Malnutrition, some proposals for issue of economic development in Medak villages

Malnutrition, some proposals for issue of economic development in Medak villages - Damien Molliet

Centre for Action Research & People Development (CARPED), subject written by Molliet Damien, June 2004

Table of contents



2.1 The policy of the World Bank

2.2 Economic development as an extension of freedoms


3.1 What can we do with the available food ?

3.2 How can we enhance the available food ?


I Introduction
Medak district is one of the most backward districts of India as a result of the low income per person. It also has the lowest female literacy rate and the highest school drop out rate in Andhra Pradesh. Almost every child suffer from malnutrition. There is no sanitation and hygiene practice because 96,82 % of the people in the mandals practice open defecation, while only 3.18 % population have individuals toilets.

The NGO CARPED (Centre for Action Research & People Development) has been working in this district since 1995. Its action focuses on tribal/rural issue and children community development. CARPED programs include sanitation infrastructure, school building and irrigation infrastructure. According to the work of CARPED, I’ve chosen the children’s health issue, especially the problem of the malnutrition for my traineeship. I will deal with this issue in two parts. Firstly, I think that all the development issues are
connected. For example, we can’t reduce the malnutrition to a lack of food. We must include other issues like women right, education or economic growth. In the first part of my report, I’ll set out this idea of interconnected freedoms. Then, according to this background, I’ll propose some ideas for the malnutrition issue.

II Economic development and the role of freedoms
As a result of my visit to several villages in the Medak District (Thallagada Thanda,Kannaram, , Kandhra Thanda, Mondi Thanda, Jaji Thanda ), I would say that poverty is an absence of freedom. In my opinion, we can define a poor person as a person who doesn’t have the possibilities to come out of difficult situations or extend his opportunity of lifestyle. The people in the village can’t increase their low incomes caused by the fluctuations of the seasons in rural activities. They can’t treat their ills. They haven’t enough money to buy medicine, to go to hospital, to pay school fees, to leave to change their life/find another opportunities,… They don’t have enough education to do research in efficient productive capacity in the agricultural sector or for a good job in the labor market … They haven’t any possibilities to change their conditions in dignity.

Consequently, the main problem for the economic development issue in Medak is the expansion of their active capacities. In other words, we should teach people to help themselves, give them the possibilities to turn the situation around to their advantage. However, how can we improve the people’s possibilities ? According to the studies of famous economists like Amartya Sen or Joseph E. Stiglitz and the recent work of the World Bank, I think that there are two main lines.

Firstly, the development of infrastructure is essential for the undeveloped countries. By infrastructure, I mean road, electricity, irrigation that are necessary for the economic activities. I also include social infrastructure like schools, care centers or sanitary installations. Since the 1990s, social investment has been increasing thanks to the World Bank Policy. In my first part, I’ll briefly speak about this new policy.

Then, in a second point, I’ll stress the importance of access by the people to the infrastructure. Indeed, we should consider how the people can profit from the offers of goods/services (school, hospital, care service, irrigation,…). Do they have the same opportunity of access? In my opinion, the response is negative. That is why the development issue should also focus on the real capacity of the persons. In the following sections, I’ll discuss thoroughly this idea.

2.1 The policy of the World Bank
The World Bank has changed its strategy concerning development policy since the beginning of the nineties. This organization has been considering the criticisms concerning the impact of income growth up on economic development. Several reports have demonstrated that we can’t only reduce the process of economic development to income growth. There exist other elements which impact positively on the economic activities. In other words, income growth is a necessary condition but not a sufficient condition for economic development. For example, several reports have prooved that an improvement of the health, or a better education also impacts positively upon productivity and income. Consequently, the World Bank has built a new indicator for comparing the level of development and suggesting some policies to poor countries. This indicator is called the Human Development Indicator (HDI). It is created from three thers indicators : the longevity, the knowledge and the standard of living. The first is measured by life expectancy, the second by literacy rate and the third by the real income per person.

