A disproportionately large number of Indians have congenital defects and visibly stunted growth. The poorest of them are often abandoned by their families and/or forced to beg. Tourist and pilgrimage sites inevitably become their favorite stomping grounds. Why does it seem so much worse in India, even compared to the lower GDP nations of, say, East Africa (the only part of sub-Saharan Africa I have seen)?

Excluding the unlucky rolls of genetic dice (many of which can be avoided by a medical pre-screening), most birth defects are due to maternal malnutrition and substance abuse, as well as exposure to toxins, pollution and hazardous waste. In India, the latter may be no less significant. Given India’s worsening urban environments and anemic healthcare, one has to stretch facts, ignore evidence, and be a determined optimist to see light at the end of this tunnel. At least for the foreseeable future, India should remain the prime destination for photo ops of the kind below.