RUTF-WHAT IS IT?

That undernourished and malnourished population in India account for almost 50% of that in the world is known since long, with very little progress achieved by many schemes and programs of GOI during the last six decades. The recently enacted Food Security Bill boasts of stopping serving of processed ready to eat foods under the applied nutrition programs being run with public money, though no one knows what is the logic behind such a move. Obviously government thinks that the food industry is totally corrupt scheming surreptitiously to loot public money and hence cannot be trusted to deliver foods with approved nutrient contents. Fortunately there are some state governments which are more conscious of the limitations of localized cooking arrangements in thousands of feeding centers and still depend on the organized food processing sector to help them with RTE foods containing the prescribed nutrients at adequate levels recommended by experts. Unfortunately these states are being accused of colluding with the private sector in price fixing and siphoning of public funds. This attitude must be condemned and inability or incompetence to manage and and monitor such nutritional projects should not be used as an excuse to sabotage these programs. The action on the part of Jharkhand government in providing nutritious processed products, in stead, must be lauded.

Food Security Bill might have been amended to prevent backdoor entry of contractors to provide micronutrients in meals through industrially-processed food, but theJharkhand social welfare department is bringing in the food industry right through the front door in the name of seeking energy-dense food fortified with micronutrients to treat children with severe acute malnutrition(SAM). The social welfare department of the Women and Child Development ministry of Jharkhand has issued a tender inviting "expression of interest" from food manufacturers for packaged Ready-To-Use Therapeutic Food (RUTF) to be given to children afflicted by SAM. This comes close on the heels of a recent Cochrane review which looked at numerous studies on RUTF and concluded that there was little evidence that RUTF was any better than standard diet in treating Severe Acute Malnutrition (SAM). The tender document claimed that the central ministry's department of health and family welfare along with Indian Academy of Paediatrics had recommended community based therapeutic feeding programme as part of a holistic approach to SAM. "The community based approach aims at provision of energy dense fortified RUTF which is nutritionally adequate for the child with SAM," stated the document. It further stated that "to initiate the appropriate and adequate nutritional treatment at the household level a specific therapeutic food is required. The food is part of the nutritional treatment and is meant only for children afflicted with SAM." However in a paper published in 2009 on whether India ought to use RUTF for SAM, the Working Group For Children Under Six, comprising paediatricians and nutritional experts had stated: "The guidelines for community and homebased treatment of SAM formulated by a large group of experts and supported by the Indian Academy of Pediatrics recommends the use of home-based food (modified from the family pot). It specifically warns that commercially available international RUTF may not be suitable, acceptable, cost-effective and sustainable. In the context of SAM in India, an Experts' Group Meeting was held under the chairmanship of the Director General of Health Services in May 2010 in which the group decided that trials would be conducted to study different indigenous nutritional interventions in the community management of children affected by SAM. Despite the clear emphasis on indigenous nutritional interventions of which there are several examples which have been shown to be very successful in the treatment of SAM in various states, Jharkhand seems to pushing for commercialisation in the name of addressing malnutrition.

Ii is ridiculous to talk about local foods, prepared by untrained and semi literate cooking personnel with no idea about either basic nutrition or the tenets of hygiene, to be fed to SAM children. Even the industry which has adequate facilities to make packed foods finds it difficult to get suitable supply of micro nutrients with assured quality and potency and to expect the local kitchens to access them is just a pipe dream! Every one seems to have forgotten the Bihar tragedy which killed scores of children after consuming locally cooked foods which was contaminated with deadly insecticides. During early seventies of last millenium Karnataka government set up 5 processing units to manufacture specialized food product under the name of energy food containing all the micro and macro nutrients in adequate amounts to feed children under different ages. It is condemnable that these factories functioning under the public sector were closed down unceremoniously under political pressure as "looters and thieves" were not able to siphon off funds from the program. It is time that Government of India stops the mindless expenditure in setting up the so called "cooking shops" with the pious hope that they will serve the impoverished children with nutritious foods. The country has not heard the last word about tragedies and miseries being hurled upon its children through such half baked programs       

V.H.POTTY
http://vhpotty.blogspot.com/
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