How Shit Stunts: India’s Tragedy and Undernutrition’s Blind Spot

FTIs, 5 As and StuntingWhy a blind spotThe Indian tragedyWhat can be done?

THE 5 As of Nutrition

ORAL -FOOD• AVAILABILITY • ACCESS

ANAL - FTIs (faecally transmitted infections)• ABSORPTION

Evacuation – diarrhoeasTheft - nematodes – ascaris, hookworm (sucking blood), trichuris, tapeworms, giardia

Diminished, damaged and leaky gut- ENVIRONMENTAL ENTEROPATHY

through bacterial infections etc• ANTIBODIES to fight infections, using nutritional energy and proteins • ALLOPATHOGENS other pathogens - liverfluke, hepatitis A, B and E, typhoid fever,

polio, trachoma, various zoonoses etc

Poorest 10% 2nd 3rd 4th 5th 6th 7th 8th 9th Richest 10%India: Rural areas

Average height for ages & Open Defecation density, globally

http://www.ideasforindia.in/article.aspx?article_id=108

Change in number of

persons per square kilometerwho defecate in

the open

source: Gupta & Spears, 2014

What is stunting

Growth failure. Stunting – low height for age – is the preferred measure for undernutrition. The children in this picture were aged 2, 4 1/2 and 5 1/2 years from left to right. The first two are normal but the last is grossly retarded in growth although his weight to height ratio is normal and there is no evidence of clinical malnutrition.