Fighting malnutrition
Saturday, 23 February 2008
Farzana Shammi
At a hospital Mariam was in great pain, awaiting the birth of her first child. Her frail figure did not give the impression that she was pregnant. Doctors were worried for both the 25-year-old and her incoming child.
"She has long been suffering from malnutrition. Now she has lost her appetite and cannot digest properly. Whatever she eats she cannot digest due to vomiting tendency," said an attending doctor at the Bangladesh Medical College Hospital in Dhaka.
Surviving with IV saline, Mariam awaited the delivery of a malnourished baby. She feared that she would give birth to a still baby. Doctors always warned her against expecting a healthy baby. She herself was too weak to worry too much about the baby still in her womb.
Mariam could have avoided all these problems and worried had she not suffered from severe
. From the very childhood she was deprived of nutritious food as her poor parents could not afford nutritious diet. She faced the same fate after getting married to a poor man.
According to WHO and UNICEF, malnutrition acts in a cyclic pattern - it goes from mother to child. A girl child who grows up with little nutrition becomes a malnourished mother. Thus malnutrition casts a long-term negative impact and it is passed from generation to generation.
Twenty-seven-year-old Fahmida Akhtar is another victim of malnutrition. She was underweight and suffering from malnutrition while giving birth to a girl child. Her daughter Nafisa is now five years old, but her physical growth doesn't match with her age.
"Nafisa remains sick most of the time. She is getting skinny day by day," said Fahmida who also couldn't recover from the adverse effects of malnutrition.
The status of mother and child malnutrition in Bangladesh is very acute.
According to World Health Outlook 1998, 70 percent pregnant women while 56 percent under-five children of the country are suffering from acute malnutrition.
The Nutrition Surveillance Bulletin June 2000 of the Helen Keller International placed Bangladesh on the top of the world malnutrition chart.
Bangladesh Demographic and Health Survey 1999-2000 reveals that 45 percent women of the country are both underweight and victims of malnutrition. Besides, malnutrition is the main reason behind the death of 1.44 percent women and 1.80 percent men.
"The situation is even worse than that of the African countries," said Dr AFM Iqbal Kabir, a senior nutritionist and team leader of World Bank.
He, however, said some positive changes occurred in last 10 years. "If we consider the situation of the last decade or before, we'll find some changes. We were able to prevent a disastrous situation that would have affected the entire present generation."
According to the World Bank, the rate of improvement is very slow - only 0.5 percent per annum. The vitamin-A deficiency of the children of Bangladesh has been reduced to a tolerable limit in the last decade with the joint efforts of the government and donors.
"The rate must be improved to 3 percent to bring more effective changes," Dr Kabir observed. Bangladesh Integrated Nutrition Programme identified three major causes of malnutrition. These are inadequacy of food served in the family, absence of necessary public health service and lack of proper healthcare.
UNICEF's viewpoint on malnutrition focussed on lack of proper care rather than lack of nutritious food. About 60 percent of the malnourished children come from solvent families. "So, lack of food is not the main reason behind malnutrition of children," said Dr Iqbal Kabir.
Poverty, culture, lack of knowledge, role of women at the family-level and many other factors are behind malnutrition, he said and pointed out that women in Bangladesh are the major victims of malnutrition.
Dr Hasina Banu of Gonoshyastha Nagar Hospital described some other reasons like taking low-calorie food, pregnancy in early age and lack of timely healthcare.
According to the data of the year 2000 compiled by Bangladesh Bureau of Statistics, 13.2 million urban people and 42.6 million rural people do not take food valued 2122 kilo calorie which is necessary for checking malnutrition.
However, the intensity of malnutrition is even severer in urban slums than in rural areas.
The economic consequence of malnutrition is also a matter of great concern. The World Bank says malnutrition disrupts the productivity of people reducing their capability of acquiring knowledge and utilising available intellect.
As malnutrition causes many diseases, people have to spend more on medical treatment. Around 3.3 million children are born every year in Bangladesh and one third of them weigh below 2.5 kgs during birth while two-thirds of the under-five children are found malnourished, the World Bank says.
Malnutrition is blamed for the death of some 2.5 lakh children every year. It also causes thousands of maternal deaths during delivery caused by excessive bleeding and anemia.
Since 1996, the government has been running an Integrated Nutrition Programme (BINP) by setting up community-based nutrition centers (CBNC) in rural areas. The programme currently covers 59 upazilas with 13,322 CBNCs.
Seven NGOs, including BRAC, CARE, Proshika and World Vision, are extending cooperation to the government in implementing the nutrition programme jointly financed by the government and the World Bank.
Considering the slow pace of improvement in nutrition management, the World Bank forecast that Bangladesh would need at least 80 years to achieve the goal. It suggests that the nutrition programmes be accelerated to achieve the goal by 15-18 years.
"We must take nutrition more seriously. Because everyday 600-700 children are dying for malnutrition," said Dr Iqbal Kabir stressing the need for more government-NGO initiative for improving the nutritional status in Bangladesh.
The government budget for nutrition programmes is not more than 0.03 percent of the GNP. If it is increased to 0.3 to 0.5 percent, the nutrition programmes could be extended to the entire country, experts said.
They said India invests 0.3 percent while Sri Lanka 1 percent of GNP in nutrition programmes. To save lakhs of mothers and children from untimely death, the country's nutritional status must be improved through implementing more effective programmes and creating
greater awareness among the people about nutrition.
"The mass media can play a great role in highlighting the negative impacts of malnutrition," said Dr Ahaduzzaman Mohammad Ali, Chairman of Mass Communication and Journalism Department of Dhaka University.
He said short dramas with clear messages and effective language could be broadcast through electronic media to make the people aware about the ways to protect themselves from the curse of malnutrition.
