NAWAIKOROT, 6 October 2008 (IRIN) - Angelina Abura cradled her malnourished child in Nawaikorot, Moroto District of the Karamoja region, as she waited for his polio vaccination, thinking of her next meal. “We have not harvested anything of late, our granaries are empty,” she said on 1 October. “We survive by eating some leaves and when it rains, some green plants; but gathering them is a risk because you can lose your life in the process.” Alice Ngorok, who was also waiting, agreed. “Our main harvest of sunflower is no more, the sorghum plant which is our staple food has failed and we last received food relief on 7 July,” she told IRIN. “We now survive by eating shrubs,” she added. “Our children have refused to go to school because they have not eaten.” Thousands of people in Karamoja are facing serious food shortages. Largely inhabited by agro-pastoralist communities, the remote region in north-eastern Uganda suffers endemic security problems. Home to about 1.1 million people, the semi-arid region has the highest maternal and infant mortality rates in Uganda and the lowest life expectancy. It is also awash with weapons. In a 31 August update, the Famine Early Warning System Network (FEWS Net) warned that the number of food-insecure people in Karamoja had risen. “Food security in Karamoja (Abim, Kaabong, Kotido, Moroto and Nakapiripirit Districts) continues to deteriorate, and will require assistance until the next harvest in 2009, as a result of failed rains, depleted food stocks, low incomes, high prices, poor livestock terms of trade, and widespread livestock disease,” it noted. “The number of people highly food-insecure has increased 7 percent between July and August 2008 alone, to 750,000 people.” Separately, the International Federation of the Red Cross (IFRC) said the region lacked food stocks to take its population through to the next harvest season and malnutrition rates among children were relatively high. The situation is particularly bad in Abim and Kotido, where nearly 80 percent of the population is highly food-insecure due to three consecutive seasons of poor harvests, depleted food stocks, low livestock production and poor livestock and/or cereal terms of trade related to high cereal prices. “Many parts of Karamoja have been described as chronically food-insecure for the past five years due to a combination of factors, including recurrent drought, over-population and declining resource base for agro-pastoralism,” the IFRC noted in a 23 September report. “As the rainy season is approaching and the seed requirements, especially in the two districts of Abim and Kotido, are not covered, it is [expected] that the problem of food insecurity will escalate dramatically after the rainy season due to lack of food production,” it added. Coping mechanisms “People are at a risk of being killed when they go to the forest to gather firewood and fruits,” she told IRIN. “They waylay us and take whatever food we have gathered.” Jacob Lokeris said some of the weapons are used to loot food aid. “After food is distributed [by relief agencies], they attack and loot all of it and leave us with nothing to feed on,” he explained. “If you resist, you are killed.” The other problem, however, is rising food prices. Between the third quarter of 2007 and August 2008, cereal prices have increased by 20-65 percent, say local residents, while beans cost 60 percent more than normal. “There is an acute shortage of food everywhere,” Julius Ochieng, chairman of the neighbouring Amuria District, said.
“Recent floods rendered most families unable to raise seed for planting and those who planted could not harvest anything because of crop failure due to harsh climatic conditions,” he added. Successive shocks Last week, Ugandan officials said at least 346 Karamojong women and children had crossed into neighbouring Pader District in search of food, and had settled in the sub-counties of Adilang, Lapono, Paimol and Parabongo, adjacent to Abim and Kotido. The region, according to agencies, has been severely affected by three years of successive shocks. These include severe drought in 2006 and a combination of dry spells, flooding, animal disease and crop fungus. In July, Musa Ecweru, state minister in charge of refugees and disaster preparedness, told IRIN that prolonged dry conditions after flooding last year had led to a 90 percent crop failure. Plants had failed to germinate in the heat. “Karamoja is facing an acute nutrition crisis that requires a scaled-up emergency nutrition and food security response in addition to interventions to improve coping mechanisms and prevent maladaptive coping such as out-migration,” the government and UN Children’s Fund (UNICEF) said in a joint statement. But all these efforts, Abura said, would need to coincide with ending the insecurity. vm/eo/mw |
||||
|
Theme(s): (IRIN) Children, (IRIN) Early Warning, (IRIN) Food Security, (IRIN) Health & Nutrition
[ENDS] |
||||
Archive for the ‘Malnutrition’ Category
UGANDA: Shrubs and leaves on the menu as Karamoja food shortages increase
Tuesday, December 30th, 2008
Learning To Farm In Kazakhstan
Tuesday, December 23rd, 2008USAID helps orphanage produce 2.3 tons of vegetables and earn $3,300 in revenues.
