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How poor sanitation in India makes children malnourished

Published: Monday, July 21 2014 4:10 a.m. MDT

Updated: Monday, July 21 2014 4:22 a.m. MDT

Indian children from a slum eat on the banks of the polluted river Yamuna in New Delhi, India Saturday, Aug. 31, 2002. The 10-day World Summit has been focusing on ways to get water, electricity, education and health care to the world's poorest while protecting the environment. About 1.2 billion people lack clean drinking water and 2 billion are without sanitation.

AIJAZ RAHI, Associated Press

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Vivek, a 1-year-old Indian from a small but progressing village in northern India, was diagnosed with malnutrition — despite being breast-fed by his mother, the family owning six goats and having plenty of fresh buffalo milk, wheat and potatoes, New York Times reporter Gardiner Harris wrote.

Why Vivek and 162 million children worldwide are suffering from malnutrition may be attributable to more than just a lack of food. The missing link? Poor sanitation. Children living in areas with poor sanitation (mostly in places with high rates of outdoor defecation) easily become sick, so their bodies are unable to process nutrients, a situation that stunts growth and hinders the ability to attain a healthy body weight, Harris reported.

Surprisingly, "a child raised in India is far more likely to be malnourished than one from the Democratic Republic of Congo, Zimbabwe or Somalia, the planet’s poorest countries. Stunting affects 65 million Indian children under the age of 5, including a third of children from the country’s richest families," wrote Harris.

Researchers say that the average height difference between Indian and African children can be "explained entirely by differing concentrations of open defecation," Dean Spears, an economist at the Delhi School of Economics, told the Times.

And India has the most of it, by far. Census data from the RICE Institute reveals that "most people in India defecate in the open without using a latrine, and most people who defecate in the open live in India."

A research project from Institute for the Study of Labor in Germany found that by age 5, Muslim children survive at a higher rate than Hindu children by about 2.3 percent, even though Hindus experience higher social status than Muslims, the report says.

That's significantly higher than the gender disparity of child survival at 0.3 percent, even though the gender difference is more widely discussed. "This enormous difference in infant mortality is explained by the fact that Muslims are far more likely to use latrines and live next to others also using latrines," Harris wrote. So housing discrimination that separates Muslims from Hindus may save thousands of Muslim Indian babies every year.

The lack of available toilets in India made the news in May when two teenage girls were raped and murdered because they were forced to go to the bathroom outdoors, The Guardian reported.

Certainly, increasing the availability of toilets or latrines in India would help the situation. But The Economist pointed out that a household survey of almost 23,000 north Indians by Princeton economist Diane Coffey found that "even among households with a working latrine, more than 40% reported that at least one family member preferred to defecate in the open. Those with a government-built toilet were especially likely to choose a bush instead."

So a collective, cultural change of heart may be as necessary as the simple building of more latrines.

"The mere availability of government-built latrines will not end open defecation for decades yet. What is needed instead are public campaigns, in schools and in the media, to explain the health and economic benefits of using toilets and of better hygiene. Researchers found that only a quarter of rural householders understood that washing hands helps prevent diarrhoea," according to The Economist.

The Times' Harris noted that Gandhi himself wrote in 1925, "The cause of many of our diseases is the condition of our lavatories and our bad habit of disposing of excreta anywhere and everywhere. I, therefore, believe in the absolute necessity of a clean place for answering the call of nature and clean articles for use at the time, have accustomed myself to them and wish that all others should do the same."

amcdonald@deseretnews.com

Twitter | @amymcdonald89

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