— NewsNetwork
At a hospital Mariam was in great pain, awaiting the birth of her first child. Her frail figure did not give the impression that she was pregnant. Doctors were worried for both the 25-year-old and her incoming child.
"She has long been suffering from malnutrition. Now she has lost her appetite and cannot digest properly. Whatever she eats she cannot digest due to vomiting tendency," said an attending doctor at the Bangladesh Medical College Hospital in Dhaka.
Surviving with IV saline, Mariam awaited the delivery of a malnourished baby. She feared that she would give birth to a still baby. Doctors always warned her against expecting a healthy baby. She herself was too weak to worry too much about the baby still in her womb.
Mariam could have avoided all these problems and worried had she not suffered from severe
. From the very childhood she was deprived of nutritious food as her poor parents could not afford nutritious diet. She faced the same fate after getting married to a poor man.
According to WHO and UNICEF, malnutrition acts in a cyclic pattern - it goes from mother to child. A girl child who grows up with little nutrition becomes a malnourished mother. Thus malnutrition casts a long-term negative impact and it is passed from generation to generation.
Twenty-seven-year-old Fahmida Akhtar is another victim of malnutrition. She was underweight and suffering from malnutrition while giving birth to a girl child. Her daughter Nafisa is now five years old, but her physical growth doesn't match with her age.
"Nafisa remains sick most of the time. She is getting skinny day by day," said Fahmida who also couldn't recover from the adverse effects of malnutrition.
The status of mother and child malnutrition in Bangladesh is very acute.
According to World Health Outlook 1998, 70 percent pregnant women while 56 percent under-five children of the country are suffering from acute malnutrition.
The Nutrition Surveillance Bulletin June 2000 of the Helen Keller International placed Bangladesh on the top of the world malnutrition chart.
Bangladesh Demographic and Health Survey 1999-2000 reveals that 45 percent women of the country are both underweight and victims of malnutrition. Besides, malnutrition is the main reason behind the death of 1.44 percent women and 1.80 percent men.
"The situation is even worse than that of the African countries," said Dr AFM Iqbal Kabir, a senior nutritionist and team leader of World Bank.
He, however, said some positive changes occurred in last 10 years. "If we consider the situation of the last decade or before, we'll find some changes. We were able to prevent a disastrous situation that would have affected the entire present generation."
According to the World Bank, the rate of improvement is very slow - only 0.5 percent per annum. The vitamin-A deficiency of the children of Bangladesh has been reduced to a tolerable limit in the last decade with the joint efforts of the government and donors.
"The rate must be improved to 3 percent to bring more effective changes," Dr Kabir observed. Bangladesh Integrated Nutrition Programme identified three major causes of malnutrition. These are inadequacy of food served in the family, absence of necessary public health service and lack of proper healthcare.
UNICEF's viewpoint on malnutrition focussed on lack of proper care rather than lack of nutritious food. About 60 percent of the malnourished children come from solvent families. "So, lack of food is not the main reason behind malnutrition of children," said Dr Iqbal Kabir.
Poverty, culture, lack of knowledge, role of women at the family-level and many other factors are behind malnutrition, he said and pointed out that women in Bangladesh are the major victims of malnutrition.
Dr Hasina Banu of Gonoshyastha Nagar Hospital described some other reasons like taking low-calorie food, pregnancy in early age and lack of timely healthcare.
According to the data of the year 2000 compiled by Bangladesh Bureau of Statistics, 13.2 million urban people and 42.6 million rural people do not take food valued 2122 kilo calorie which is necessary for checking malnutrition.
However, the intensity of malnutrition is even severer in urban slums than in rural areas.
The economic consequence of malnutrition is also a matter of great concern. The World Bank says malnutrition disrupts the productivity of people reducing their capability of acquiring knowledge and utilising available intellect.
As malnutrition causes many diseases, people have to spend more on medical treatment. Around 3.3 million children are born every year in Bangladesh and one third of them weigh below 2.5 kgs during birth while two-thirds of the under-five children are found malnourished, the World Bank says.
Malnutrition is blamed for the death of some 2.5 lakh children every year. It also causes thousands of maternal deaths during delivery caused by excessive bleeding and anemia.
Since 1996, the government has been running an Integrated Nutrition Programme (BINP) by setting up community-based nutrition centers (CBNC) in rural areas. The programme currently covers 59 upazilas with 13,322 CBNCs.
Seven NGOs, including BRAC, CARE, Proshika and World Vision, are extending cooperation to the government in implementing the nutrition programme jointly financed by the government and the World Bank.
Considering the slow pace of improvement in nutrition management, the World Bank forecast that Bangladesh would need at least 80 years to achieve the goal. It suggests that the nutrition programmes be accelerated to achieve the goal by 15-18 years.
"We must take nutrition more seriously. Because everyday 600-700 children are dying for malnutrition," said Dr Iqbal Kabir stressing the need for more government-NGO initiative for improving the nutritional status in Bangladesh.
The government budget for nutrition programmes is not more than 0.03 percent of the GNP. If it is increased to 0.3 to 0.5 percent, the nutrition programmes could be extended to the entire country, experts said.
They said India invests 0.3 percent while Sri Lanka 1 percent of GNP in nutrition programmes. To save lakhs of mothers and children from untimely death, the country's nutritional status must be improved through implementing more effective programmes and creating
greater awareness among the people about nutrition.
"The mass media can play a great role in highlighting the negative impacts of malnutrition," said Dr Ahaduzzaman Mohammad Ali, Chairman of Mass Communication and Journalism Department of Dhaka University.
He said short dramas with clear messages and effective language could be broadcast through electronic media to make the people aware about the ways to protect themselves from the curse of malnutrition.
— NewsNetwork