Stunned by stunting
24 June 2012 06:30 pm
Chronic malnutrition steals IQ points, immunity, and sometimes the lives of children too
By Dawpadee Kawshalya in Kathmandu
The misconception that genes alone make Asians small-made will be busted in the days to come; for according to the World Bank Nutritionist Nkosi Mbuya, more than genes it is malnutrition that accounts for short statures of the people who live in the eastern side of the world.
When the World Bank called on journalists across South Asia to take home the message of eliminating malnutrition during a two-day workshop and a knowledge forum, the revelations were too shocking for bland reporting. There were stories that needed to be heard, and facts that were begging attention. From Afghanistan to India and from the Nepalese peaks to the Maldivian waters, it was an echo of interwoven misery of poverty and the enigma of South Asia’s development. The fact that South Asia despite its forward drive towards development has failed to remedy malnutrition and food insecurity, is bewildering enough. The entire region shares a common storyline - that of Sri Lanka may not be as bad as those of the rest, yet it is neither happy nor is there an ending.
Acute and chronic malnutrition
Commonly known as wasting, acute malnutrition is a result of rapid deterioration in nutritional status during a short period of time. This signifies the disparity between the child’s height and weight. If treated properly, this can be remedied and the child can live a normal life. In contrast, chronic malnutrition, also known as stunting, results in lasting consequences. Insufficient nutrition over a long period, poor maternal nutrition and poor infant and child feeding practices are the reasons for stunting. This can be measured using the height-for-age nutritional index.
Why is stunting so bad?
A stunted child can never be normal again. He/she can never gain the few inches and the many points of IQ he/she is losing due to the lack of nourishment. Perhaps, looks do not matter much. Yet, one cannot easily ignore the fact that, a child suffering from chronic malnutrition inevitably becomes a poor performer in school. Such children are not only at a risk of impaired cognitive development but also poor fighters of disease. What is sadder perhaps, it is none other than the parents who create this fate for their children. Lack of awareness on nutrition, busy lifestyles, cultural practices or simple lethargy, call it what one will, chronic malnutrition is one instance where one has to pay a great price for looking for convenience.
A thousand-day window
In order to beat the demon, the battle needs to be fought for a thousand days. This includes the 270 days of women’s pregnancy and 730 days (till the second birthday) after the child is born. This period is considered the most critical of the human life cycle, because malnutrition and disease can very easily lead to impairment of a child’s physical and mental growth. This can also make the child prone to diabetes, hypertension and even obesity in adulthood.
A thousand days is all about making sure that the mother’s nutritional needs are answered during the time of pregnancy and lactating. There is also the need to provide adequate healthcare facilities during this period. Common causes for malnutrition during the thousand days range from wrong feeding practices to unnecessary delays in seeking treatment for common childhood ailments.
Breast-milk - nectar of happiness and protection
Experts say exclusive breastfeeding for the first six months eliminates the chances of a child being a victim of chronic malnutrition. They also emphasise that a child should be breastfed within the first two hours after birth as the mother’s first milk (colostrum) contains essential proteins and boosts the immune system.
Coming to terms with harsh realities, the financial situation of a family does not always give a mother the chance to exclusively breastfeed her child. Sometimes, there are mothers who are bread-winners of families with many mouths to feed. The short number of days of maternity leave and the type of employment compel a mother to resort to infant food formula and supplements which should ideally be introduced after the first half -year.
The mothers who resort to the convenient method of prodding anything down the throat of her child may not be aware of the fact that depriving a child of his/her rightful meal can leave scars that last forever.
Hence, however impossible, an effort needs to be made to encourage mothers to breastfeed, for their inability to do so can breed a generation of stunted children who will not only devour the country’s wealth but also become citizens of a bleak future.
SRI LANKA: ARE WE MALNOURISHED TOO?
Compared to the other countries in the region, Sri Lanka has come a long way to stand abreast with some of the developed countries, thanks to free healthcare and a well-organised state hospital structure in the country.
In the global stunting prevalence ranking, Sri Lanka ranks 89th out of 136 countries. World Bank statistics show that 18 percent of the children are stunted, 22 are underweight and 15 are wasted. The reasons identified are, poor infant feeding practices, maternal under nutrition and limited access to nutritious food. Yet, compared to the peers in the region, Sri Lanka has the highest percentage (76 %) in the exclusive breastfeeding index.
Though overall figures give the impression that Sri Lanka can heave a sigh of relief, the prevalence of under-nutrition among the children in the estate sector, is as high as that in the African region i.e. 40 percent. Though the overall figure continues to drop, the individual percentage remains intact. With such a disparity in the bag, Sri Lanka cannot really boast of high living standards nor can it be complacent about remedying the situation by putting forward the readymade excuse that the victimised community is numerically small.