to fall sick pretty often worried her parents. She had already fallen ill twice due to diarrhoea during the monsoons. As a result, she missed three weeks of classes and was unable to comprehend mathematics lessons. Her parents also noticed that she was visibly thinner and shorter than her cousin who lived in the city.

Swati was then taken to a hospital at the Taluk Headquarters, where the doctor told her parents that she was malnourished. They were immediately taken aback; how could Swati be malnourished when she was always fed well? What the doctor told them next surprised them even more. He said Swati had fallen sick not because she was underfed, but because she was not following proper hygiene practices.

Multiple researchers have proved the link between lack of hygiene and malnutrition/stunting in children. A New York Times report titled ‘Poor Sanitation in India May Afflict Well-Fed Children with Malnutrition’ suggests: “Across the world, children under the age of five, who are malnourished are suffering less of lack of food than poor sanitation”.

In Swati’s case, she, her family, and the people residing in her village defecated in the open. To add to the crisis, water at Swati’s home was not boiled or filtered before drinking. Soap was rarely used for washing hands and only used for bathing.

Cause for concern

According to the National Family Health Survey - 4 (NFHS-4) 2015-16, 38.4% of India’s children in the age group of 0-59 months are stunted, which is substantially higher than the world average of 22.9% (joint malnutrition country dataset, May 2017, UNICEF, WHO, and World Bank Group).

The UNICEF defines stunting as the “percentage of children, aged 0 to 59 months, whose height as per age is below minus two standard deviations (moderate and severe stunting) and minus three standard deviations (severe stunting) from the median of the WHO Child Growth Standards”.

The illness is associated with an underdeveloped brain, which has long-lasting harmful consequences including diminished mental ability and learning capacity, and increased risk of nutrition-related chronic diseases such as diabetes, hypertension, and obesity.

Higher economic growth as well as increased spending on nutrition access programmes compared to other developing countries has not resulted in a proportionate decrease in child malnutrition or stunting.

“Defecation in open is a global health hazard. Approximately 40% of world population lacks access to safe sanitation. 15% of world’s population is estimated to defecate in open and is higher in our country. Defecation in open leads to diarrhoeal diseases, helminthic infections and environmental enteropathies. These lead to malnutrition, decreased linear growth (inability to achieve target height) and even affect the child’s learning abilities. Moreover, if a mother is stunted due to malnutrition or recurrent infections, her baby is going to have low birth weight and thereby subsequent growth of the baby is affected, again leading to stunting. Infections, severe or subclinical, in children are also a leading cause of stunting in our country. Infections lead to poor nutrition, weight loss and decreased linear growth.” — Dr. Sumit Chakravarty, Consultant - Paediatrics & Neonatology, Asian Institute of Medical Sciences, Faridabad

“The difference in average height between Indian and African children can be explained entirely by differing concentrations of open defecation. There are far more people defecating outside in India more closely to one another’s children and homes than there are in Africa or anywhere else in the world,” says Dean Spears, Assistant Professor of Economics at the University of Texas at Austin and author of ‘Where India Goes’.

In addition, 9.2 % of children suffer from diarrhea at any given point of time (Prevalence of diarrhea (reported) in the last two weeks preceding the survey (%) - NFHS 2015-16). This leads to loss of school hours and an inability to fully enjoy their childhood.

The way forward

The solution to India’s sanitation crisis lies in following the simple hygiene practices highlighted in the campaign- ‘Haath, Munh, Bum’. The latter has been launched by Hindustan Unilever Limited (HUL) as part of its Swachh Aadat, Swachh Bharat programme, and is committed to educating nearly 28 million children about the importance of hygiene by 2020.

Since Swati’s story from last year, things have changed for the better. HUL workers visited her village as part of the Swachhata Doot initiative and used mobile phones to spread the message of using clean toilets, drinking boiled or filtered water, and washing hands with soap. The government has also encouraged the residents to build toilets as part of the Swachh Bharat Mission. The villagers have promised to follow these habits.

A 21-day Swachh Aadat curriculum was also introduced in Swati’s school to inculcate good hygiene habits in the students. Today, they are the flag-bearers of change in their village. Swati’s future also looks brighter, and she has a better shot at being the next Mithali Raj.

Visit here to know about a group of children from Ramkulla in Madhya Pradesh, who loved cricket but missed the bus due to repeated illnesses.

(*Name changed)

First Published: Feb 28, 2018 12:16 IST