When Orphanage #3 in Almaty, Kazakhstan saw its funding levels cut year after year in the 1990’s, it decided to get entrepreneurial. A state-supported orphanage with 300 children, Orphanage #3 decided that some kind of small business activity was its best chance to support the rising costs of raising and educating its children. With six hectares of land donated from the local government and over $14,000 worth of cash and materials (seed and equipment) donated by private companies, the orphanage was on its way to launch a productive greenhouse initiative - it just needed help getting started.
Through USAID’s Farmer to Farmer program, working with Winrock International, volunteer Dave Pearce of North Dakota worked with the orphans as well as local university students to establish a direct farm marketing operation. Over the course of several assignments, Pearce and other Farmer to Farmer volunteers taught the children how to draw up a field plan for their operation, prepare the land for planting, monitor the soil for proper nutrient levels, construct and maintain a greenhouse and drip irrigation system, and transport and market the produce.
Prior to Pearce’s arrival in Kazakhstan, the children had no experience growing or marketing vegetables. Through Pearce’s hands-on approach, the children developed capabilities both in farm management and marketing. The orphanage produced 2.3 tons of vegetables in its first season of operation, and earned nearly $3,300 in revenue. As word got out about the orphanage’s activities, demand grew and a produce truck began traveling different routes throughout the capital city to delver produce to customers including restaurants and staff at foreign embassies.
Saving Lives Through Improving Children’s Nutrition
Tuesday, December 23rd, 2008Twenty-five year old village volunteer teaches healthy child-rearing in Cambodia.
Kim Yeng is a twenty-five-year old who lives in Cambodia. She was forced to leave school after the third grade because her parents could no longer afford to pay for her education. She had to help her parents by doing housework, farm chores, and taking care of her siblings. Yeng married her husband at age 20, and the couple soon started a family.
Last year, the eldest child died at the age of 4 after several bouts of high fever. Yeng recalls, “The nurse said our child had ‘krun sonthom’ (cerebral malaria) and said we had waited too long to take her to the hospital. I was so careless with my kids. My child would have survived if we had given her better care.
After losing one of her children due to lack of knowledge about proper health care, Yeng was asked to take part in a community assessment conducted by the Partners for Development (PFD) community health team. She participated in focus group discussions and helped to gather village children for height, weight, and age measurements. This lead to more discussions on malnutrition, malaria, and other common childhood illnesses.
Yeng’s motivation and interest in helping to improve the health of children in her community made her a natural fit for selection by the community for the village health volunteers program.
Through USAID, PFD provides support for training in the community. While discussing malnutrition, the community health team talks about the Hearth model - a community-based approach to reducing malnutrition developed as an alternative to more costly rehabilitation efforts that require use of a health facility. Mothers of well-nourished children set a positive example for mothers of malnourished children by teaching them to improve the nutritional content of meals using affordable foods available in the market, or which can be grown or gathered locally.
Mothers gain the knowledge, skills, and confidence needed to significantly improve their children’s health and nutritional well-being through workshops facilitated by government health workers, PFD staff, and local women trained in the Hearth method. By introducing these messages directly in the community, mothers are more likely to permanently adopt the new behaviors and continue providing nutritious food after the program is completed.
Over 100 moderately to severely malnourished children in twelve rural villages have recovered from this life-threatening condition during 2003 due to this program. Yeng is well respected in her village due to her work as a Village Health Volunteer, which has been officially recognized by the Provincial Health Department.
Yeng proudly displays her training certificate in her home and says, “I was elected as a Village Health Volunteer. I received strong encouragement from the PFD staff and wanted to learn everything I could about my new tasks. I have learned the importance of good health and what parents and the community need to do every day in order to improve the health of our families.”
Women Lead Effort to Clean Up Canal
Monday, December 22nd, 2008The El-Sharakah canal is no longer used for waste disposal
Abd-El Reheem Ali, head of El-Sharakah Canal Water Users Association, knows how important women are as members of his association. It was through their efforts that the community cleaned up its canal, improving everyone’s health, as well as the farmers’ crops.
