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Bureaucrat-turned-social activist Harsh Mander's book Ash in the Belly: India’s Unfinished Battle With Hunger is an eye-opener. Dr. Ajey Hardeekar presents a book review

My first encounter with someone suffering from malnutrition was in the Pediatrics ward of Sassoon Hospitals, Pune, where I was a post-grad student. As budding doctors we discussed kwashiorkor (acute form of childhood protein-energy malnutrition) and marasmus (severe malnutrition) more as medical conditions than something causing real human suffering. We were young and insensitive. The situation in the rural hinterland was unknown to us city dwellers–exposure to the poor and the destitute was limited to the occasional beggars one encountered on Pune’s streets.

Almost three decades later, Harsh Mander’s book is a grim reminder that the spectre of malnutrition continues to haunt our less fortunate populace. Actually, as Mander convincingly shows, hunger and starvation are less a matter of misfortune and more a matter of bad governance among many other things. He writes with authority that comes from having been very closely associated with his subject– he is a former IAS officer who has worked in tribal belts, a former member of the NAC (National Advisory Council), and special commissioner to the Supreme Court of India in the Right to Food case.

Growth Without Development?

After the opening up of the economy more than two decades ago, it is now quite clear that India’s growth story has left a vast majority of our population languishing in poverty. When Mander joined the IAS, the role of government was believed to be ‘to serve the people, especially the disadvantaged.’ This was at least accepted in theory, if not in practice. But since the 1990s we have seen a progressive change towards government abdicating its basic duties and serving only to ‘promote an environment that attracts investment’.

The book is divided into three parts. The first deals with real-life stories of children, adults, and the destitute living with hunger. These moving accounts in bold italics, are interspersed with grim statistics and persuasive prose. To give just one example, more than 27% of the world’s undernourished population lives in India. Ironically, we allow millions of tonnes of food-grain to rot in warehouses. Of course there has been some fall in food production too, as a direct consequence of the chronic neglect of the agricultural sector. However, while the relative price of food items has remained stable over the past twenty years, consumption has declined. This can be attributed to the diminished purchasing power of the poor. They are forced to spend a greater part of their already meager income on non-food items like transport, fuel and lighting, health-care and education. Considering that several countries that were poor and politically unstable too–Pakistan, Nepal, Bangladesh, Vietnam, Nigeria, to name a few–have actually reduced hunger levels in their land, India’s performance becomes all the more culpable. We have a democracy, relative peace and economic growth, and yet we have failed.

Hunger And Governance

The second part of the book is somewhat technical as it deals with issues of hunger and governance. Mander tells us of the long shadow of the British colonial administration still falling over the culture of bureaucracy in India. When dealing with scarcity and famine, the British objective was officially to ‘save lives at minimal cost to the exchequer.’ We do not have large-scale famines any more. But we do have endemic hunger and widespread malnutrition, especially among children. The ‘right to life’ is a fundamental one as recognized by our Constitution, and the Supreme Court has ruled that this includes the right to food and work with dignity. As for work, a conditional statutory guarantee to the ‘right to work’ has been created by the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA, 2005). This envisages at least 100 days of work in a year for any citizen seeking it.

One of the biggest hurdles in the battle against hunger has been that the famine, drought and scarcity codes (colonial and contemporary) cannot be enforced in any court of law. They only lay down the duties of various public authorities. In other words they are not rights-based. Citizens cannot take the concerned authorities to court if they have failed in their duties– even if such a failure has meant preventable death, and suffering. So what we need is a food rights law or code that can be legally enforced.

Chronic under-nutrition cannot be looked at in isolation. It is intimately linked to public health. Malnutrition makes children more susceptible to debilitating illnesses which in turn reduce their capacity to absorb whatever limited nutrition is available, making them further prone to infections. It is a downward spiral that can end in death. Thus the food rights of a vulnerable population can be secured only by simultaneously ensuring their right to health. Often health disasters are the last straw that thrust the concerned household into further poverty and starvation. India’s current public health expenditure is a little above 1% of GDP. In the UK and Germany it is 6 – 8%. Our private health expenditure is 4% of GDP, which is more than that of these rich countries!

Another aspect of starvation is that the government is obsessed with ‘starvation deaths’. It will go to any extent to prove that a given death is not because of starvation, but from some other cause. Mander argues that any debate about starvation should shift the focus from death to ‘starvation as a way of living desperately and perennially at the edge of survival’. A person should not have to die to prove that he is starving.

The third and final part of the book deals with ‘Hunger and Justice’. Hitherto discussions about dealing with poverty and hunger revolved around charity, the goodwill of people and religious organizations, and so forth. Today the focus is shifting towards making ‘access to food’ a rights issue. It is based on the notion that every individual human being has equal intrinsic worth.

Middle Class Apathy

However we see poverty and starvation as steadily disappearing from middle-class consciousness. They are vanishing from cinema, literature, and the media. The concept of globalised free markets has further helped in making this vast majority of deprived people ‘invisible’. It is obvious that technical expansion of food production has not translated into food security. Mander believes that for people who are the most deprived and powerless, it is only an accountable State that can reverse their suffering. So ultimately people will have to act and this action will have to be backed by a regime of enforceable rights. But even this is not enough. Justice and caring has to develop within local communities. Women’s groups will have to be involved. Further, local people will need to have more control over the production, storage and distribution of food. Finally, everyone needs to open his/her eyes to the misery around. If India is to rewrite her history it could draw inspiration from Brazil’s Food Security Policy and its implicit ethical and political convictions.

Mander is convinced that an enactment of a comprehensive food-security bill can change the course of India’s history. He says that the most compelling argument for a right-to-food law is neither economical nor political. It is an ethical imperative. As Holocaust survivor and Nobel laureate Elie Wiesel observed: “The opposite of love is not hate. It is indifference.” We need to be more outraged than we are, about the inequity and suffering of our populace. The great gaping hole in our collective souls needs to be mended.

This is a well-written and convincing book, though it makes for a very uncomfortable read, in that it forces the reader to introspect and think–even feel somewhat guilty about being born into a privileged class. Nowhere does the author resort to hyperbole or sentimentality. A minor grouse is that the text, especially some of the statistics could have been trimmed a bit–it could be too technical for the average lay reader. Moreover this would not detract from the essence of the subject.

I felt that this book is a must-read at least for any student of sociology, medicine, and the social and political sciences. To me, it posed many questions for which answers may not be forthcoming easily. One of them was ‘how do we “create” many more Harsh Manders among us?’ Can ethics and morals be taught? If so, how does society go about instilling them into its present and future generations? I am sure there are millions of city dwellers like me who are aware that ‘something is seriously wrong, and that one needs to do something’. This ‘something’ has to go beyond not wasting one’s food and similar gestures, important as they may be. After all ‘awareness’ is only the first step towards solving any problem. The real battle starts after that–and we need able generals like the author to inspire and guide us.


  Ajey Hardeekar is a medical doctor by training and has been working as a Medical Officer in a major industry in Pune for more than two decades. Since the last ten years or so, he has been translating and editing books about painting, and has illustrated books about birds. His other interests include evolution and human behaviour, and ecological issues.

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