Of Food and Fibula

Numbers tell us that India is struggling with hunger and malnutrition. What is the reality on the ground like?

The masses are there again to refresh my haunting memories. The climate is also punishing. The unrelenting sun and extreme humidity cook those half-bodies to release the smell of sweat reminding one of who most of them are - manual laborers. It is only day 1. I gulped. I tried to look here and there to avoid meeting the sunken eyes. Not all are patients. So mere illness doesn't explain the stick figures.

Oh! These are new. The cats in the cafeteria. The frail kittens are fearless jumping onto the table even if people are around. The mother is groaning- those sounds I've heard at Tribal Health Initiative in Sittilingi when a cat had a catch in its jaws. Same here - she had a frail mouse in her mouth and was trying to ward off her babies from getting too close to her. I wondered what she would get out of this lean catch. There was hardly any meat in that mouse and the bones sounded easily crushable - I could hear them crackle and crumble like crisp wafers between her teeth set in a small jawline.

The next day, a young woman with oral cancer was posted for plastic surgery in which the fibula and calf muscles would be used to reconstruct her lower jaw. Like many withered people, a common sight in this part of India, she too was just a bit more than skin and bones. There wasn't much fat in her legs and the loose calf muscle could be felt. When the skin was cut there was some, just some, pink muscle underneath but it appeared friable or limp and could easily be cut into. The fibula bone could also be easily cut. It reminded me of that lean mouse from last night.

Would this be the case in a well-fed Norwegian or a well-fed Indian? 

By the way, the minimal well-built people I see here do not have as much muscle bulk as the well-built people in Tamil Nadu. Sugary fat makes people look well-built here, highlighting the other end of malnutrition which goes unnoticed in a hunger-stricken region.

There were 3 lean women sitting outside on the hospital veranda. One of them was nearing the completion of 9 months of her pregnancy. I chatted with them about their unsurprising diet, always in the hope that the situation would have changed or be different in a different village. They were having dinner - more rice, a bit of yellow dal, and yellow vegetables just enough to give a pale color other than white to the rice. 

They said, a kilo of fish, if ever, gets shared between 8 people. Similarly the 2 kg lentil per month. Black tea is not a fashion or a choice as in the privileged world but there isn't any other option. Vegan diets are forced and enforced upon them.

I might sound obsessed about hunger but I do not want to get rid of it either. Then like the consequence of new anemia cut-offs, I'd be overlooking or invisibilizing a sizeable chunk of these masses. You know what? It sounds like charity but damn it! Food and good food seem to be the need of the hour more than anything else.

About the Author:

Vasundhara Rangaswamy is a primary care community physician and a microbiologist working mostly in different parts of rural India.