“Starvation is the characteristic of some people not having enough food to eat. It is not the characteristic of there being not enough food to eat. While the latter can be a cause of the former, it is but one of many possible causes.” (Amartya Sen, 1981)

The pristine gift of independence is the equal right of all to celebrate and foster.

True independence disentangles the crippling knots of hopelessness, with a beacon of opportunity for fuller lives through physical, mental and social well-being. Everyone everywhere must attain purpose and potential, forge ahead, and confidently take the quantum leap.

Yet, despite a country’s independence, populations, especially of women and children, continue to be embroiled in unheeded voices, unfulfilled dreams and unsatisfied hungers.

The diet should provide balanced and essential nutrients, the fundamental building blocks of life with its quality and vigour, because in their absence, life is not lived or entirely savoured.

Investments through food and nutrition

Food must be available, accessible, utilised by the body and stable. Everyone everywhere must have nutritious food to eat, according to dietary requirements and cultural choices, for healthy and active lives. Stable governments, fair societal values and sound essential institutions must cooperate to prevent food scarcity, with nutritious food, made available to all.

Food must serve its biological purpose at different phases in our lives. Through adequate diets and via physical, mental and social well-being coupled with clean, healthy environments, nutritious food is utilised for dynamic metabolic needs.

Essential food components are assimilated by active absorption, hormonal and metabolic processes for ideal growth, development, replenishment, repair and disease protection. Food must safeguard us from novel pandemics and provide us resistance to freely conduct activities of daily living.

However, it is still possible that even if sufficient nutritious foods are not available (given that natural food sources are often the best), yet populations may still get the missing nutrients. For example, through food fortification, biofortification of crops or supplementation of nutrients, people can still have balanced diets even if certain foods are not readily available or accessible.

We must also realise that persons can still be malnourished in settings of adequate diets. For instance, at a cellular level, in diabetes mellitus, a scenario aptly referred to as “starvation in the midst of plenty”, cells cannot utilise the energy from glucose-rich blood all around them due to the lack of the hormone, insulin.

Collectively, all factors that ensure accessibility of nutritious food, utilised through measures that emphasise holistic health, are starkly important.

Citizens can then enjoy liberties of basic living and forge ahead to excel, giving back to society crucial investments in them.

The burden of gut parasites and costs of freedom

In the context of parasitic diseases, or parasitism, freedom to enjoy the nutrients we procure from diets should be ours alone, and not taken advantage of, by fluxes of other life forms, of parasites, that steal our dietary earnings, which may well be marginal, solely to benefit them.

Parasitic infections could occur through arthropod vectors in unclean environments, larval skin penetration by walking barefoot or via unhygienic conditions supporting the ingestion of cysts or eggs that contaminate our food or water.

Overcrowding and lack of physical distancing endanger lives and reduce aspirations of freedom in the promised land. Refugees, displaced and institutionalised people, crowded orphanages and so on, are parasitic haven, triggering illnesses and dependence on health care systems.

The voices of hidden hunger due to micronutrient deficiencies such as the unexplained exhaustion, the disturbing dizziness, the work absence and appetite losses go unheard, when parasites feed on the food eaten.

Deficient nutrients interfere with ability to work or withstand tough challenges as reduced quantities of essential nutrients are shunted for purposes of merely staying alive, unable to cope with life’s stressors.

Education is often the sharpest tool for freedom. Indigenous settlers may not be fully liberated through knowledge, on hazards of poor socioeconomic conditions in longhouses or of inadequate sanitation practices. As hookworm larvae gain entry through skin, or as whipworm eggs enter the gut through contaminated fingers in contact with soil through improper methods of sanitation, causing rectal prolapse and bleeding, they may still not be alive to the extent of the dangers of parasitism, due to lack of adequate awareness.

An individual’s independent expressions are restricted when one merely concentrates on the business of staying alive. The roundworms, hookworms and the whipworms, develop and thrive on excreta outside the body, for their life cycles. The larger roundworms can block the gut and worm bezoars can initiate surgical emergencies to drain healthcare resources and emergency services. The impoverished host is further encumbered because of delayed wound healing from surgeries.

Parasitic infections add to the burden of immunosuppression and growth failures. In the immune-suppressed host, some parasites, victorious against human immunity, are free to roam outside the gut, reaching any site such as the nostrils and ears, crippling the dignity in life.

Notably, today, preventive health measures to eliminate parasitism would improve public health indices of avoidable immunosuppression, as current pandemics target the immunosuppressed.

While parasite-induced gut damage is distressing at all ages, children suffer most because they will never achieve their genetic potential nor push any further.

Protozoal water pollution carries an ugly restrictive consequence by the stunting it causes children in many parts of the world and gut nutritive losses render potentially bright children, dull and unenthusiastic.

Independence of thought and ideas are integral to human freedom. In parasitic havens, iron deficiency anemia is strongly linked to lower developmental scores in infants and poor cognitive skills in children, and treatment cannot reverse it all.

The parasite-infected gut, injured by hookworm bites and mixed parasitism, loses blood and absorptive function involving iron, iodide and other essential microminerals.

Children’s poor attention spans and problems with short- and long-term memory, certainly do not augur well towards a nation’s prized investments in its leaders of tomorrow.

Retardation of physical and mental growth, due to deficient nutrients compulsorily shared between host and parasite as well as the parasite-induced gut impairments, deprive an independent country of dynamic action, innovative thinking and illustrious ideas as bedrock for excellence.

Merdeka

The independence of a nation is achieved through the liberation of its people within the constraints of morality. These are established through integrated and intercultural dynamic action, wisdom of purpose and rational philosophy, all of which are founded and strengthened through food and nutrition security.

Merdeka!

-- BERNAMA

Dr Prameela Kannan Kutty is Professor of Paediatrics at Universiti Pertahanan Nasional Malaysia.