Thanks to the introduction of the HDI, the improvements of economic development can not only evaluated by the level of the income. The development is also dependent on others indicators : the health and the education. Under the supervision of Chief Minister N. Chandrabadu Naidu, the government of Andhra Pradesh has been following the new strategy of the World Bank. In fact, Andhra Pradesh (AP) has been increasing its investment in human development (education, health, gender,), in irrigation (irrigation rehabilitation and maintenance) and rural road.

2.2 Economic development as an extension of freedoms
I agree with the decision of the government that the highest priorities of these people are basic needs like : sanitary installations, school, water or electricity. Consequently, an improvement of the health conditions or a better education will surely have a positive impact in the village. For example, a better education can give them some ideas or knowledge to improve the productivity in agriculture. It may also increase their possibilities to find jobs. Moreover, the people can create different strategies to come out of their difficulties, to extend their possibilities of lifestyle. The health conditions are also important. If the workers are in good health, they will work more efficiently or they can concentrate on the education of their children. Moreover, if the children are in good health, they can learn more efficiently at school.

However, the investments in school or in health do not seem to me not sufficient because they don’t provoke automatically an increase of the education or in the health conditions. The World Bank programs focus too much on the way/the supply but not enough on the real capacity of the people to profit from the infrastructure. Indeed, several studies of the SACMEQ (Southern African Consortium Educational Quality) or the ANTRIEP (The Asian Network of Training and Research Institutions in Educational Planning) demonstrate the inefficiency of some education programs in Africa and in Asian. For a same rate of school attendance, the purchase of knowledge is completely different.Moreover, the state of Sri Lanka or Kerala doesn’t invest much more money than the other states in India for the education. Nevertheless, their results in education are excellent. Consequently, there is no link between the building of school, school attendance and effective learning.

This is the same problem for health. The health policy encouraged by the World Bank concentrates on the infrastructure (building of care center), vaccination and nutrition. However, the building of a care center or the supply of vaccination treatments say nothing about the capacity of the people to profit from these supplies. In fact, some people can ́t afford the hospital because the cost of transport is too high for them or the medicines are too expensive. Even if they go to the hospital, it’s likely to be understaffed. We experienced this when we visited the general hospital in Kowdipally. Moreover, several people don ́t use the treatment service because they have low knowledge or on account of cultural problems. For example, when a child is ill, the parent sometimes do nothing because they interpret this ill as a decision of god.

I think that the human development indicator doesn’t concentrate enough on the real capacity of the individuals to use the supply of goods/services. That means we don’t consider that the individuals present some characteristics (age, disabilities, bad health,social factors) that prevent an efficient use of the potentials available (school, treat service, hospital, sanitary installations, social insurance…).

The approach of the World Bank isn’t sufficient. Another approach that focuses on the real capacity of the people should be complementary to the World Bank policy. This approach implies that we must consider all the freedoms like civil and political rights, social and economical politics or the culture. Indeed, according to the work of the famous economist Amartya Sen, we can say that all those freedoms are linked. If we act on a freedom we also impact on the others, and we impact finally on the capacities of the people. For instance, the trade freedom may provoke an income growth and an increase of funds for social rights. In other respects, education may also impact on the politics because the voter will become more responsible. Then, the politicians must focus on the malnutrition or the poverty if they want to be re-elected. With this approach, we can ask more relevant questions for the research of poverty solutions like :

● Why don’t the children go to school ? Do their family forbid it ? Is this is a conviction problem or fear ?

● How can we manage the problem of the children’s work and the education issue ?

● Can the parents pay the expenses of schooling ?

● Are the installations in the school unsuitable because the school is too fare or not well supervised ?

● Do the parents support the education of their children ?

● The number of students in the class is too much or there is not enough equipment (screen, books, paper, desks, chairs, qualified teacher).

● Do the children have access to information (radio, TV, newspaper, books). If it’s the case, can they use/exercise what they have learnt.

● Are the children well fed ? What can best we done in the village with the available food to fight malnutrition?

With this background, I deal with the malnutrition issue in the next part of this report. In my opinion, we should act on several freedoms for the resolution of this issue. This is not only a problem of lack of food. If we act also on the problem of women’s issue, the education ,the development of rura activities, we can be more efficient. I’ll try to call some proposals concerning this issue in the following part.

