Category Archives: India

A New Report Reveals What is behind Maharashtra State’s Reduction in Stunting

 

Photo by Esther Havens

Photo by Esther Havens

In 2005, an alarming 39 percent of children were stunted in Maharashtra state, the second largest state in India with a population of over 100 million people. By 2012, a survey revealed that this number dropped to 24 percent among children under the age of two. A recent report published by the Institute of Development Studies (IDS) examines why this unprecedented reduction in stunting occurred.

Stunting is a condition that causes irreversible damage and occurs when a child does not receive the right kind of food and nutrients. Stunted children often have weaker immune systems leaving them more susceptible to infections and making them five times more likely to die from diarrhea. Infections caused by neglected tropical diseases (NTDs) are closely linked to malnutrition. Intestinal worms, for example, are among the underlying causes of stunting, anemia, loss of key nutrients like Vitamin A and iron, and overall poor nutritional status. Not only does India have more children suffering from NTDs than any other country in the world, they are home to the highest number of stunted children under the age of five.

Historically, Maharashtra state’s high levels of income inequality have contributed to malnutrition and stunting in children. Even though Maharashtra is one of the wealthiest states in India, children who are stunted are not benefiting from this growth.  Stunting impairs a child’s growth and perpetuates poor health and nutrition, preventing them from growing into their full physical and economic potential. Children who are unhealthy and lack access to proper diets, safe water, healthcare and sanitation facilities are trapped in a perpetual cycle of disease and poverty.

According to the authors, a number of key factors, working in tandem, contributed to Maharashtra state’s reduction in stunting. The launch of the state’s Nutrition Mission and the National Rural Health Mission created strong political will to improve nutritional status of young children. Because NTDs can contribute to malnutrition, Maharashtra state’s Nutrition Mission Action Plan ensured that deworming tablets were distributed to children at risk for intestinal worm infections.  And promisingly, the number of children receiving deworming treatments more than doubled, increasing from 8 percent to 19 percent. Maharashtra’s efforts towards addressing NTDs is a positive step in the right direction to lower the occurrence of stunted children and subsequent malnutrition among young children.

IDS also noted that other important factors in the reduction of stunting include: a favorable political, social and economic environment; strong economic growth; robust poverty reduction performance; and improvements in women’s empowerment and health. In the same manner, addressing NTDs requires a multi-pronged approach. In addition to deworming, creating an enabling environment for children will amplify the possibilities for the future, particularly by simultaneously improving access to clean water, sanitation and hygiene and delivering key nutrition interventions like Vitamin A alongside deworming treatments.

While the rapid decline in stunting in Maharashtra state was unique, we congratulate them on embracing a comprehensive approach to tackling this issue and remain hopeful that other states endemic for NTDs and malnutrition will feel encouraged to follow their lead.

BRICS in the Response to Neglected Tropical Diseases

 

Children march through  the streets of Ghorahuan Village

Photo by Esther Havens

The BRICS nations (Brazil, Russia, India, China and South Africa) have a unique opportunity to lead the world in eliminating the threat of neglected tropical diseases (NTDs). Released just ahead of the BRICS annual meetings, a paper published in the Bulletin of the World Health Organization, explains how the BRICS could draw upon their own experiences tackling domestic global health challenges to further advance global efforts to control and eliminate NTDs by 2020.

In their paper, titled  BRICS in the response to neglected tropical diseases, authors Amber Cashwell, Anupama Tantri, Ashley Schmidt, Neeraj Mistry and Greg Simon call on the BRICS to lead the rest of the world by example. The BRICS countries – in particular, India and Brazil– shoulder a large NTD burden. By scaling up their own domestic NTD programs, the BRICS can help close the global NTD treatment gap and lead by example.

In addition, the authors call on the BRICS to pursue opportunities for joint cooperation. The annual BRICS Heads of State and Health Ministers meetings offer platforms where BRICS countries can exchange experiences and increase collaboration on NTDs. The BRICS countries can help apply best practices, innovative models, and lessons learned about NTD control and elimination to other NTD endemic countries.

And lastly, as powerful and emerging economies, the BRICS can use their collective voices to build political commitment, mobilize resources and implement policies that will help meet global NTD goals.

As the BRICS countries gear up to launch their own development bank this July, it’s important to keep in mind that addressing NTDs will also help the BRICS countries – and the rest of the world – develop economically. Global health challenges like NTDs perpetuate poverty and inequality, thus thwarting opportunities for social progress and economic growth.  NTDs can result in long-term health problems such as blindness and other physical disabilities, delayed cognitive development and malnutrition, leaving people unable to go to work, learn and live productive lives.

Controlling and eliminating NTDs by 2020 will surely be a global effort – and one that will progress more quickly and sustainably with BRICS at the lead.

To read the full paper, click here. 

