“Anaemia is a public health issue, and not a matter of feasibility or logistics of distribution of fortified rice. Health is a state subject, as per India’s Constitution. The state government, given that Chhattisgarh is self-sufficient in paddy production and also has a decentralised procurement system in place, should step out of Government of India’s unscientific and risky policy of iron-fortified rice in public schemes”, said the fact team members.
The report prepared by two fact-finding teams, which consisted of public health practitioners, following their visit to 11 villages of 5 blocks of 4 districts, asserted, “There is really no basis for the large scale scaling up of rice fortification scheme in Chhattisgarh, where the state government is distributing 25% to 45% of all fortified rice being distributed in the entire country in just this one state right now.”
The teams, which met state food minister Amarjeet Bhagat in addition to senior bureaucrats at the state level, medical experts, district level officials and frontline functionaries of different line departments, PDS dealers, a rice miller and other stakeholders, regretted, the pilot study on rice fortification intervention in Kondagaon district has not been completed, nor evaluation done and results put out for public scrutiny.”
The report pointed out, “It is important to note that Chhattisgarh distributes more fortified rice per beneficiary household than in other states (more than 10 kg per individual per month in many cases), and it is not clear if rice fortification standards have been set by FSSAI keeping this in mind.”
“Further”, it noted, “Even the Take Home Ration (THR) distributed in the state is fortified where norms require 50% of the RDA of iron to be met by the fortified THR. Meanwhile, micronutrient supplementation programmes are also going on, along with iron-rich foods being distributed in government schemes. There is no evaluation of potential iron-overdosing from a plethora of interventions.”
“While this would be a matter of concern even in a normal situation, Chhattisgarh also has high disease burden of sickle cell disorders in the state and around 1.5 lakh persons are estimated to be sickle-cell-diseased (which is an extrapolated estimate given that comprehensive screening and diagnosis has not happened)”, the report said.
It added, “While the numbers cannot even be estimated at the population-level due to a lack of any screening programmes as of now, thalassemia is also an issue to contend with. There are also other diseases like malaria and tuberculosis that the state has high prevalence of. In all these conditions, iron-fortified food is contra-indicated.”
The report underlined, “These diseased persons (whose numbers are significant) and their families are already going through enormous hardships in accessing diagnostic and medical-care facilities, and indiscriminate distribution of iron-fortified rice is irresponsible on the part of any government. It is also quite unjust that Adivasi communities are getting subjected in a disproportionately high manner to this risky approach to tackling anaemia.”
The report said, “We found that labelling regulations are being flouted in numerous ways, and in any case, such labelling regimes have no real meaning in the context of undiagnosed and uninformed communities, and when the end consumer buys a product in a loose, unpackaged form.”
It added, “There is only an aggressive promotional campaign from the state government to extoll the virtues of fortified rice at this point of time, without giving a full picture to beneficiaries and without allowing them prior informed choices.”
According to the report, “It is also seen that in Chhattisgarh, the stencilled and labelled gunny sacks are returned back to the procurement agencies and the fortified rice transferred into other bags at the dealer shops which defeats the purpose of labelling.”
Stating that all of these factors should be enough for the state government “to immediately stop the rice fortification programme”, the report said, the rice fortification plan comes amidst “some exemplary and unique initiatives of Chhattisgarh government which have the potential to address malnutrition.”
It said, “This includes the Suposhan Abhiyan, a holistic, diversity-laden, food-based intervention. The NGGB and Godhan Nyay Yojana in Chhattisgarh also reflect a ‘One Health’ approach, which is that soil health and nutrition is connected with plant health and nutrition, which in turn is connected with human health and nutrition.”
Further the state government is “yet to scale up its millets mission but this intervention is on the anvil. Poshan Vatikas have also been noted by the fact-finding teams in schools and anganwadis”, it said, adding, “Chhattisgarh is also home to nutrient-rich diverse local foods, including uncultivated forest foods and greens. It has been home to nutritionally superior traditional landraces of paddy and millets.”
Seeking “community-controlled, natural alternatives” the report asked the state government to reject offering “synthetic chemicals in the name of fortified foods in a reductionist, ineffective and potentially risky approach to malnutrition.”
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