The canal water used to be very dirty. People would throw garbage into the canal, and as rubbish accumulated it blocked the flow of water. In rural Egyptian households, women are usually responsible for throwing out garbage. Women in the association took the initiative to launch an awareness campaign among women in this rural farming community. The women went from farm to farm teaching the women who were running each household that throwing garbage in the canal was not only endangering their health, but also affecting their source of income as well — the family’s crops.
“No matter how little education a woman has had, once she knows that her acts can negatively affect her family’s land and source of income, she will be willing to do anything to correct the situation,” said Haneema Basry, a member of the El-Sharakah water users association.
The association needed to attack the problem but also effect a cure to the current problem so the association teamed up with the Islamic Charity Association to rent a tractor that collects garbage two times a week. As a result, the canal now is no longer used for waste disposal. And Abd-El Reheem Ali will readily confirm the effect of their contribution, as he surveys his fields and prepares to harvest what promises to be an excellent crop of sugar cane
Fighting Childhood Malnutrition in Mozambique
Monday, December 22nd, 2008
|
||
| Like many women in rural northern Mozambique, Atea Mussa started giving her children water to drink in addition to breast milk on the day they were born. Her own mother taught her that without water, the babies’ throats would dry out and they might die.But finding clean water near Atea’s village of Ampivine in Nampula Province is a daily struggle. The area lacks piped water and sanitation is poor because most households have no toilet or latrines. The available water often carries microbes that cause diarrhea, putting children at risk of malnutrition even when food supplies are adequate. | ||
| When Atea was pregnant with her third child, new ideas about child rearing came to the village and surrounding areas. The radio began to play messages about the benefits of exclusive breastfeeding and ways to improve children’s diets with local foods. A community volunteer trained through a USAID program offered free nutrition and hygiene classes, which Atea attended. Although others initially were skeptical, Atea trusted Amina Abubakar, the new community volunteer or “animadora” in Portuguese.These activities are part of an initiative, funded largely through USAID’s Food for Peace program, to address the root causes of chronic childhood malnutrition. USAID is investing $20 million a year in food security programs that combine nutrition education and agriculture extension services to reach more than 200,000 poor rural families. The programs are designed to give Mozambicans the skills they need to reduce malnutrition through healthy diets, produce more food, and increase their household incomes.
When Atea gave birth to her son Nelson Aldi in late 2003, she broke with tradition and followed the animadora’s advice, giving the baby nothing but breast milk for the first four months. Then she added porridge mixed with nutrient-rich foods like peanuts and sesame to his diet. Nelson not only survived without water, he thrived. At six months, he is a happy, chubby baby known and even envied in the community for the fact that he is rarely ill and has never suffered from diarrhea. When a visitor asks the animadora how she knows her program is working, she takes Nelson from his mother and lifts him into the air with a big smile. Because of his example, more mothers are adopting new ways of feeding their children. “The children are healthier and the sicknesses are less severe,” Amina observes. “The mothers always congratulate me and are grateful.” Beliefs are changing even among the older generation. “The grandmothers see the advantages because the children are growing well and don’t suffer,” says Atea, who is proud that her son has a healthy start in life. She hopes Nelson will grow up “to help others in the community” as a nurse, a highly respected profession. |
Malnutrition and Starvation
Monday, December 22nd, 2008Description
The terms malnutrition and starvation are used interchangeably, when in reality, there are specific definitions for each. Malnutrition is the inadequate intake of any of the required nutrients. This can even occur in an animal receiving large amounts of food, but is not able to ingest, digest, absorb, or utilize this food. Causes for this inability are injuries, poor teeth, parasitism, disease, foreign bodies in the digestive tract, tumors, or an increased motility of the digestive tract. Malnutrition can also occur if the food is inadequate in one or more of the required nutrients. If an animal is not able to obtain food for an extended period of time either for the above reasons or due to an unavailability of food or insufficient energy intake, this is defined as starvation. Malnutrition and starvation can be caused by diseases, injuries, the range the animal lives on, or the environmental conditions it must live in. Starvation and malnutrition occur in several wildlife species and routinely eliminates the young, old, weak, and sick animals. Winter is when mortality usually occurs due to the negative energy balance brought about by the cold weather, deep snow, increased energy demands, snow covered food, and human and predator induced stress.