III The malnutrition issue, some proposals
As a result of my visit in the Medak, I’ve noticed that a lot of children and women suffer from malnutrition. Nutritional anemia mainly includes deficiencies in iron, folate and vitamin B12. It can also be due to deficits in vitamin A and zinc. Anaemia is one of the main causes of infant mortality. It also leads to the development of several illnesses and may provoke backward in cognitive capacity.

In this part, I’ll try to propose some ideas for resolving malnutrition. I’m sure we can improve the situation if we have a multi-faced view of the problem. Firstly, we should work with the available resources. At the same time, we should think about other issues that are connected to malnutrition and are able to enhance the available resources. I’m sure that if we act on the rights of women, the development of agriculture or the education of the children and parent, we’ll impact on malnutrition. I’ll set out my point of view in the following sections.

3.1 What can we do with the available food ?
The first things we can do against malnutrition is working with the possibilities available. In other words, the main question is what can we do with the available food? We can find several simple and practical ideas that could have an impact on this issue. Personally, I’ll focus on four points : the education of the parent, the establishment of small kitchen garden, education of children in schools, and access to the care treatment.

1. Educate the parents
The role of the parents, especially of women, is important concerning cooking. Consequently, it is important to educate them in healthy cooking practice. The education can include the presentation of a film show a nutritious diet, regular medical camps or regular meeting on nutrition. According to nutritional information, the following recommendation should be followed :

  • Use cooking salt that is iodized at the recommended level of 15 parts per million. Andhra Pradesh is a salt-producing state, but a great percentage of the population consums salt with nil iodine (because of transportation and complementary monitoring method),

  • Green leafy vegetables and such staples as potatoes and yams are important sources of folic acid. Green leafy vegetables are also rich in riboflavin. Most cereals, meat and again green leafy vegetables contain iron. Meat and fish enhance iron absorption, so they are doubly valuable.

  • Peanuts have a high protein content. Moreover, peanuts are a good source of several essential minerals like calcium, potassium, magnesium, phosphorous, iron, copper, zinc and manganese. One pound of peanuts has more nutritional value and calories than one pound of beef. Peanuts are cheap and also easily available in the village. That’s why we should encourage the consumption of this product.

  • Reduce foods or drinks that inhibit iron absorption such as tea (phenols),

  • Vitamin C has an enormous effect on the absorption of iron: a fruit drink taken with meals helps the body to use the iron from food,

  • Use iron tables (in combination with an acidic or sour food drink (for example orange or lime juice)),

  • Eggs, milk, butter, meat, liver and all sort of fish contain iron and vitamin A, but they are very expensive. In the villages, dark green leafy vegetables, sweet pumpkin and (seasonal) fruits are more available and much cheaper. Red, orange and yellow fruits and vegetables, such as carrots, mangoes and papaya contain carotene, which the body converts to vitamin A. Red palm oil is also very rich in carotene,

  • Expectant and lactating women should mix green leafy vegetables – dry or fresh, raw or cooked – with their own food every day or they should eat red fruits or red palm oil. They should also try to add some fat to the food,

  • Deficiency of vitamin B (complex) can be prohibited or reduced by eating whole cereals and millets, such as wheat, ragi (kind of mustard seeds), jowar, etc. and pulses, nuts and oilseeds. Also milk is rich in vitamin B,

  • Vitamin D (calciferol) does not come only from the diet; substances in the skin are also converted to vitamin D by the action of sunlight. This vitamin is needed for the incorporation of calcium into the bones, and children who lack it may get rickets (a disease in which the bones soften). Treatment: Use calcium lactate and 1000 units vitamin D daily orally for three months unless urgent then single larger dose of 600,000 units by mouth or injection. Exposing the skin on any part of the body tosome sunlight every day best prevents vitamin D deficiency (ricklets).

  • Breast feeding is also important for the malnutrition issue. Indeed, Milk from an adequately nourished mother provides all the nutrients that an infant needs for, on average, the first 6 months. Somewhere between the 3rd and 8th month infants needs supplementary foods. Start supplements by 6 months is a reasonable rule that covers the needs of most infants. Start too early and you risk diarrhea, start too late and you risk malnutrition. Remark: The baby needs other food in addiction to breast milk, not instead of it! All that the child needs is some extra energy and protein.

