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Development
in Nepal: Reports on Food Crisis |
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Nepal Development |
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Nepal Development |
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Focus
on malnutrition and the conflict |
KATHMANDU,
4 May 2006
For
Goma Shrestha, providing for her children's daily needs is more than a
challenge; it's impossible. Despite the fact that her one-year old son's
normal body weight should be 10 kg, Babu Shristha, weighs just eight kg,
leaving this impoverished mother-of-four in a quandary over what to do.
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| Like many mothers in Nepal, Goma Shrestha struggles to provide her children
with the food they need.
Arriving
in the capital Kathmandu from Sinduphalchok district 200 km away,
one of the worst affected areas of the decade-old Maoist insurgency against
the state, she now lives along the polluted banks of the capital's Bishnumati
River, where she cleans houses and alongside her porter husband, earns
a combined income of just US $50 a month.
"Life
is very difficult for us," the 35-year-old domestic helper said. "I would
like to do more, but I can't." |
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THE
PROBLEM OF MALNUTRITION |
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| A mother and her baby in a village outside the capital, Kathmandu
That's
a fundamental problem for many mothers with children in Nepal, where more
than 50 percent of all children below the age of three are malnourished.
The question, however, is whether the insurgency, a conflict which has
already taken the lives of more than 13,000 and displaced thousands more,
is now actually making those numbers worse. |
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"The
conflict is exacerbating malnutrition levels. Definitely, we can prove
it," said Reinhard Fichtl, country representative for the international
NGO Terre des hommes Foundation, which has been working closely
with thousands of impoverished mothers and their children in the country
for years.
"We
are doing this since 2001 and it seems that the number of needy families
is increasing," he said, citing an earlier study the NGO had conducted.
According
to findings published in its "Nutritional Status of Children Victims of
the Armed Conflict in Nepal", a 2005 survey of internally displaced children
in Banke district in midwestern Nepal, of the 264 children under
the age of three surveyed from four project locations where IDPs families
were living, 59 percent were found to be underweight and up to 15.9 percent
wasted.
The
highest number of malnourished children were found in the Rajhena internally
displaced persons (IDPs) camp (73 percent) near the southern border
city of Nepalganj. At least 55 percent were suffering from common illnesses
like diahhorea, fever, acute respiratory infections and skin ailments,
the report said, adding malnutrition rates and prevalence of common illnesses
(82 percent) in small children, especially in Rajhena, could be considered
as worrying.
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THE
HISTORY OF MALNUTRITION |
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| Malnutrition has been a problem in impoverished Nepal for decades
But
malnutrition is nothing new in the impoverished nation of 28 million. Even
before the start of the conflict in 1996, malnutrition levels in Nepal's
central mid western districts stood at between 60 and 65 percent - a key
indicator of chronic underdevelopment.
Today
that situation is worsening, Fichtl asserted - particularly among children
between the sixth and sixteenth month of life, many of whom will never
become strong adults or become resistant to diseases, are susceptible to
stress, and may even die young.
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During
this critical age in a child's development, a large number of calories
are needed to support the child's growth, otherwise the child may be permanently
stunted - a condition generally determined in the first two years of life
- and largely evident in the country's population.
The United
Nations Fund for Children (UNICEF) reports that 50 percent of children
in the mountain kingdom are stunted, referring to those children as short
for their age, with that figure rising to up to 80 percent in mountain
areas.
"Malnutrition
is one of the most challenging tasks in a country like Nepal and its worsening
because of the conflict," Fichtl repeated.
And
with little improvement over the past three decades, the veteran aid worker
might just be right.
"We
now even have the problem that many donors don't want to fund malnutrition
projects because the success rates are so low," he said, emphasising the
need for patience and many years before real results can be achieved.
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THE
GOVERNMENT'S POSITION |
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| Reinhard Fichtl, country representative for the international NGO Terre
des hommes Foundation
Speaking
at an orientation programme for media professionals on the role of nutrition
in the attainment of the country's Millennium Development Goals (MDGs)
in March, Dr Yahsobardhan Pradhan, director of the Child Health Division
of the Ministry of Health and Population, said that a concerted effort
by government and other partner agencies had made it possible that Nepal
could raise its head in the international forum in its campaign against
malnutrition. |
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But
that may be premature. Malnutrition among children in Nepal remains a major
cause of child mortality, claiming around 50,000 children each year.