Historically, in Michigan the number of species diagnosed at the Laboratory as dying from malnutrition and starvation are second only to those dying from traumatic injuries. Numerous bird and mammal species annually (depending on the severity of the winter) die from insufficient nutrition. Currently we have 3 primary species that die from malnutrition or starvation: white-tailed deer, mute swan, and wild turkey. The majority of the animals have come from the Upper Peninsula and the northern half of the Lower Peninsula with mortality occurring almost exclusively during the winter when food availability is at its lowest.
Susceptibility
Susceptibility to starvation and malnutrition usually occurs in the winter and early spring months for wildlife in Michigan. Animals cope with the severe weather and shortage of food in 1 of 3 ways: hibernate (amphibians, reptiles, and several mammals), migrate (most avian species), or remain active and attempt to survive. Juvenile, yearling, and old animals are the age groups most susceptible to starvation and malnutrition because they enter the winter with the smallest fat reserves, the highest nutritional demands, the greatest heat loss, and the lowest position in the social hierarchy. Of the winter starvation deaths observed, 60 to 70% may consist of animals less than 1 year of age. Adult males and females and juveniles of both sexes of various species may have smaller reserves of fat due to breeding activities, rearing of the previous year’s offspring, and their growth requirements, respectively. Most wild animals in colder climates undergo an annual fat cycle whereby fat is deposited and then utilized as the physical condition declines. During a severe winter, adult deer may lose as much as 25 to 30% of their body weight and still survive. The loss of weight occurs during the winter because of snow depth, ambient temperatures, and the quality and quantity of the available forage. Because of these factors, the physical condition of animals at the onset of winter is critical to their survival. The adequacy of summer and fall ranges is thereby very important. The duration and severity of the winter is critical to the animal’s chances for survival, as it determines the length of time the animal must depend on its body fat reserves and on poorer forage for survival. Deep snow and cold temperatures, especially during the latter part of the winter can result in very high numbers of deaths attributed to malnutrition and starvation. The cover available to the animal is also of utmost importance as this allows the animal to escape from the low temperatures and the wind. Offspring of weakened animals that survive the winter are also susceptible to the effects of starvation as they may be absorbed or aborted as fetuses, or if born, may be improperly cared for.
Avian species are highly mobile and usually migrate, thereby lessening the chances of mass starvation. Extremes of weather (sudden snow or ice storms) may result in birds becoming trapped in inhospitable areas and not having food available. Some species experience mortality of the females due to nesting activities in the early spring, when they are unable to leave the nest to feed. Deaths attributed to malnutrition and starvation are seen in young birds during the hatching season due to parent neglect, or once they are fledged from the nest, the inability to acquire their own food.
Physiology
If an animal is forced into an inadequate plane of nutrition, there are many physiological changes as the animal attempts to satisfy its energy requirements. At the cellular level, catabolism (the breaking down in the body of complex chemical compounds into simpler ones) continues to supply the substances required for anabolism (the usage of nutritive matter and its conversion into living substance) and to continue vital functions. Reserve stores of nutrients contained in the individual are utilized to compensate for the lack of nutritional intake. Energy is generated from the utilization of proteins, fats, and carbohydrates. The most readily usable material, the carbohydrate glycogen, is utilized first. This is derived from glycogen stored in the liver and is exhausted within a few hours. This is followed by stored fat from the various subcutaneous deposits, around the kidney, and in the mesentery and omentum tissue. Fat deposits in the parenchymatous organs are utilized next. The last area of the body to lose its fat deposits is the marrow of the bones. The final source of energy available is the protein comprising the cytoplasm of the cells. It is at this time that ketosis and an increase in nitrogen excretion may occur. Ketosis (a condition in which ketone substances appear in the blood and urine) is commonly seen in malnourished animals. This is because it is necessary for the animal to derive its energy from the stored fat and protein. After all the fat reserves have been exhausted, nitrogen excretion rises due to the protein catabolism which occurs just prior to death. The animal will eventually reach a point where the cells of the body are unable to perform the functions necessary for life. Death results from lack of sufficient blood glucose to provide the energy needs of the brain and hypoglycemic shock occurs.
At the microbial level, inadequate food intake, especially in a ruminant species, results in a rapid decrease in the number of bacteria and protozoa present and in the volatile fatty acid concentration in the stomach. The ruminant obtains approximately 70% of its energy from these fatty acids, so a reduction in the level has a significant impact on the animal. The pH of the rumen becomes more alkaline because of the lack of these fatty acids. Decreasing the microbial populations probably diminishes the animal’s ability to digest cellulose (fibrous material).
