I have seen the benefits of aid to India

As you walk through Delhi’s slums, you realise the enormous scale of the problems India faces.

I’ve just returned from visiting Save the Children programmes in India, where I saw that all eyes were fixed on London for the Olympics. When asked in a Delhi slum if the Queen and James Bond really had parachuted into the opening ceremony, I’m afraid I couldn’t bring myself to tell the children that they hadn’t , but it showed how the Games have shone a spotlight on the UK. As the Olympics close next week, David Cameron will host a summit of world leaders to try and address hunger and malnutrition. The convergence of global attention on London provides an opportunity to galvanise political commitment to tackle these critical issues, which each year mean that 2.6 million children die before their fifth birthday.

Having visited India before, I knew it was a place of enormous contrasts; death is part of life and life can be desperately cheap. I was, however, still shocked to learn that in India nearly 5,000 children die every day.  Can you imagine the outrage if 5,000 children died every day in a war? A major cause of these deaths is malnutrition, which weakens children so their bodies can’t withstand routine illnesses like diarrhoea and pneumonia.  Almost half of India’s children that do survive are stunted, meaning their bodies and brains don’t develop properly due to lack of nutrition.

In Delhi, I visited the Okhla slum, home to some 100,000 of the most marginalised people. Many of the slum dwellers are migrants from rural India who, ironically, came to Delhi in search of a better life. Okhla is like much of Delhi; chaotic and vibrant, the skyline breached by hotels, factories and businesses. It is as you delve deeper in to the winding, rubbish strewn streets that you realise the sheer size of the slum. It was in Okhla that I met Kusum and her baby daughter, Ritu.

Ritu was born nine months ago, the sixth of Kusum’s children. Her eldest child is 16 years old, born shortly after Kusum’s marriage at the age of 15.  Ritu was severely underweight at birth, weighing just three and a half pounds. At nine months, she is about the size of my own four month old daughter.  For Kusum, life is a daily battle to find enough food to feed her six children, with wheat the staple food in the slums and vegetables incredibly difficult to afford.  Kusum told me that Save the Children’s mobile health unit allows her to seek regular medical advice and treatment, without which she’s not sure what would happen to Ritu. She may not be sure but I’m certain what would happen to her.

The mobile health unit is a free service provided to the community for women and children. The unit I visited was well equipped with medical stocks, and I watched professional and dedicated doctors and staff dispensing diagnosis and treatment for a broad range of ailments and infections.  Importantly, the doctors also provide education to the local community about health, hygiene and sanitation, in order to reduce the reoccurrence of preventable diseases.  On the day I visited, and despite monsoon rains, the mobile health unit treated over 200 patients from Okhla alone. 

There are those who question British aid to India. At a time when India is investing in a space programme and our economy is in recession, with severe cuts being made to vital local services in our communities, that is understandable. But seeing the benefit that the poorest gain from lifesaving interventions such as this, justifies Save the Children’s investment in India and the Department for International Development’s largely well-targeted aid programme.  And as you walk through Delhi’s slums, with children scavenging piles of rubbish in search of food to eat or scraps to sell, you realise the enormous scale of the problems India faces. 

The elephant in the room is the extent to which India, a brilliant and proud nation, can better ensure that it invests its own resources in the most effective way – given our historic links, a diplomatic minefield for the UK and a huge challenge for India. Fundamentally though, for the UK to behave as a responsible member of the international community, it is right to take action that saves lives every day.

The government is right to convene next week’s meeting of world leaders to address the crisis of malnutrition, which is responsible for 300 children’s deaths around the world every single hour.  But to turn the tide on this endemic problem, one summit will clearly not be enough.  Next year, as the UK hosts the G8, there is a real opportunity to further galvanise global action to address hunger.  And to truly demonstrate his commitment to tackling poverty, Cameron must now introduce the long-promised legislation committing 0.7% of national income to aid, and secure a brighter future for millions of children like Ritu.

Labour MP Dan Jarvis listens to slum dwellers in Delhi.

Dan Jarvis is the Labour MP for Barnsley Central and a former Major in the Parachute Regiment.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear