While you eat your breakfast and read this article, I urge you to just for a minute, imagine a day in your life where you don’t know if you’ll have a meal to eat. Scary, right? I know. However, there is a child out there right now who doesn’t have to imagine it because he is living in this unfair reality.

Since independence, the provision of health infrastructures has improved over time but remains inadequate, particularly in rural areas. An important index of health and nutritional status of a community is its “under-five mortality rate.” For Pakistan, it is 137 for 1,000 births. That is very high, by international standards. According to nation-wide food consumption surveys done by Pakistan’s Agriculture and Consumer Protection Department, 40 percent of children in Pakistan are underweight and over half of the children are affected by stunting. Our country has made some progress in the recent years but 37.6 percent of children under 5 years of age are still affected. The prevalence of malnutrition and stunted growth seems to have a positive correlation with the level of development in a provinces, being lowest in the Punjab and highest in Balochistan.

Did you know that cereals provide 62 percent of energy and remain the main staple food in Pakistan? Studies show that compared to other Asian countries, milk consumption is extremely high in Pakistan, whereas consumption of fruits and vegetables, fish and meat remains very low. One of the reasons for this is seasonal availability and lack of organised marketing facilities in the country.

It is no secret that Pakistan is facing a crisis in terms of malnutrition that is among the worst in the world. Many studies have been done over the years for us to understand the roots of this crisis. According to published articles, most of the factors are preventable. Some of the factors that account for malnutrition in our country are mother’s age at time of marriage, number of children she has, level of mother’s education and her nutritional and socioeconomic status. We are seeing more done about women’s health and education; however, it is not enough. Unfortunately, this is more of a problem in our rural areas, where some women still are not allowed to get an education and underage marriages are more frequent. Lack of education robs them of the ability to be healthy or choose a healthy future for their children. There is also a lack of awareness about basic and important things like prenatal and regular appointments with gynecologist during pregnancy and exclusive breastfeeding for the first few months to boost their immune system, which foods to eat and feed a child in order to avoid sub-clinical deficiencies in nutrients such as vitamins A and D, zinc and iron.

Studies show that compared to other Asian countries, milk consumption is extremely high in Pakistan, whereas consumption of fruits and vegetables, fish and meat remains very low. One of the reasons for this is seasonal availability and lack of organised marketing facilities in the country. 

Another factor is overpopulation. As a result of high birth rate, 60 percent of Pakistan’s population is still under the age of 30. This has dangerous consequences because more resources are required to raise more children. With nearly 39 percent of families living in poverty, it is not easy to provide for so many children. Hence, more children end up hungry and severely malnourished. Besides lack of education and basic knowledge of health, one of the reasons for our overpopulation crisis, is the fact that family planning is still taboo in parts of the country.

According to the United Nations, women are expected to have as many children as possible during the child-bearing age. As a result 70 percent of them use no contraceptives. It wasn’t until 2012, with the help of Family Planning 2020 programme that Pakistan made a commitment to increase fertility management and education. The Supreme Court of Pakistan proposed a two-child limit on families at one point, but this was met with strong opposition. The United Nations has predicted that at the going rate, Pakistan’s population will rise to 400 million by 2050. That will make it ten times harder to tackle the issue of malnutrition and hunger in Pakistan. Policy changes are critical as how we deal with this situation will affect the world the next generation will inherit.

From a medical point of view, the vast number of malnourished children will have very low immunity. Their bodies will never receive the proper nutrients, maternal antibodies or vitamins in order to be strong enough to fight diseases in general. The cases of rickets (bowed legs), short stature, asthma, upper respiratory tract illnesses and pneumonia are higher in malnourished children. The UNICEF executive director, Henrietta Fore, has said, “Despite all the technological, cultural and social advances of the last few decades, we have lost sight of this most basic fact: If children eat poorly, they live poorly.”

Some wonderful NGOs and individuals are trying to combat hunger and malnourishment in Pakistan. An excellent example is Rizq. In 2015, Huzaifa Ahmad, a student from the LUMS, had the idea of gathering leftovers from people and giving them to people in need. When Covid-19 hit Pakistan, government and other individuals approached Rizq and asked them to help distribute food rations in 23 cities. To put about 600 tonnes of excess food to good use, is surely an achievement.

Population control, better access to education, healthcare, and affordable quality food are essential in tackling this crisis. What can you do? Don’t throw away your leftover food, give generously, spread awareness about family planning, visit your doctor regularly and educate your children about their health and nutritional needs.

The writer is a doctor, a violinist, the general secretary of the Zain Ul Haq Foundation, Lahore, and a TEDx motivational speaker