At the individual level, weight loss of 25 to 30% can occur and the animal may survive, but death is often the result. Wild ruminant physiology has developed to allow them to withstand dietary deficiencies and obtain energy from the consumption of poor quality forage. Adult ruminants are able to store large amounts of nutrients and fat within their body tissues. They are also able to store minerals and nitrogen in their tissues for secretion into the rumen during the winter months. These fatter, older animals are thereby able to utilize more fat than protein, especially in the early stages of malnutrition and starvation. Young animals, which have smaller fat reserves because of their higher nutritional demands for growth, smaller body size, and position in the social hierarchy, utilize more protein than fat under starvation conditions.
Clinical Signs and Pathology
Clinically, mammals suffering from malnutrition or starvation are lethargic, unsteady, listless, and unafraid of humans. The skin may appear loose, the hair coat erect, dull, and rough and the body more angular. The animal may have a humped or sagged back, a swollen appearing face, sunken eyes, and a small tucked up abdomen. Due to atrophy (shrinkage) of the muscles, there is usually an increased prominence of the bones of the shoulders, ribs, vertebrate, and pelvis. The muscles appear more prominent, but usually do not appear full, and consequently a definite demarcation may be seen between the neck and shoulders and the upper forelegs and chest.
Clinical signs of an avian species dying from malnutrition or starvation are listlessness, unsteady locomotion, ruffed feathers, and a lack of fear of humans.
Pathological changes which occur in a starved animal are many and varied. The most striking gross change is a lack of fat in the subcutaneous, visceral, and bone marrow locations, and atrophic changes which occur in the musculature. Serous atrophy, a reddish gelatinous appearance to the fat tissue, is commonly seen in starving animals. The organs of the body decrease in size and weight. The digestive tract of most species is empty and/or shrunken with dark green bile staining of the lining and contents. The stomachs of ruminant species usually contain food, but the contents are often dry and of poor quality. The rumen lining may be ulcerated, have erosions present, and shrunken villi. The femur marrow, due to a lack of fat present, will be red or yellow in color, transparent, and gelatinous in a starved animal.
Severe weight loss (up to 50%) is a common occurrence in malnourished and starved avian species. Gross lesions seen are an absence of fat deposits and atrophy of the musculature, with breast muscle atrophy being the most noticeable. The digestive tract is shrunken and/or empty with dark green stained linings, and there is a marked increase in the size (possibly 2 to 3 times normal) of the gall bladder due to an accumulation of bile. In avian species, malnutrition may increase the susceptibility of the bird to parasitic infection (lice and other endoparasites are more common), and may result in the drawing of contaminants from the fat deposits being used, thereby resulting in the circulating and redistribution of these compounds. Diseases which could cause a malnourished condition, such as chronic infections of aspergillosis and lead poisoning must be ruled out when a definitive diagnosis is made.
Diagnosis
Starvation can be diagnosed either by field techniques through gross examination, or by laboratory analyses. To grossly diagnose starvation, the overall physical condition of the animal must be determined by examining for the presence or lack of adipose tissue (fat deposits) in the various subcutaneous and visceral locations. In ruminants, the femoral or mandibular bone marrow fat can be examined and the percentage of fat present estimated visually. Some care must be taken when examining the femur marrow as it is used for fat storage in adult animals but serves as a production area for red blood cells rather than fat storage in young animals. Laboratory methods that are used nationwide are varied. There is a femur marrow compression method, ether-extract method, kidney fat index, and wet weight-dry weight method. We have used the latter 3 methods for determining physical condition of the various mammals we examine. Blood parameters provide little information that can’t be gained from gross examination of the carcass. Gross examination of birds dying from malnutrition or starvation is sufficient for a diagnosis providing other disease entities are investigated and ruled out.
