Malnourished ---body , mind and soul ?

30th May 2018
by Javed Jabbar

When this writer began voluntary work in the Tharparkar arid region over 33 years ago in February 1985 , perhaps the first reason why one became enduringly engaged with the area was the ultra-thin , emaciated infants in the laps and arms of bony , under-fed teen-aged mothers . Though their eyes cast a spell , their faces were grim and gaunt .

Malnutrition spanned generations and impacted parents as well as children . Fortunately , in the past three decades , global research , new knowledge and potentially effective solutions have emerged to create scope for alleviating malnourishment in Tharparkar , as also across those parts of Pakistan where poverty , ignorance , inaction still prevail .

Lack of appropriate nourishment exists even in non-arid regions . Inequitable distribution --- of wealth , income food . Not enough food for too many mouths --- due to unwanted births and inaccessibility to family planning services . Girls who prematurely become young mothers always being second-priority recipients of choice food---because boys and males come first in a misogynistic culture . Anemic mothers unable to provide minimal levels of breast -milk for , ideally , the first 2 years . Absence of awareness about relatively low -cost food fortifications . Inability to afford even these low- cost food fortifications . Consumption of unhealthy food . Other factors too . Whatever the reason , the scale is huge , the effect awesome .

About 44 per cent of Pakistani children are reliably estimated by UNICEF to suffer malnutrition . This is not a transient illness curable by medicines ۔ Once the adverse effects of malnutrition are imprinted into the molecules and muscles of infants and children , they become like permanently embedded organisms . They prevent the child from developing potential brain and body power , they stultify and suppress the spontaneous urge to grow freely and fully . A single cruel word enslaves an innocent human being for a whole life-time --- " stunting " . It's very sound reflects the affliction's debilitating nature .

Beginnings shape future happenings . Only 38 per cent of infants under six months of age are breast-fed . The percentage declines after the first six months , without adequate supplementary diet compensating the loss of mother's milk . Whereas research conclusively shows there is also a need for fortified food in the first 1000 days . This writer's instinctive opposition to powdered infant milk as a substitute for mother's milk has been tempered in view of the under-nourished , over-worked dimensions of the lives of the vast majority of Pakistan's women in the fertility-child-producing age segments.

In the recent 3 decades, as voluntary work takes this writer to villages and towns in all 4 Provinces , the commonality of young female deprivation , from girl-child to adult womanhood is vividly visible . Every fifth pregnant woman and every child under 5 years survives with severe Vitamin A deficiency . 62 per cent of children under 5 years of age are anemic . In characteristic examples from over 12 million children who are out-of-school , one discerns distractedness and listlessness . If in school , a passivity and lack of energy in classroom inter-actions . Invariably , they are the ones who show poor learning indicators. They face frequent episodes of infection and illness contributing to high drop-out rates.

A World Bank study estimates large-scale malnutrition causes a country to lose about 3 per cent of GDP. Pakistan has fallen behind other nations in adjacent regions in tackling this threat . Fortunately, there are several international organizations committed to supporting countries like Pakistan to combat this condition. These include UNICEF , WHO , the Global Alliance for Improved Nutrition ( GAIN ) , US Centres for Disease Control ,Nutrition International and others .

Just as imbalanced population growth has a cross-cutting relevance for virtually every sector of our country's development, so too does malnutrition on so large a scale reverberate in multiple spheres . For the individual --- in body, mind --- and even soul ! For the nation , in health, education and the economy . The July 2018 elections afford an opportunity to citizens and political parties to prioritize this subject, alongside critical issues of enhanced access to family planning services and innovative approaches to primary school education .

The National Maternal and Child Health Programme acknowledges the importance that malnutrition deserves . Alleviation measures should be vigorously implemented . Increased awareness of life-long damage caused by stunting , enhanced access to complementary foods ,fortified milk and food at fair cost to compensate for deficiencies in household income or in maternal health , subsidies through State intervention and/or through private philanthropy to enable low-income or the poorest families to purchase supportive diets , participation by community organizations , side by side with Government , in a shared duty to effectively address this major challenge .

(The writer is a community development practitioner and a former Federal Minister & Senator