With several complaints coming in about fortified rice, several doctors, health workers and nutritionists have written to the Odisha government demanding that the state suspend its fortified rice distribution immediately and not go along with the “misadventure being attempted by the union government”. This has come after the recent incident of children complaining of stomach pain after consuming fortified rice in Jhankarpali village in Khaprakhol block of Bolangir district.
The letter highlighted that this was not an isolated incident and reports from ground indicated that it was more than fears about ‘plastic rice’. The communities did not prefer the fortified rice and this was more of a top-down approach where the concerns of the communities were not taken into consideration. Moreover, the communities were also worried about people experiencing adverse impacts resulting from the consumption of fortified rice.
Members of various organisations, in the letter, underscored that the efficacy of rice fortification has not been proven and there were safety concerns about iron-fortified rice, in addition to the one-size fits all approach with regards to anaemia which is prevalent among several people in the region. They pointed out that anaemia was a medical condition and was best addressed in an individual case management approach.
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“If it has to be dealt with as a public health matter, then it is an imperative that proven, holistic, community-controlled dietary-diversity-enhancing approaches be followed. Reductionist solutions which try to address malnutrition micro-nutrient by micro-nutrient are not likely to yield results and are likely to pose unacceptable risks too,” stated several members in the letter.
The letter addressed to the department of school and mass education, department of food supplies and consumer welfare, and the department of women and child development, called for a comprehensive review meeting, to assess the need for such an approach, alternatives available for the same, and involve civil society groups in such a dialogue.
It was observed in the letter that iron-fortified food were contra-indicated for people with thalassemia, and sickle-cell anaemia as well as particular stages of infectious diseases such as malaria and tuberculosis. It is also not administered when there is severe acute malnourishment (SAM), and such SAM cases are known in Odisha (and other states) as the Nutrition Rehabilitation Centres indicate.
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The members questioned about the so-called pilot in Malkangiri district that has not been completed or evaluated nor the results were put out for expert public scrutiny, but instead it was being rapidly scaled up to all schemes.
In 2019, the NITI Aayog had identified 15 districts across the country including the tribal-dominated Malkangiri in Odisha to implement the scheme for distribution of fortified rice through the PDS on a pilot basis. The scheme was launched in Odisha in July 2021, but the results of the pilot have not been published yet.
Expressing their deep concerns about the rice-fortification plan, the experts said the state was gaining a good name for its more holistic approaches around Nutrition Gardens (“Mo Upkari Bagicha” programme under OLM) and reviving millets in our food systems (Odisha Millets Mission). Pointing out that in Odisha, scientific research had occurred on the nutritional importance of uncultivated forest foods, the experts asked if many solutions existed, why were risky approaches being adopted for addressing malnutrition?
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