Prevention
Supplemental feeding of starving wildlife is an alternative to allowing wildlife species to die. This, however, involves a philosophical question of maintaining wildlife populations at a level above their normal carrying capacity, interfering with nature’s checks and balances on populations and encouraging transmission of diseases (bovine tuberculosis). It may also be cost prohibitive. If a feeding program is to be used to maintain a high plane of nutrition it needs to be started early in the winter, continued throughout, and a surplus of food must be provided. If food is not provided (especially in ruminants) until malnutrition is in its advanced stages, the animal will probably die anyway. This is because once food is made available, the ruminant must be able to live in a negative energy balance for up to 2 weeks, before its digestive tract can adjust to the new diet and change to a positive energy balance. Generally, starved ruminants do not eat large quantities of food when sudden access to unlimited food occurs. However, due to an altered microbial population in the stomachs, it is possible to observe mortality in deer when shelled corn is overeaten. The reason for this is that lactic acid from the fermentation of starch accumulates to toxic levels. High quality palatable feed is essential in a feeding program: feed which contains readily available carbohydrates, roughage, minerals, and vitamins. Pelleted formulated feeds are the best ration that can be provided for ruminants. Elk can survive on high quality second or third cutting alfalfa but deer have greater difficulty in obtaining adequate energy from roughages like this that are high in fiber. If baled hay is all that is provided for deer, it must be high quality alfalfa fed at a level where the deer do not have to consume anything but the leaves and small stems.
Supplemental feeding of birds is usually only cone for songbirds but does occur with waterfowl species and turkeys under certain circumstances. The feeding of waterfowl during the winter may encourage alterations of normal migration patterns and possibly be of disease importance. Avian species respond faster to the providing of food once physical condition has been affected. Consequently, if the necessity arises, supplemental feeding can be started at anytime and probably be successful.
Significance
The plane of nutrition animals are on in the winter influences the severity of mortalities due to starvation, the reproductive success of the females, and the animal’s resistance to disease, parasitism, and predation. Deaths attributable to starvation may have a great and persistent effect on a population, not only due to the loss of individuals, but also due to the disruption of fertility and reproductive success. In mammals, the effects of starvation on a pregnant female and her fetus(es) may be seen in utero, or after birth. Pregnant females catabolize their own fat and protein reserves during periods of food deprivation. The fetus is protected by these actions and continues its development. If a pregnant female is forced to withstand prolonged malnutrition, however, the fetus may die and be absorbed or aborted. A fetus that is not absorbed or aborted, but survives and continues its development to term, may be born small and have a reduced chance of surviving. This is especially true if malnutrition occurs during the third trimester of the pregnancy. These small offspring will probably have difficulty in suckling and the female may not permit them to do so, thus rejecting them. It is, however, possible that a malnourished pregnant ruminant will maintain its pregnancy until it dies from starvation.
The ability of the malnourished animal to resist bacterial and parasitic infection is markedly reduced when the body’s immunological system has been compromised by the animal’s malnourished condition.
In conclusion, malnutrition and starvation can be significant influences on a population of animals, but usually this effect is short term and the population returns to its normal level.
Malnutrition Responsible for a Third of Child Deaths Worldwide
Monday, December 22nd, 2008| Report also found it accounted for 11% of international disease burden.
By Amanda Gardner |
(SOURCES: Jan. 16, 2008, teleconference with Robert Black, M.D., professor, Johns Hopkins Bloomberg School of Public Health, Baltimore; Joy Phumaphi, Ph.D., vice president/network head, Human Development, World Bank; Kent Hill, Ph.D., assistant administrator, global health, USAID; Jayaseelan Naidoo, board chairman, Global Alliance for Improved Nutrition (GAIN); Tadataka Yamada, M.D., president, Global Health Program, Bill & Melinda Gates Foundation; Jan. 17, 2008, The Lancet online)
THURSDAY, Jan. 17 (HealthDay News) — A international epidemic of maternal and childhood malnutrition accounts for more than one-third of childhood deaths and 11 percent of the world’s disease burden, researchers report.
“The key messages here are that the international nutrition system is fragmented and dysfunctional, and reform is needed,” lead researcher Dr. Robert Black, a professor at the Johns Hopkins Bloomberg School of Public Health, said during a news conference Wednesday. “The problems are long standing and embedded in organizational structure, but a concerted effort can provide greater progress and accountability. Progress is possible.”
Black was lead author of a special series on maternal and child malnutrition appearing online Jan. 17 in The Lancet.
The issue was hailed by different development agencies at the news conference.
“[The World Bank] does agree with the conclusions in the series. They have huge implications for the architecture of an international nutrition system,” said Joy Phumaphi, vice president and network head of human development at the World Bank. “We want to associate ourselves with the report.”
