THE FLIPSIDE: An Indian tribal woman with her malnourished child inside a nutrition rehabilitation centre at Khalwa village, district Khandwa, 350 kilometres outside of the Madhya Pradesh state capital Bhopal, 22 September 2011.

By Siddhartha Kumar


Seated and constantly taking sips of water, Indian Finance Minister Arun Jaitley addresses parliament in the Indian capital, taking a five-minute break when his back pain overwhelms him.
Not long after, the 62-year-old politician underwent an operation to reduce the size of his stomach. Tipping the scales at more than 100 kilograms, Jaitley needed to lose weight urgently.
Jaitley was by no means an isolated case. The ministers Nitin Gadkari and Venkaiah Naidu, who share a predilection for Indian snacks and sweets, have also undergone surgery to lose weight.
In this rapidly industrialising country, infectious disease and diarrhoea have long given way to cardio-vascular disease as the main cause of death.
Tuberculosis, malaria, dengue fever and bronchial infections have by no means disappeared, and malnutrition is ever-present. Millions of people in India continue to go hungry.
Some 30 per cent of children under five are malnourished, according to a study compiled by the UN children’s assistance programme Unicef together with the Indian government — more than in sub-Saharan Africa.
Almost half of Indian households lack a toilet, leading to diarrhoea and reduced ability to take in nutrition.
Nevertheless, according to the World Health Organization (WHO), the risk of dying from non-communicable disease is now twice that for infectious diseases.
Ten years ago, the figures were roughly equal. India now has an estimated 60 million overweight people in its population of 1.2 billion.
Among them are the brothers Vijay, 16, and Suresh, 20, who weighed 190 and 150kg respectively when they underwent surgery to reduce their stomachs.
“Suresh could barely walk a few steps and wheezed. He had high blood pressure and high blood sugar,” his mother Sonu Lugani says.
“We ate a lot of junk food with no restraint, did no sport and sat the whole day in front of the computer,” Suresh says.
His doctor, Vivek Bindal of Gangaram Hospital in New Delhi, carried out 250 stomach reductions last year. Five years previously it was just a fifth of that figure. The numbers are representative of the country as a whole.
Aniruddh Vij, a doctor from the Pushpawati Singhania scientific institute, says that many Indians do not see being overweight as an illness.
“It’s simply seen as normal, as something that happens with age, or it is even seen as a sign of prosperity,” he says.
The Indian lifestyle contributes to the problem. Hardly any middle-class Indian can be seen walking. Even a litre of milk or a package of medicines is ordered by phone and delivered to the door by runners.
Health Minister JP Nadda is seeing the number of cancer, asthma, cardio-vascular disease and diabetes cases increase “alarmingly quickly.”
Whereas the number of diabetics around the world rose by 45 per cent between 1990 and 2013, in India the figure was a plus of 123 per cent, as the US Institute of Health Metrics and Evaluation (IHME) discovered.
But the ministry has yet to launch broad-scale education and preventive care campaigns.
On top of this is the poorly organised health system. According to WHO figures, in India there are just seven doctors per 10,000 people, against 15 in China and 39 in Germany.
Moreover, almost all Indian doctors live in the cities, while three quarters of all Indians live in the countryside.
The subcontinent is ill prepared for the avalanche of disease coming down on it, says Vivekanand Jha, chief executive of the George Institute for Global Health in Delhi.
Prime Minister Narendra Modi has declared an official policy of giving every Indian access to medical care, but no extra funding has been made available.
People are compelled to seek help from expensive private doctors, many using up all their savings to do so, while others are simply unable to afford a visit to the doctor.
“What’s different about India is the enormous size and the heterogeneity,” Jha says. “And the complete lack of a plan.”
The lack of education means that scarcely anyone knows about healthy eating and the advantages exercise, says Atul Gogia, a doctor at Gangaram Hospital.
“We are always boasting about our workforce potential, but what’s the use of that if our working population is sick,” he asks.  —dpa