KARACHI, Pakistan, Aug. 14 (UPI Next) -- Moosa Khan, a low-level worker in Karachi's local government, is one face of Pakistan's significant problem with malnutrition.
He looks back nostalgically at the time when he could feed his family three solid meals a day. Now, he calls nutritious, wholesome meals "a luxury," adding, "more often than not we have nothing to eat."
Pakistan is suffering from acute food insecurity, particularly in the southern province of Sindh. The province's Planning and Development Department recently reported that eight of its 23 districts have "extremely poor access to food."
Figures from the Sustainable Development Policy Institute, a policy analysis organization in Islamabad, indicate that nearly 48 percent of Pakistan's population lacks sufficient access to food and is anemic and malnourished. In some parts of the country, the problem is especially serious. Pakistan was 75th among the 107 countries ranked by the Economist Intelligence Unit's Global Food Security Index for 2013.
The 2008 food crisis is seen as the beginning of the current problems. The Pakistan Bureau of Statistics found then that food price inflation had risen to a record 34.09 percent.
The Sindh government reported July 15 that more than 71 percent of the province's households face food security issues -- even though Sindh's economy is by and large agricultural, with 14 million acres under cultivation, and farming is the main source of livelihood. Among households without secure access to food, 34 percent report moderate hunger and 17 percent report severe hunger. Their agricultural production is usually exported for foreign exchange or smuggled to neighboring countries, such as Iran or Afghanistan.
"The reason for the extensive food insecurity in Sindh is the same as in the rest of the country and is a complex mix of poverty, poor governance and inequitable distribution," Abid Suleri, Sustainable Development Policy Institute executive director, said. Other factors, he said, include climate change, insufficient emphasis on agricultural growth, urban development, a growing population, fluctuation in oil prices, wide-ranging inflationary trends, political influences and displacement of people through natural disasters such as floods and drought.
Ghaffar Khan, a driver serving in a household in Karachi, earns about $150 a month, quite low by Pakistani standards, and has a family of five, including three children.
"After paying house rent, utility bills and school fees, I have a negligible amount to spend on food," Khan said.
"The result is that the nutritional needs of my family are compromised, and we eat one meal a day to make ends meet," he said.
Climate change is also a factor in access to food. Changing weather patterns – recurring drought, floods and volatile precipitation patterns – have played havoc with centuries-old agriculture, affecting the most vulnerable.
Allah Wasayya, a farmer in the coastal district of Thatta, has a large family, including nine children and elderly parents. Ten years ago, he was living a comfortable life with enough food for the family. Since then, floods and droughts induced by climate change, as well as sea erosion, have left his land barren.
"Most of the time we sleep hungry, as we have nothing to eat," Wasayya said. "Our lands have become unproductive because of waterlogging and intrusion of sea water."
Women, especially single women, children, and the elderly are hit hardest by food shortages. Gender plays a role in nutrition: even now, particularly in poorer rural communities, women are the last to eat, and poor nutrition in this patriarchal society is worst among young girls and women.
Teenage sisters Kulsoom and Rashada work nearly 10 hours a day as housemaids in two Karachi houses. Both are anemic and severely malnourished and, despite their youth, have low blood pressure that sometimes keeps them away from work. They do not get leave as domestic workers, and absences slash their pay.
"Our mother prefers her sons when it comes to the food distribution in the family, as girls and women are supposed to eat the leftovers," Kulsoom said, a common story across the country.
Most small or subsistence farmers are women, as they are traditionally responsible for the family's food. Climate change affects men and women alike, but women suffer more.
"Rural women provide subsistence to their families through kitchen gardening, poultry and dairy husbandry," said Tahir Hasnain of Shirkat Gah -- Women's Resource Center, a Pakistani organization that focuses on globalization issues and ecological agriculture, especially for women.
"Changes in the climate usually impact on sectors that are conventionally associated with women, which in turn affect the food security of the families," he added.
This problem has affected middle-class Pakistanis as well. Because of mounting inflation and the soaring cost of living, they are also forced change their nutritional habits.
To make ends meet and provide three staple servings of food a day they have had to compromise on the quality of food.
Milk, fruits, eggs, meat and fish are vanishing from their tables, and they are eating more vegetables and grains.
Sindh also faces relocation of refugees from the insurgency in northwest Pakistan, as well as victims of natural disasters such as floods in 2010 and 2011. This large-scale exodus has also severely strained limited food resources.
"The irony is that Pakistan, or for that matter Sindh, has no clear-cut national food nutritional policy," said Additional Secretary Abdul Basit Khan of the Ministry of Food Security and Research.
"Though the ministry was formed in 2010 on the federal level, which later devolved to the provinces ... no initiative has been taken since then, which is quite unfortunate, keeping in mind the severity of the problem. Our constitution guarantees the right to food by its Article 38-B, but the government is not taking any steps to ensure its availability and access," he added.
"Provinces are taking steps to assure their citizens of a food supply," Khan said, "but the process is slow, and hopefully will yield results in the near future."