According to Kent Hill, assistant administrator for global health at USAID, there are some 852 million chronically hungry people living in the world today, and roughly half are children. Even though many can eat enough to ward off hunger, many still don’t get the nutrition necessary for growth and development. Mothers and children are the most vulnerable, Hill added.
The quandary has far-reaching consequences for individuals, societies and economies, the experts said.
“Malnutrition and nutrition as a whole is an economic imperative,” Phumaphi said. Nutrition affects productivity as well as cognitive functioning and performance in school. “It also increases health costs and, therefore, has catastrophic implications,” she noted.
According to Jayaseelan Naidoo, board chairman of the Global Alliance for Improved Nutrition (GAIN), in the absence of proper nutrition, many people are abandoning therapy for HIV/AIDS because of side effects.
The Lancet series starts off with a paper from the Johns Hopkins School of Public Health in Baltimore and Aga Khan University in Karachi, Pakistan, which finds that one-third of child deaths and 11 percent of the total disease burden globally are a result of maternal and child malnutrition.
Deficiencies in vitamin A and zinc had the greatest effect among the micronutrients studied and caused 0.6 million and 0.4 million deaths, respectively, in 2005. Deficiencies in iodine and iron are of lesser concern because of successful interventions. But suboptimal breast-feeding is estimated to be responsible for 1.4 million child deaths worldwide.
“We concur with the report that the first six months of a child’s life should be exclusively focused on breast-feeding,” Naidoo said.
The second study reported that poor fetal growth or stunting during a child’s first two years of life can lead to shorter adult height, lower school attendance and reduced adult income potential. Better nutrition can remedy much of this.
Other researchers found that implementing existing nutrition-related interventions for mothers and children could prevent one-quarter of all child deaths in the 36 countries with the most severe deficits. Breast-feeding counseling and vitamin A supplementation would provide the greatest boost.
The fourth study found that 80 percent of undernourished children worldwide live in just 20 countries. The final paper reported that the international nutrition system is fragmented and needs reform.
“We need to take this amazing piece of work and translate it into practical, measurable results,” Naidoo said.
But in addition, said other experts, the world needs better knowledge.
“As much as we know about food, we know very little about the science of food,” said Dr. Tadataka Yamada, president of the Global Health Program at the Bill & Melinda Gates Foundation. “In a sense, nutrition has been a little bit of a fractious community, because the less you know, the more your opinion counts. We need new knowledge in nutrition, and we have to invest in this because that will allow other investments we make in nutrition to be wisely and strategically placed.”
Guarani child dies of starvation
Saturday, December 20th, 200819 December 2008
 |
| Guarani mother and child © João Ripper/Survival |
A Guarani child has died of starvation and at least four others are suffering from malnutrition in the community of Kurusu Mba, in the Brazilian state of Mato Grosso do Sul.
Gleide Barros was 18 months old when she died on 10 December.
Around 60 Guarani families from Kurusu Mba are camped beside a highway and depend solely on the government’s food aid programme, as they are landless.
They were evicted from their land in 1972 by cattle ranchers, and spent years living on a government reserve. Tired of waiting for the authorities to return their land to them, they have made three attempts to reoccupy part of their ‘tekoha’ or ancestral land. Each attempt has been violently repelled by the ranchers and their gunmen. Two leaders have been killed and several other Guarani hurt.
In the last five years alone, 80 Guarani children have died of malnutrition in the state of Mato Grosso do Sul. Guarani man Elizeu Lopes says, ‘It is a very precarious situation. We don’t have anything.’ Lack of land is widely recognized as one of the main causes of malnutrition among Guarani children, as families cannot feed themselves.
The Guarani also face high rates of suicide, violence and alcoholism.
Kurusu Mba is one of many Guarani ‘tekohas’ occupied by ranchers. FUNAI, the Brazilian government’s Indian affairs department, has set up a specialist group to identify and map out land traditionally occupied by the Guarani, with the aim of recognizing several large territories encompassing many tekohas. However the state government and ranchers’ groups have mounted a high profile campaign to derail the project.
Survival International has opened a fund to support the Guarani, in association with the the film ‘Birdwatchers’, which stars Guarani-Kaiowá Indians. All donations will go towards helping them defend their rights, lands and futures.