Nurse

To Arthur Road Jail and back again

In Mumbai, locations are marked not by street names and numbers, but by landmarks. For a retail store, a street name may be given, but a landmark is also included. For example, the Nature’s Basket in Worli is located at 227, Samarth Vaibhav Building, Opposite Tarapur Towers, Adarsh Nagar, Beside ICICI Bank, Mumbai. Yesterday, when I travelled to the Foundation for Mother and Child Health office, the landmark was Arthur Road Jail, a notoriously overcrowded prison near Mahalaxmi railway station. The jail has featured prominently in David Gregory Roberts’ Shantaram and Katherine Boo’s Behind the Beautiful Forevers. It is not a place I would ever want to enter, but my driver made sure to point it out as we passed it. So, now I can say that I have been to Arthur Road Jail. Well, not really, but I got your attention, didn’t I? And, now for the real topic of my post: childhood malnutrition.

India is home to the most malnourished children in the world, both in seriousness of malnutrition and sheer numbers. The latest estimates indicate that one-third of the world’s malnourished children live in India. Every minute, four children under the age of five will die of malnutrition in India. Every minute. That is more than 2 million children annually. In a country of more than 1 billion, 2 million may seem like a drop in the proverbial population bucket. But, that number is higher than coronary heart disease, the leading cause of death among adults in India. Besides, we are talking about children here. The preventable death of a child from any cause is unacceptable. The statistics become increasingly alarming. Over a six-year period from 2005 to 2011, the prevalence of child malnutrition in India is estimated at just over 43 percent. Almost half of the children in India. Second only to East Timor and just ahead of Bangladesh. By contrast, the global rate for the same period is just over 16 percent.

The infant mortality rate in Mumbai alone is more than 30 percent, with more than 25 percent of all children born with low birth weight. These children are at a disadvantage from the moment they arrive in this world. The children who survive the critical period from conception to age five are still at great risk for developmental and physical disabilities as they grow.

Everywhere I look, children are starving, but how to help them? For various reasons, I don’t like to hand out money or snacks to kids at street corners. It is not that my heart does not break at the sight of them, but, ultimately, I know that giving this way is a temporary solution to a permanent problem. The problem is systemic and requires a systemic solution, one that fights the problem at the grass-roots level, one that changes the lives and attitudes of the mothers whose infants and children are starving, one that embraces the “teach a man (or, in this case, a woman) to fish” philosophy. For feeding those kids on street corners will feed them only for the day—and no longer. But, teaching their mothers how to feed them with the limited resources they possess can effect a positive change that will last a lifetime. That is where the Foundation for Mother and Child Health (FMCH) can help.

The mission of FMCH is to “work in economically underprivileged communities to provide full access to preventive health and balanced nutrition.” Through three clinics in the Dhobi Ghat area near Mahalaxmi, FMCH’s team of highly trained doctors, nurses, and midwives provides basic preventive health screenings and access to vaccinations and medical care that might otherwise be out of reach for these mothers. But, healthcare is only one part of the equation.

Nutrition is the other. To fight the greatest killer of children under five, FMCH employs a team of nutritionists and community volunteers who educates mothers about how to feed their children. Some mothers attend cooking classes; others receive 1-to-1 nutritional counseling. But, their children also participate in the supplement program. These supplements are the Nutribars made by volunteers here in Powai and delivered weekly to FMCH. These Nutribars are dense, vitamin-rich, calorie-packed foods that resemble the protein bars popular with fitness fanatics in the US. A single weekly batch provides a daily nutritional supplement to 30 children at an average cost of Rs. 50 or USD 1.00 per child. The Nutribars are not meant to provide full nutrition, but to help supplement the children’s existing diet and encourage weight gain. Preliminary studies have shown promising results that the Nutribars have a positive effect on growth and overall nutrition.

I was introduced to FMCH when I attended the American’s Women’s Club Bourbon Street Bash the first month I was in Mumbai. All money raised that evening benefited FMCH and its beneficiaries.  Many women I know in Powai volunteer with the organization, especially in producing the Nutribars. One thing that attracted me to the Nutribar rota is that I could perform the service from Powai and still make a tremendous difference in the life of a child.

After our whirlwind travel across India in November, I wanted to spend a quiet Christmas at home. It turned out we were pretty much the only expats left in Mumbai for the holiday, so I volunteered to make the Nutribars for the first time. I had learned how to make them a few weeks earlier from Rosie, the founder of FMCH. So, while Brian decorated our Christmas tree, I toasted the nuts and seeds, ground them into edible pieces, and mixed them into a huge pot of ghee (clarified butter) and jaggery (unrefined cane sugar).

Our beautiful Christmas tree courtesy of Brian
On Christmas Eve, after our first tree bit the dust, Brian bought a second one at Cheap and Best, where I had purchased the Nutribar ingredients. He spent Christmas morning decorating the tree and did a fantastic job.

Brian provided considerable support during the pouring, cutting, and boxing phases of the operation. In the end, the Nutribars looked like they were supposed to, and I delivered them to the office on Thursday as requested. Mission accomplished.

Trays of Nutribars cooling on the counter
The Nutribars are not quite complete at this stage. We still needed to cut and package them. This batch will feed about 30 children.

I was a little nervous making them without another experienced Nutribar helper, but Brian assured me that if the Nutribars had not turned out, we would have supplied granola bars or other equivalent so that the children did not go without during Christmas. After making the Nutribars, we made our Christmas dinner of ham, stuffing, mashed potatoes, zucchini, and brownies. I spent all day in the kitchen for the first time in…well, actually, I can’t remember the last time I spent all day in the kitchen. It was exhausting but rewarding—and a great way to spend a Merry Christmas in the Maximum City.

We wish you a Merry Christmas
Fortunately, Chip and Peanut had no interest in making Nutribars and spent Christmas on the couch. Helping with ham was another matter entirely.