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The International Food Policy Research Institute (IFPRI), a poverty and hunger watchdog, estimates around one in five of Pakistan's more than 200 million people are malnourished.
And yet, the nation is not short of food - in fact, according to the US Department of Agriculture, it is projected to export 500,000 tons of wheat from May 2018 until April 2019, and 7.4 million tons of rice in the same period.
Dawn, the English-language daily newspaper, even reported a potato glut earlier this month.
The issues, experts say, are socio-economic - that is, just because food is available, does not mean people can access it.
"There are four key pillars of food security in Pakistan: The first is availability, then accessibility, utilisation and stability," says Dr Ambreen Fatima, senior research economist at the Applied Economic Research Centre of the Karachi University.
In Tharparkar, where Mithi Civil Hospital is, all four are lacking, she explains, adding that in other parts of the country they are present only to varying degrees.
"Pakistan is quite well off in wheat production," comments Dr Kaiser Bengali, a veteran economist, who has done field research on poverty and hunger in the country, but adds that much of it is sold for export.
This means ordinary people in the country may not have access to it, and if they do they may not have the resources to pay for it.
"Affordability is the biggest challenge here in Pakistan," he says.
Karachi is Pakistan's financial capital, but Bengali says he has seen alarming examples of poverty and deprivation there.
"In our surveys we came across the kids who had never eaten an apple, and when we offered him an apple he was reluctant to take the bite wondering whether it was an edible thing or not," Bengali reveals.
"In another case a family had never had eggs in their whole lives," he adds.
A survey of the state-run Planning Division in 2017 found that 40 percent of Pakistan's population lives in multi-dimensional poverty.
That means they are not just short of money, but are also facing a shortage of basic needs, including health, clean water, and electricity, among other factors - all of which can impact their access to food.
Cycle of malnutrition
"Poor physical infrastructure, particularly in the remote rural areas throughout Pakistan is also a limitation on access to food and influences market prices," according to a recent statement from the Food and Agriculture Organization (FAO).
"This is also linked to inadequate water and sanitation, education and health service delivery, which together with the lack of awareness of appropriate dietary intake contributes to greater food insecurity and malnutrition."
Tharparkar district is frequently highlighted in Pakistan's media because of its high rate of child deaths, with politicians blaming the situation on drought - but economists and physicians say that is not the sole explanation.
"Causes of malnutrition are multiple pregnancies, young-aged marriage, iron deficiency in mothers, (lack) of breastfeeding, weak immunization, and early weaning," Dr Kumar insists.
Bearing large numbers of children from a young age takes its toll on women's health, but also impacts the well-being of the foetus and ability to breastfeed a newborn.
In Pakistan, only 38 percent of babies are fed breast milk exclusively during their first six months in line with UN recommendations.
This low figure is blamed on local traditions, the heavy workloads of mothers and powerful marketing by the milk industry.
Many mothers are told to feed their newborns tea, herbs, which can stunt growth.
Some are unnecessarily persuaded to use formula instead of breastmilk by doctors.
This can introduce health problems if the water use to make it is unclean, or if poor families scrimp on the amount of powder to create the drink.
Sindh's high number of child deaths are the result of a vicious poverty cycle that begins with malnourished mothers, agrees Bengali.
He adds: "An infant is not fed with wheat or solid food."
Rancher under investigation in death of cows
An Idaho rancher says 29 of his cows died in winter storms in Washington state, but investigators suspect he let them starve.
James Peter Marek, 42, of Slate Creek, Idaho, appeared in Franklin County Superior Court last week after being arrested for investigation of animal cruelty, the Tri-City Herald reported .
Marek filed a claim with the U.S. Department of Agriculture in February saying he lost an unspecified number of cows.
The Washington State Dairy Association estimates 1,800 dairy cows died during the blizzard on Feb. 9 and 10, at an estimated loss of $3.5 to $4 million.
The Franklin County Sheriff’s Office said investigators received a report from a witness who spotted dead cattle on Bureau of Land Management property off Highway 395.
Deputies flew over the area and saw the carcasses scattered across less than a third of a square mile (over 0.8 square kilometers), Capt. Monty Huber said.
Deputies said they found no sign that Marek’s cows had been provided any food and there were no tire tracks in the snow suggesting they’d been attended to.
Marek’s attorney, Scott Johnson, said there’s no evidence of what caused the deaths because no necropsies have been conducted. Judge Jackie Shea Brown ordered Marek released from custody Thursday.
“All that the witness knows is that there is possibly 29 dead cows. But there is no evidence of how these cows died,” Johnson told the judge.
Franklin County Prosecutor Shawn Sant said he has not decided whether to file charges.
“The investigation is ongoing, and as additional information is obtained, the prosecutor’s office will evaluate what charges, if any, are appropriate,” Sant said.
“The allegations are concerning and warrant further investigation for all interested parties.”
Marek has faced legal trouble in Idaho and Washington before. In 2016, he was accused of stealing cattle in Idaho from a South Dakota rancher.
He bought the cattle for the rancher, then used his own brand to brand them and sell them, according to the Idaho County Free Press. He was ordered to pay nearly $3,200 in restitution.
On Feb. 26, Franklin County deputies found him in a warehouse parking lot on the Pasco-Kahlotus highway hitching up a $9,000 trailer and 500-gallon (1,893-liter) stainless steel water tank.
Marek told deputies he was letting the water in the tank thaw, but didn’t tell them that he borrowed the trailer in 2015 and never returned it, according to court records.
He’s awaiting trial on four charges, including possessing stolen property, obstructing law enforcement and resisting arrest.
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