2. Kitchen Garden
During my visit in the village, I have noticed that the people could not always go to the market to buy fresh vegetables. They could not afford transportation and the food was likely to be too expensive for them. Consequently, their restricted diet sometimes lead to illness and their families are malnourished. Although some grounds aren’t exploited, the tribal village don’t have small kitchen garden. I think that this is pity because this is a way to have cheep and healthy food. We also should educate the people in the tribal village to have a small kitchen garden. Indeed, by having access to vegetables throughout the year, the women could improve the health and nutrition of their families and reduce food costs. In my opinion, the kitchen garden project should respond to two questions :

what kind of vegetables and how can we grow them ?

A. What kind of vegetables can we grow in the garden ?
According to the previous nutritional recommendations, these gardens may include:

● Green leafy vegetables
● Staples as potatoes and yams
● Dark green leafy vegetables,
● Sweet pumpkin
● Red, orange and yellow fruits
● Vegetables, such as carrots, tomatoes,
● Mangoes and papaya
● Whole cereals and millets, such as wheat, ragi (kind of mustard seeds)
● Medicinal herbs (ginger, garlic, chili)

B. Recommendations

In my opinion, we can meet some obstacles in the village for a kitchen garden project related to the space, water, time and animals. According to my inquiries on the Internet, I would like to purpose some simple solutions to face these problems.

● Concerning the space available, I would say that a large plot of land is not needed for a garden. Vegetables can be grown in 2 or 3 square meters. If you do not have much land, you can grow vegetables in large, broken, or thrown away pots or buckets, basins, or motor tires, as many people do with home grown flowers. All you need is to fill them up with humus, soil or compost.

● The water may not be available for the garden in Medak. Nevertherless, the water from the kitchen can be stored and used to water the garden in the evening. Avoid using soapy water and water with chemicals in it. Let hot water cool before watering.

● We can also use a rainwater catchment system to enhance the available water for the garden. We can find new innovative ways to catch rainwater from rooftops, tree trunks, tanks or other catchment structures. For instance, an african woman developed a system to catch rainwater from her roof. She built a bamboo gutter which attaches to the edge of the roof. Then, she attached at the end of the gutter some palm leaves, in the shape of a funnel. In this way, the water flows into a container on the ground which she uses for the house or the garden.

● Hot, dry conditions encourage evaporation of water from the garden soil surface. The longer the water remains on or near the surface the more is lost through evaporation. As they haven’t enough water, we should find solutions to limit the evaporation process. For instance, heavy soils keep water on or near the surface due to slow infiltration rates, and soil amendments such as organic matter and sand improve soil porosity, hastening water infiltration. Vertical mulches can be made using garden by-products such as maize, sorghum or sunflower stalks, or just sand, arranged in a vertical row or column in the garden bed. These create pathways in the soil through which irrigation water can travel quickly down to the root.

● Another simple and effective method for reducing evaporation is the use of surface mulch to shade the soil and capture some of the water evaporating from it. Compost, leaf litter, pulled weeds, and other kinds of organic matter make good surface mulch which also improve the soil as they decompose.

● Transpiration is the loss of water vapor from the plant and is an essential part of photosynthesis. However, the high temperatures, sunshine, and drying winds common in many dry lands increase transpiration rates beyond those required by the plant for maintenance and harvest production. This stress- induced transpiration can be reduced by using shades, windbreaks, and mulch made from locally available materials such as palm fronds or maize stalks. In Egypt, for example, young tender seedlings are protected from drying winds and wind-borne sand by careful placement of maize or wheat stalks just upwind of the seedlings.

● Mixed plantings combining garden crops of different forms and life cycles reduce both evaporation and transpiration. Larger plants in these mixtures, such as perennial fruit trees, provide shade and protection from winds while squash vines and other rambling plants spread out over the soil and act as living mulch.

