Killing Kids to Save Them?

I'm bummed that I'm going to have to leave India soon (tomorrow we fly to Hyderabad, then back to Delhi on Friday... I leave for Jo'burg very eary Sunday morning, as in 4am... who schedules a flight at 4am?). Not just because I'm loving this country, but also because of the work we're doing here.


Rajasthan's #2 bureaucrat asked us yesterday why they would risk poisoning kids with too much iron in their diet by fortifying cereals (the raw stuff, not the breakfast variety). While part of the answer was that we're not talking about high enough doses to push any kid over the line (it would take 600 times the levels of nutrients in fortified foods to be toxic... if someone is at 599 times the dosage level of iron, they're probably in the habit of gnawing on the family's cookware and / or licking the local blacksmith's anvil at night and have much bigger problems than the bowl of porridge they're eating... if not, it's impossible to eat 600 times the serving size), the focus of our discussion was around how that may be the very rare case for a handful of kids, but as a matter of public policy, we had to go with the decision that would have the biggest net improvement in lives and public health, even if the policy harmed some.


On one hand, that's a heavy thing to say... but on the other, when you see how many kids are outright suffering and dying so unnecessarily (there is actually more than enough food in the world, it just doesn't get to the people who need it... since that is a big problem to solve, an easy interim solution is fortification, even though in the US and Europe, pretty much everything is fortified... ironically, we have malnutrition in the West because we eat too much of the wrong stuff... in the developing world, it's because they eat too little, and what they do eat is also the wrong stuff, just a different variety), it's a no-brainer.


Though I can't imagine having to stand there and explain that to the parent of a child that was killed by a policy decision. I would want to personally dismember the bureaucrat / politician who made a decision that killed my kid.


(Thanks to Joel for inspiring this post.)