"Apart
from malnutrition being the underlying cause of child mortality, it impacts
on child growth and mental development, thereby affecting social and economic
development," Pradhan was quoted as saying, a sentiment echoed by his colleagues.
Sharda
Pandey, chief of the Nutrition Section of the Child Health Division, said
malnutrition had proven a multi-dimensional problem, related to education,
economy and levels of awareness. "Good nutrition is a fundamental right
for all, for survival, growth and development," she added.
Sadly,
however, that is a right many still do not have; a fact that should make
those in the donor community stand up and notice, aid workers say.
"It's
absolutely unacceptable that we have malnutrition levels above 50 percent.
And in Nepal, it seems to be accepted," Fichtl argued, noting many donors
still failed to understand the problem's complexity.
Nutrition
programmes have to be social programmes which are interrelated to the empowerment
of women in marginalised communities to increase their level of decision
making at home, access to food, along with access to money and resources,
he explained.
According
to another study by the NGO two years earlier, the primary cause of malnutrition
amongst children in Nepal is the stress of mothers, many of whom have to
work or lack enough time to concentrate on the child's actual needs.
"Very
often they do not realise how much attention a small baby needs and they
simply forget to feed it," Fichtl explained, stressing the fact that malnutrition
was not always related to food shortage.
Most
of the malnourished children cited in the NGO's 2005 report came from female-headed
families and knowledge among mothers on the feeding practices of small
children seemed limited.
Moreover,
only one of the 18 mothers surveyed said she fed her child five times a
day while others fed much less. Whatever little food they had access to,
many mothers were not aware that these very food items could be prepared
nutritiously for their children, while none of the mothers prepared separate
food for their children.
Indeed,
at least in Nepal, malnutrition is very often related to stress symptoms
brought upon the family by the ongoing conflict, Fichtl added, particularly
with regard to displacement or the absence of a husband or male family
member who may have migrated abroad for work.
Upwards
of 80 percent of all children surveyed below the age of three at the Rajhena
IDP camp were sick, caught up in the traditional conflict scenario in which
disease causes malnutrition and malnutrition causes disease, the report
noted.
"So
many children are caught in this vicious cycle and unfortunately many people,
including many NGOs, don't see the relationship between the conflict and
malnutrition," Fichtl asserted.
Terre
des hommes country representative, Richard Fichtl, says the conflict is
making malnutrition levels even higher
Following
a recent visit to the mid-western districts, he was appalled by the lack
of health posts in the area, saying: "There is nothing. Outside the district
headquarters, health posts were nonfunctional."
"When
we talk about malnutrition, it needs a constant interaction between health
workers and affected families. That system has gone and it's very difficult
to reestablish such a system in the framework of health because you need
health workers, you need coverage, you need social interventions - all
of which are particularly difficult in Maoist-controlled areas," he further
explained.
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A
NEED FOR FURTHER ASSESSMENT |
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Others,
meanwhile, are less convinced that malnutrition levels as a result of the
conflict are actually rising. "Malnutrition is a disaster in Nepal and
has been forever," Po Blomquist, chief of UNICEF's nutrition and care section
in Kathmandu, said, noting that although one would think that the situation
is deteriorating further, they had not seen any conclusive evidence of
that happening.
If
body weight or body wasting were used as indicators, the figures could
be misleading, Blomquist said, depending on the season. "Trends such as
stunting are a better indicator. Stunting does not change with the time
of the year, while wasting goes up and down," he clarified.
Moreover,
women in Nepal are often very short already or malnourished during birth
which in turns results in babies having a low birth weight as well - or
who inherit malnutrition.
"This
is not to say that there might not be localised examples in which malnutrition
rates had worsened because of the conflict. [But] we don't see anything
strongly suggesting that the rates are increasing," the UNICEF official
stressed.
Source:IRIN 2006
Copyright
© UN Office for the Coordination of Humanitarian Affairs 2006
[
This report does not necessarily reflect the views of the United Nations] |
Integrated
Regional Information Networks (IRIN), part of the UN Office for the Coordination
of Humanitarian Affairs (OCHA).
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