● Usually, the parents don’t have time for the kitchen garden. They work many hours every day. That’s why they can ask children to carry buckets of water every evening to water the vegetables. Approach them tactfully and explain to them the importance of growing vegetables and then do a follow up to see that the work is done. You should sometimes do the work yourself to let the
children appreciate the real importance of the work.

● This is important to explain that not a lot of time is needed to maintain a kitchen garden. They need to spend some time starting the garden because you have to clear, till, make beds, and look for manure. After the garden has been established, maintenance is easy especially if you cover the beds with dry grass as mentioned above. The beds will remain cool, and little or no weeds will grow, thereby reducing labour. They can then, from time to time, check and control pests and diseases. If they plan well, they will always have time to do most of their important work.

● Stray animals are a hindrance to crop cultivation both in towns and villages. However, where there is a will there is a way. Any family that wants to grow vegetables must work hard to protect the garden. The best thing to do is to fence your garden. You could also politely ask the owner of the animals to confine them.

● If it is wild animals that are destroying your vegetables, you can keep the garden and its surroundings clean, set traps, and mount scarecrows.

● They can use the rubbish as compost for the kitchen garden. Some of the rubbish could be used to fill the trench of the garden. For instance, the leftovers from people’s kitchens, the vegetable scraps, fruit skins, peelings, egg shells, maize cobs, wood ash. All these elements would add many different nutrients to the soil as they rotted. Moreover, the bones would add calcium to the soil as they broke down over time. The tin cans from soups and prepared foods would also rust in the soil and add iron, another valuable nutrient. Even papers would break down, adding organic material.

3. Educate the children at school

It is easier to educate the children on nutritional issues. They haven’t developed their habits as the adults. School is also important for the education of appropriate nutritional behaviour. Moreover, education also impact income and health which indirectly affect the malnutrition.

A. Establishment of canteen at school
The development of canteen at school is a good way to correctly feed the children. They have safe water and healthy food. We can also educate them in good nutritional practice as eating fruits, doing fruit juice,… Thanks to the canteen, we can also furnish them with high energy biscuits to help them to compensate their lack of nutritional.

B. Lessons on nutritional issue

We can also change their nutritional behaviour at school. We can profit from science lesson to experiment how we grow the vegetables. I’m sure that the best way to learn is through projects. We should encourage the students and the teachers to plant a school garden. The children will gain skills they can use in their community. The teachers also will find also new ways to teach by including lessons in the garden. For instance, the students could learn about a different crop each year, through many different activities. The teachers match one school subject with the study of corn. For example, they sing and compose songs about corn and food for their families. The grade two students make art and crafts with corn. They make corn husk dolls and musical instruments. The grade five students study the vocabulary of imports and exports. They learn the uses and tenses of words related to the farming industry such as growth, plant, market and salary. And they write poems and letters about growing corn. Moreover, they can stress the importance of eating fruit, to have diverse food. We can also imagine cooking lessons at school.

C.Importance of education for income and health
It is important for boys and girls to stay in school. If children have a basic education they can help their parents on the farm by reading information about new farming practices, and instructions on seed packages and fertilizer bags. They can keep basic accounts for the farm business. This will allow farm families to increase profits and improve their lives. Moreover, when girls are educated they
learn to prevent illness and take care of sick children.

Nevertherless, as I said in the previous part, we can go to school and attain low knowledge. The use of knowledge is an important part of the learning process. I would like to briefly stress this. Indeed, after my visit in the Medak village, I think that there is an important problem concerning the use of knowledge. It isn’t efficient to learn something at school if we can’t exercise it. For instance, reading books or newspapers, listening radio, confer a better comprehension of language. Moreover, reading books as well as listening radio or watching TV enhance the ability to deal with life’s challenge, with maturity and sensitivity and allow the use of other skills. In this way, game society or sport are also important because they create situation to use what they have learnt at school, to challenge the limits
of the child, to learn fairplay or social skills.

Moreover, while the children play cricket for instance, the older people watch the match and at the same time gossip about neighbourhood concerns, conditions of schools, roads, garbage, water supply,… We shouldn’t underestimate the importance of social capital. It is often across singing groups, sport activities, cooperatives that the people get involved in the community problems. Several sociological studies indicate that that Indian are intensely connected. If someone fell sick, the entire village will show up at the hospital. At the same time, the interactions outside one caste are limited and formal. That’s why it is important to enhance social capital in the villages.