Abhishek Bachchan Visits with Patients Suffering from NTDs

 

Abhishek Bachchan

Bollywood celebrity Abhishek Bachchan visitis a community health center in Odisha, Bhubaneswar, India. (Photo by Vivek Singh)

Shortly after Bollywood star Abhishek Bachchan joined the END7 campaign, we travelled together to Odisha (formally known as Orissa), near India’s east coast, to visit the Banamalipur Community Center. Here, the Church’s Auxiliary for Social Action (CASA) is providing community-based care for patients suffering from, and the community at risk for, lymphatic filariasis (LF) and other neglected tropical diseases (NTDs). Through the work of volunteers and community health workers, the program currently serves more than 20,000 patients with LF and works in partnership with the government to support the distribution of medicine to everyone in the region to protect them from NTDs.

Abhishek met with patients who were suffering from chronic LF, and listened to their stories and experiences. They spoke of the previous hardship caused by the disease and, through the staff and services, had experienced considerable improvement in their quality of life. Yet, among many of them, there was a tangible sadness, which resulted from the stigma and ostracization caused by the disease: in a community where marriage of children is seen as a fulfillment of parenting, many of their daughters remained unmarried because suitors feared that the diseases was genetic.

LF is just one of the NTDs that can be prevented with annual medication. Once the limbs have swollen, there is no cure for LF but further disability can be prevented with proper care. CASA health workers explained and demonstrated morbidity management and disability prevention for patients with LF, which included proper washing and drying techniques, exercise massage and elevation of limbs. Abhishek was moved to join in, helping the CASA staff to wash the limbs of LF patients. Later, he took albendazole pills, one of the two medicines taken to treat and prevent early LF infection.

This visit only confirmed that there is more work to be done. While we control and eliminate these debilitating diseases, we must also improve the mental and social well-being of those suffering from NTDs. This goes beyond medicine and requires engagement of families, local community organizations, and the media and entertainment industry. With the help of organizations like CASA, and champions like Abhishek, we can take a holistic approach to addressing NTDs.

Of the 1.4 billion people in the world affected by NTDs, more than a third live in India. Global progress on NTDs hinges on India’s efforts and successes.

India is a historic leader in ending some of the most devastating diseases of our time, including smallpox and guinea worm, and most recently, polio. Now, India has the opportunity to achieve another significant public health milestone: the control and elimination of five NTDs.

Highlighting the Women of Orissa on International Women’s Day

 

Anupama standing with the women she met at the Church’s Auxiliary for Social Action (CASA)

Anupama standing with the women she met at the Church’s Auxiliary for Social Action (CASA)

In honor of International Women’s Day, I’m sharing the stories of a group of women living in Orissa State, India. Last month, I had the opportunity to travel to a community center in Banamalipur run by the Church’s Auxiliary for Social Action (CASA), an NGO that works on a range of development and health issues, including morbidity management and disability prevention from lymphatic filariasis (LF). LF is a painful and disfiguring neglected tropical disease (NTD) that impacts more than 20 million people across India.

At the community center, I was introduced to a group of women suffering from the impacts of long-term LF infection. Many of them were grandmothers and mothers, and while we needed a translator to speak to each other, we were full of smiles and eager to learn about one another.

The women I met spoke openly and honestly with me about the challenges they face as women living with LF. Some of the women described how their disease impacted not only themselves, but their daughters as well.

Women in Orissa State, India

Sulochana Behara, 43, from Dhalapathar village, for example, has five healthy daughters for whom she’s having trouble finding grooms; many people incorrectly believe that the swelling of her leg caused by LF is hereditary and that her daughters will also develop this same disability.

The visible signs of LF, which include swelling and inflammation of the extremities, often do not present themselves until adult age. In fact, the average age of the individuals with LF that CASA works with is about 57. Yet one woman I met explained she began noticing symptoms when she was only 12 years old. Now 40, she explained with tears in her eyes that she never married because of the stigma she faced.

In addition to the social stigma, LF also makes it hard for women to work and live comfortably. Many women explained that even working at home was difficult and that they couldn’t sit in certain positions for long periods of time because of the pain they suffered.

For these women, CASA is a welcomed respite from the stigma and challenges they often face as women living with LF. Staff and volunteers who work at CASA help the women wash and care for their swollen legs. The health workers carefully cleanse the women’s skin to remove bacteria. This process can reduce or reverse skin or tissue damage. This type of care does not cure, but can manage, the symptoms and progression of LF.

Unfortunately, the experiences of the women I met are not unique. Millions of women in India are living with or are at risk of contracting LF. As a whole, India bears 45 percent of the world’s population living at risk for LF.

WOMENSDAY (1)I am hopeful that with the support of our celebrity Ambassador, Abhishek Bachchan who accompanied me on the trip, we can help give voice to the stories and experiences of these women and end the stigma that they face. I am also hopeful that India’s efforts to eliminate LF will help protect millions of women from having to deal with the pain, disability and stigma of LF.

This International Women’s day, let’s share these women’s stories and raise the awareness needed to ensure that no woman lives a life of pain and stigmatization due to this preventable disease.

photos by Vivek Singh