Hunger has many manifestations.
According to a Food and Agriculture Organisation study, around two billion people suffer from hidden hunger – a deficiency caused by micronutrients (vitamins and minerals needed in small amounts to live and thrive). Of the many under-developed countries that suffer from hidden hunger, Bangladesh has been affected by it the most. More than 20 million people including women and children, in Bangladesh suffer from chronic deficiencies of vitamin A, iron and zinc. This stunts their growth and inhibits their brain development and cognition. As a result, children are unable to perform at school while women find it difficult to work within and outside their homes. While Bangladesh may have achieved its target of having almost enough food to feed its people, it has yet to overcome the insidious problem of hidden hunger.
Rice is the country’s staple food but unfortunately, it is missing the vitamins and minerals needed to maintain a healthy, balanced diet. If anything, the malnutrition rate in Bangladesh is alarming – around 41 per cent of children under five are stunted while 36 per cent are underweight. Add to this poverty and restricted access to education hinders the ability to learn and perform, says Rudaba Khondker who works with the Global Alliance for Improved Nutrition (GAIN) in Dhaka. Khondker explains that these children would never be able to explore their full potential as stunting has long-term physiological and neurological consequences affecting height and cognition. According to a GAIN study, turning the stunted child into a normal one increases the present value of their lifetime income by $2,311. Thus, spending on malnutrition — for government and non-government alike — makes sense.
The causes of micronutrient deficiencies are multiple and interconnected. At the most basic level, the problem is related to an inadequate diet, either in quantity (easy to detect)
or quality (not so easy to detect until the damage has been done). Throughout the world, people living in poverty do not consume sufficient amounts and variety of nutrient-rich foods, such as meat, eggs, fish, legumes and vegetables, to cover their daily needs, which increase in periods of growth, pregnancy or lactation. And it is not a problem only for the poorest. Micronutrient deficiencies are also frequent in emerging and highincome economies, where overweight and obesity rates are rising, multiplying the burden of disease and disability.
While Bangladesh, seeking to join the club of middle-income nations, has lifted itself from the 'Noon-pantha' stage (fermented rice soaked in salt, the proverbial staple of the extremely poor in the country), there are major gaps in nutrition one cannot overlook. Fifty percent of the salt produced in Bangladesh is not adequately iodized, rice dominates the diet and its low nutrient density perhaps contributes to the high rates of zinc deficiency. Experts indicate, even fortifying meals as humble as noon-pantha can significantly help GDP growth and it is high time Bangladesh did what it takes to overcome hidden hunger.
In fact, addressing micronutrient deficiency as a prioritized post-2015 agenda is crucial because not doing enough to fight that means "a loss of an estimated $7.9 billion in national GDP,” according to the National Micronutrients Status Survey 2011-12.
There are several ways in which both government and non-government organizations can tackle the problem in Bangladesh, notwithstanding a strong political commitment. One way to deal with hidden hunger is finding the right proven interventions for a population and ensuring their availability, especially for the most vulnerable. Supplementation (iron and folic acid tablets during pregnancy), industrial fortification (salt iodization), point-of-use fortification (micronutrient powders), biofortification (high-iron rice) and homestead gardening (raising chicken, growing vegetables) are some of them.
On the other hand, awareness and action are important too. Families, caregivers, policymakers and healthcare providers from the public and private sectors can all demand action and access to supplies. For farmers, biofortified crops need to be profitable enough for smallholder farmers to adopt and to grow at minimal risk. The private sector and the government needs to provide incentives to support micronutrient interventions and slant food systems towards healthy foods.
Farming ought to be especially good for nutrition. If farmers provide a varied diet to local markets, people seem more likely to eat well. Agricultural growth is one of the best ways to generate income for the poorest, who need the most help buying nutritious food. In Bangladesh, women do most of the farm work. They also have most influence on children's health. Profitable farming, women's income and child nutrition should therefore go together. A rise in farm output should boost nutrition by more than a comparable rise in general economic well-being, measured by the GDP.
Policymakers can also try to increase women's control over farming decisions (in most cases, only men can own land or get agricultural credit, for instance). They could boost research into more nutritious non-staple crops; and provide clean water and better transport, which especially benefits kitchen gardeners, because their produce goes off. More data should be generated on micronutrient status and dietary intake to help guide programme and policy decisions. This involves the collection and analysis of dietary data and biological samples – a task that new technology has made much easier.
On the flip side, studies show that malnutrition does the most damage in the first 1,000 days of life. In those months, maternal health, breastfeeding and infant care, not agriculture, matter most. Better farming can mean more calories and higher incomes. But with nutrition, it offers only a few steel bullets, not a silver one.
Hidden hunger in Bangladesh can be overcome, but a consistent and coordinated effort is required. Government and non-government organizations must come together and attack this problem together because the health and well-being of millions of people in the country depends on it.
The writer is a freelance journalist who contributes regularly to various leading publications.