Consequently, the access to information and the building of game areas and other social activities should be a priority in the Medak villages. They must learn to be active and have more social capital. Actually, I think that the people are too passive. They undergo rather than confront their conditions. They don’t show enough solidarity between each other.

4. Access to care
Malnutrition causes several illnesses. It is important to care of these illnesses and prevent them. The lack of care treatment is really important in the village. Moreover, the people don’t profit from the poor care infrastructure. Indeed, the care centers are often too far for the tribal people. The transport cost is too high for them. Moreover, the quality of the service is low. The people aren’t confident in public care centers although the medicines are free. The focus on access to care should be a priority for development. However, how can we improve access to care ? According to a visit in a private clinic and an interesting discussion with Doctor Rayees Alimed, I think that CARPED should focus on the
following projects :

● The establishment of a private clinic with infrastructure for investigation (blooding test and diagnostic) which can provide a few basic medicines for free.

● Hire a surgeon who visits the village with basic equipment

● Development of herbal medicine because this kind of medicine is more appreciated by the tribal people and it is cheap.

● Mobile clinic which visits the village with a doctor and necessary equipment.

3.2 How can we enhance the available food ?
In the previous section, we have spoken about the possibilities we have with the available food. We should also think about how can we enhance the available food in Medak. In my opinion, there are several possibilities like food programs for instance. Moreover, the malnutrition problem includes other issues. Decreasing malnutrition is also linked to the improvement of agricultural growth or women right. I can’t claim to deal correctly with these issues. However, according to my visits in the villages and to my background, I would like propose some ideas concerning income growth and women right.

1. Micro-credit policy in the agricultural sector
Income growth should be a priority. Money is a spearhead for development. If the people earn more, it will be easier to deal with other issues. In Medak, the majority of people work in the agricultural sector. Consequently, the main issue for income growth is rural development. I’m not a specialist about this subject. I can’t discuss this thoroughly.However, in relation to my background, I would like to stress the lack of financial resources in the village.

In my opinion, everybody, including the poorest, is endowed with endless potential. It is a pity that they can’t afford to exploit their talent. The poor have skills which remain unutilized or under-utilised. I’m sure that if we are given access to credit, the poor people will be able to identify and engage in viable income-generating activities – simple processing such as paddy husking, lime-making, manufacturing such as pottery, weaving, and garment sewing, storage and marketing and transport services. Consequently, the availability of financial resource on terms and in appropriate conditions should be a priority in the poor areas.

The policy of the Grameen Bank ( seems to me interesting. The Grameen Bank furnishes microcredit to poor rural region in Bangladesh, without any collateral. The general features of Grameencredit are :

a) Its mission is to help the poor families to help themselves to overcome poverty. It is targeted to the poor, particularly poor women. This is important because in many communities women grow most of the food. But often their work is not recognized. The important contribution of women farmers to food production deserves to be acknowledged and valued. It is necessary to listen to women’s concerns about farming and support them by providing access to land and credit so they can maximize food production.

b) The most distinctive feature of Grameencredit is that it is not based on any collateral, or legally enforceable contracts. It is based on “trust”, not on legal procedures and systems.

c) It was initiated as a challenge to conventional banks which rejected the poor by classifying them to be “not creditworthy”. As a result it rejected the basic methodology of conventional banking and created its own methodology.

d) It provides service at the door-step of the poor based on the principle that the people should not go to the bank, the bank should go to the people.

e) Loans can be received in a continuous sequence. A new loan becomes available to a borrower if her previous loan is repaid.

f) All loans are to be paid back in instalments (weekly, or bi-weekly).

g) Generally, these loans are given through non-profit organizations or through institutions owned primarily by the borrowers. If it is done through for-profit institutions not owned by the borrowers, efforts are made to keep the interest rate at a level which is close to a level commensurate with sustainability of the programme, rather than bringing attractive return for the investors. Grameencredit’s thumb-rule is to keep the interest rate as close to the market rate prevailing in the commercial banking sector as possible, without sacrificing sustainability. In fixing the interest rate, market interest rate is taken as the reference rate, rather than the moneylenders’ rate. Reaching the poor is its non-negotiable mission. Reaching sustainability is a directional goal. It must reach sustainability as soon as possible, so that it can expand its outreach without fund constraints.

