Iatrogenic malnutrition (malnutrition in hospitalized patients) is defined as malnutrition due to various medications or some complications to medical treatment or procedure. Iatrogenic malnutrition is currently present in Indian hospitals due to various factors including increased length of hospital stay, increased morbidity and mortality, impaired respiratory and cardiac function, decreased immune function, poor growth in infants and children, socioeconomic status, educational level, age group and severity of illness (Fessler 2008). Currently in India, it is very difficult to fight against iatrogenic malnutrition and Severe Acute Malnutrition (SAM).

Cases related to Severe Acute Malnutrition (SAM) reported in the year 2011 in a news article by Mr. Aravind Gowda, Indian Today Newspaper on 3rd October, 2011.  Full article Link : http://indiatoday.intoday.in/story/malnutrition-death-in-karnataka-kids-die/1/153489.html.

List of severely affected villages (Malledevara Gudde, Nagada Dinne, Markam Dinne, Magol, Kydigera, Ganadhal and Jagirujagil Dinne villages) were mentioned in the article along with photo of one severely malnourished patient (Mr. Nagaraj of Markam Dinne Village, Raichur District, Karnataka, India).

TV9 News Channel Report 8th and 9th October 2011: The impetus of the visit came from the renewed and intense media coverage around starvation deaths in Raichur following a TV expose, which likened malnutrition deaths in Raichur District to the conditions in Sub-Saharan Africa. TV-9 showed clippings of one particular child Anjeneya, over and over again. What was deeply tragic about the news clipping was the shame of seeing children in Karnataka with distended bellies and bony hands and feet, literally being carried around as they lacked the strength to walk".

On december 2011, a report on child malnutrition in Karnataka by Adv. Clifton D’ Rozario, Advisor to Commissioners of the Hon’ble Supreme Court Download Full Report.

22 January 2012

Inspired by the articles published by the India Today Group and other media sources and for checking the health status of Mr. Nagaraj of Markam Dinne village, a two members team (Mr. R. R. Siva Kiran, Assistant Professor, Dept. of Biotechnology, M. S. Ramaiah Institute of Technology, Bangalore and Mr. Sidda Lingeswara, Friend of Mr. R. R. Siva Kiran), visited five villages (Malledevara Gudde, Nagada Dinne, Markam Dinne, Kydigera and Jagirujagil Dinne villages). The village names were mentioned in the article published by Indian Today Group on Oct 3, 2011. Mr. Nagaraj died due to severe malnutrition in Mid November, 2011 (According to the villagers). The photo was taken by the India Today Group in September, 2011 end or October, 2011 first week. The parents informed the team members that they collected money from friends and well wishers and visited Raichur City and many doctors in Raichur City, Karnataka tried but could not save him and the actual fact is that the villages in Raichur District, Karnataka are not similar to Sub-Saharan Africa.

Raichur DistrictWater SourceWater Source, Raichur District, Karnataka

Plantation and canal near Markam Dinne village. The water was also analyzed and found to be safe for drinking (The photos were taken on 22 January, 2012).

Initial Research

Who is handling malnutrition in other countries?

Malnutrition is related to Advanced Clinical Nutrition and Parenteral and Enteral Nutrition. The malnutrition is exclusively handled by PEN societies in developing countries. PEN means, Parenteral and Enteral Nutrition Societies. These societies bring people from various backgrounds (Doctors, Dietitians, Nurses, Pharma and others) for fight against all types of malnutrition. These PEN societies develop guidelines and rules and also direct or help government organizations to enforce them for fight against malnutrition in hospitals or in community.

Why such type of setup is not present in India?

Yes, there is such type of setting in India and India has its own PEN society called "The Indian Society for Parenteral and Enteral Nutrition" - ISPEN - Formed in 1991 (Based on the old website retrieved from archive.org). It is found that ISPEN was involved in some court case and stopped working since 2010 Related Documents

Why ISPEN could not succeed in India, in spite of its existence from 1991?

Nutrition was completely neglected in Indian Hospital settings. The total number of colleges offering nutrition courses in India are less, there is no sufficient evidence based data in India and many more causes are present.

4 August 2012

Malnutrition is a complex & multidimensional problem with determinants beyond the health sector. A strong foundation and better understanding is required for handling such complex problem in developing countries. .

The first conference on malnutrition was conducted by Department of Biotechnology, M. S. Ramaiah Institute of Technology in collaboration with Department of Community Medicine, M. S. Ramaiah Medical College, Bangalore and Department of Food Science and Nutrition, University of Agricultural Sciences, Bangalore.

The conference on malnutrition also contains the First Annual Meeting of IAPEN. The members who attended this meeting are the founding members of IAPEN. This conference was mainly conducted to bring all old ISPEN members and to again restart PEN society in India.

In the first annual meeting, it is decided to stabilize the Journals (Journal of Nutrition Research and Indian Journal of Parenteral and Enteral Nutrition) and to bring more experts and lifelong learners into the association. The goal to restart ISPEN never materialized but IAPEN life membership was issued to all ISPEN old members till Feb. 2013.

From 2012 to till date, IAPEN has conducted many activities throughout India to promote Evidence Based Nutrition Practice. Many nutrition support clinicians joined IAPEN lifelong learning courses in India.

In 2017, IAPEN could able to form a Nutrition Support Certification Board in India.

IAPEN with the help of Sevas Educational Society is promoting entrepreneurs to start industries for producing low cost commercial enteral and parenteral feeds.