AT PENPOINT
Prime Minister Shehbaz Sharif held one of his most important meetings the other day, one on stunting. Stunting is unfortunately too common in Pakistan. About 20 percent of children suffer from it. This compares unfavourably even with the South Asian average of 33 percent, which is much too high as it is.
That is because stunting is not just children not reaching the height they were meant to, but also means impairment to cognitive learning. It is caused by malnutrition, and just as the child’s bones do not grow as much as they are supposed to, nor does his or her brain. Why do parents inflict this on children? Essentially, they ensure that the child stays alive even if he or she is hungry. Secondly, they only keep the child short of food because they are too poor to afford it. It is not because they opt for luxuries.
Apart from being a parenting issue, stunting causes high healthcare expenses, illnesses, deaths, decreased physical productivity and impaired cognitive learning, and up to a phenomenal 46 percent loss of earnings in later years of life
It is not purely a poverty issue. No less than 22 percent of the top fifth of the population’s children are stunted. True, 57 percent of the children of the poorest fifth of the population are stunted, and it is observable that stunting decreases the richer the population.
There are two related problems, which accompany stunting, and which are also caused by malnutrition: wasting, when children are underweight, and anaemia, caused by a shortage of iron. It is not only problematic for expectant and feeding mothers, but also likely to perpetuate. Their daughters will become anaemic mothers in turn, and the vicious cycle is thus perpetuated.
But how can the government do anything? The best, indeed the only feasible, route, is school meals. It is possible to work out what are the shortages in nutrition, and provide them in school meals. Of course, for it to be possible, one would have to ensure that children are at school. However, for the children presently at school, if they are not fed properly, the learning outcomes may be limited because the child’s ability to learn is compromised by poor nutrition. Free meals would be an added benefit, as they might help in pupil retention. Already, many children attend madressas because they give free food and lodging.
Even full meals are not necessary. Suitably enriched, even a plain biscuit and a glass of powdered milk can deliver a useful supplement to regular meals, which the child is getting at home.
An important aspect of any scheme is to ensure that the parents are on board, indeed are invested in the project. It should not be ignored that parents generally want the best for their children, and if they are convinced, they will play an important role in making sure that their children are fed the right things.
The temptation is to kick this problem down the road. Mian Shehbaz will have to stay the course and make sure that the state begins to combat this problem. There will be great temptation to leave the problem to a future generation. Unfortunately, it might already be too late. It is certainly too late for the little ones who have already been affected.
Napoleon Bonaparte’s promise “Give me an educated mother, I shall promise you the birth of a civilized, educated nation”, seems apposite. In his era, school meals were not on the table anywhere, but he expressed the ethos of the age. The purpose is not just to have educated people, but healthy ones as well.
Education is primarily about making people fit for the workplace of the future. It is also about enabling them to live a rich and satisfying life. However, to compete in the world, the populace needs to be both educated and healthy. There’s no point in having the best of educations if one is too sick to use it.
That is one of the prime reasons why the modern state is so deeply involved in education and health. If the workforce is productive because well-educated, and is healthy, then it can pay more taxes. And of course, a healthy workforce does not need as much spent on healthcare.
Therefore stunting, wasting, anaemia and all other forms of malnutrition are enemies of the government, not just of the nation. While they prove a hurdle in the way of the nation living a fulfilled and prosperous life, they also deprive the government of potential taxes, and make it spend more on healthcare.
For too long, the nation has had misplaced priorities. Education and health are low priorities, and there is no school meal programme, not even a token. Spending has gone on other national priorities. To take an example, the national nuclear programme has consumed funds. However, it was only possible because of scientists bright enough to learn how to make a nuclear device. Luckily for not just them, but the entire nation, they had not suffered stunting in their childhood, at least not enough to stop them from being able to master a complex technology. Stunting would have been instrumental in making them ill. It seems a minor factor, but if the country’s nuclear scientists had not been healthy enough, they would not have been able to put together a nuclear weapon.
What happens when the quality of manpower declines? The organizations will begin to shrink. The other alternatives to let incompetents man those organizations. In either case, those organizations will no longer be able to perform their functions. What happens when the stunted children of today are elected to the assemblies of tomorrow? Or are appointed to the courts of tomorrow?
Oldsters like to claim that things were better when they were young, the girls prettier, kids brighter, the food tastier; things generally better. What if this is not just nostalgia for their past youth? What if they are right? And the dumbing-down effect of stunting has begun?
All institutions, all organizations, need to play the long game, and while they should show concern about their own budget allocations, they need to consider the budget allocations for health and education as well. It should also be remembered that these two subjects are firmly provincial that federal ministries were downsized so that there was no overlap. The ministries exist so that provinces do not receive foreign aid directly. Besides, even if some organisations have education or health set-ups for their own personnel, the general standard of health and education in a society will determine the quality of future recruits.
There is an inherent problem. Mian Shehbaz Sharif and his party will face an election in 2029 or earlier. In five years, even if funds are sprayed at the problem, stunting will not be eliminated. The decline in the quality of recruits will not be noticed by then.
The temptation is to kick this problem down the road. Mian Shehbaz will have to stay the course and make sure that the state begins to combat this problem. There will be great temptation to leave the problem to a future generation. Unfortunately, it might already be too late. It is certainly too late for the little ones who have already been affected.