h) Grameencredit gives high priority to building social capital. It is promoted through the formation of groups and centres, developing leadership quality through annual election of group and centre leaders and electing board members when the institution is owned by the borrowers. To develop a social agenda owned by the borrowers, something similar to the “sixteen decisions”, it undertakes a process of intensive discussion among the borrowers, and encourages them to take these decisions seriously and implement them. It gives special emphasis on the formation of human capital and concern for protecting environment. It monitors children’s education, and provides scholarships and student loans for higher education. For formation of human capital it makes efforts to bring technology, like mobile phones, solar power, and promote mechanical power to replace manual power.

2.The right of the women
According to the work of the Indian economist Gurchahran Das (The Elephant Paradigm : The India wrestles with change, Penguin books, 2002, p.131), fifty per cent of children suffer from malnutrition in South Asia versus thirty per cent in sub-Saharan Africa. Moreover, one-third of the babies in India are born with low birth weight compared to one-sixth in sub-Saharan Africa. This trend is strange on account of higher literacy, income growth, access to water on the sub-saharan Africa. In an article “The Asian Enigma”, the Professor V. Ramalingaswami explains this anomaly by the low status of women in South Asia. The International Food Policy Research Institute and Emory University confirmed the Ramalingaswami hypothesis in one of its empirical studies in 2002.

We can explain the link between malnutrition and the rights of women. Indeed, the women haven’t the control of their body be according to custom and tradition they have no right to do so. In many Indian homes men eat first and women have to do with the leftovers. That’s why more Indian women suffer from malnutrition than sub-saharan African women. Moreover, they can’t decide what they drink, where they go, how they dress or how many children they want. What happens if you have too many children too quickly? You may have health problems because your body is weakened by having your children close together. Your children may also suffer from malnutrition because a malnourished woman will give birth to a baby with low birth weight.

Consequently, the improvement of women rights in India is also a priority. How can we achieve this ? In my opinion, one of the main goals is the working of women. If they earn a salary or run a business, they will become independent, they won’t become a prey to pressure or be enslaved. In this way, they would be responsible for themselves ant they would devote better pre- and post-natal care to their children. In my opinion, we can enhance the working of women if we stress the confidence and the education of women. The women must believe that they can act. They have enough talent to do something and to achieve it. However, other trainees have set up this issue in more detail than me.

IV Conclusion
In conclusion, I would like to stress two points. Firstly, according to my report, I’ll emphasize the main points of the malnutrition issue. Secondly, I would like to make some remarks concerning my traineeship which could be useful for the next trainees.

According to my research, I think that a policy for development issue, and especially for the malnutrition, must focus on four components : education, health, investment and women rights. Moreover, we must act on these components via the infrastructures and the real access of the people to these goods and services. Concerning CARPED, it should reinforce cooperation with other NGO to empower the people’s capacities. At the same time, it should focus on few projects and improve the efficiency. In my opinion, it could be dangerous to begin a lot of projects and not be efficient. Moreover, it could be interesting for CARPED to engage educational trainees in the Medak district. Indeed, the AIESEC has an educational traineeship program. It could be an opportunity for CARPED to use this traineeship for the teachers, the translators and the students in Medak.

Finally, I would say that my traineeship with CARPED has taught me a lot about the poverty and the cultural sensitivity. That corresponds to my expectations and this experience leaves a mark in my life thanks to CARPED. Nevertheless, I would like to stress up on the lack of structure and the absent of concrete activities for the trainees in CARPED. I think that it is important to give some explanations, structure and restrictions to the trainees. This is better for our work and our motivation. Moreover, I think that CARPED should use the trainees more often for the work on the ground. I’m deeply convinced that we don’t understand the world by contemplation but by action. If we have more concretes tasks to do, I’m sure that we could be more useful and more efficient for CARPED.