Malnutrition
1. Dealing with Malnutrition
2. Malnutrition versus Vegetables
Our traditional food items were, however, highly diversified. These foods provided virtually all the nutrients that were needed for proper physical and mental development of the people-both young and old. With time, population pressure increased and emphasis shifted to growing the staple food-rice. Rice growing area increased at the expense of the plant and animal sources of other essential food components: proteins, fats, minerals and vitamins.
40 percent children in the country are born with low birth weights because of malnutrition of their mothers.
1. Dealing with Malnutrition
Hidden hunger or micronutrient deficiencies continue to haunt the developing world. A large segment of population in South Asian region including Bangladesh suffer from micronutrient deficiencies. Micronutrient deficiencies have a debilitating effect on health leading to onset of several diseases and disabilities. These conditions cause not only distress but also economic loss to the individual, the family and the country. Much human suffering and economic loss could be avoided if the right strategies are followed.
Much of the malnutrition in our country is hidden and occurs on a much larger scale than can be imagined. It is not merely lack of food; it has more to do with a diet that is deficient in micronutrients (iron, vitamin A, iodine, folate and zinc). These vitamins and minerals are needed in minute quantities but the economic consequences of their deficiencies are profound:
WHY SHOULD WE CARE about vitamin and mineral deficiency: 6 million children who are 6-24 months old are at risk of disrupted brain development 10 women die daily in pregnancy and childbirth due to iron deficiency anemia, which also causes lowered productivity of working adults (estimated loss at 0.8 GDP). Vitamin A deficiency causes night blindness but that is just the tip of the iceberg as due to inadequate Vitamin A 1,183,000 children and 1,300,000 pregnant women will be at risk to increased severity to illness and death 84 million people are iodine deficient and 250,000 people are mentally impaired yearly due to iodine deficiency disorder. Malnutrition has remained a major problem in the Third World countries, according to the just published World Health report. Its direct impact is on the body weight of children. Twentyseven per cent accounting for nearly 170m children under five years of age are underweight. Of this staggering number, more than three million die each year.
The real situation is grimmer than the WHO statistics say. In countries like Bangladesh, it is not always the scarcity of foods that can be said to be responsible for poor nutrition. Once deficit in cereal production, the emphasis was primarily on rice production in this country.
A majority of people have the wrong conception that food means enough cereals and much less besides. Not many of the population can afford vitamin-rich food. But then whatever they can, get to a large extent wasted as a result of improper and unsafe method of preparation or cooking of food. Why the country's 93 per cent children are malnourished can be explained by a combination facts, all of which are not beyond our means to address. Mere changes in some of our ways and habits can improve the level of nutrition in our diet.
This is particularly important because addressing the more complex problem of equitable food distribution among the population is neither easy nor possible when the ground reality of prevalent system of politics is deemed not so congenial to the idea. Mal-distribution of national wealth is bound to take its toll on a large number of people. This continues for generations with the result that the deprived class gets further deprived in terms of using national wealth and opportunities.
No wonder therefore that charity organisations and NGOs have been welcomed to do their bits in poverty alleviation. A coordinated approach from the government and such organisations is yet to come. The next big challenge, after balanced food, the poor people face is from safe drinking water, sanitation and hygiene. The children in particular are more vulnerable to poor provisions of all these.
If lack of nutritional foods does not help their physical growth properly, diseases caused by unsafe drinking water, poor sanitation and hygiene either kill them or retard their physical and mental growth still further, from which they can never completely recover. That as many as 1.7 million deaths a year worldwide are attributed to the problem of water and sanitation clearly shows the policy failures of governments.
Deficiency of vitamin A, iron and iodine is no doubt related to poverty. But lack of knowledge and awareness are partly to blame. Here the NGOs and the government can work together to raise the level of awareness of the common people. The point is that the quality of politics must improve to identify real issues like these for their early address. A functioning local government will be better placed to do the job. The question is if the central government is ready yet to delegate such power to the local bodies.
Through empowerment of the poor at the grassroots level, their quality of life is likely to improve. And without such improvement, the poor cannot fight malnutrition. They must acquire the knowledge and means to fight their problems locally. Neither charity/aid nor imported policies are any match to the enormous problem of poverty and malnutrition. The local people will identify their special problems and opportunities and then come up with solutions to those on the basis of cooperation and fellow feeling ( The Bangladesh Observer, 5. 11. 02).
Micronutrient malnutrition is a serious threat to the health and productivity even though it is largely preventable. The 3 pronged approaches to addressing micronutrient deficiencies are :
Food Fortification- the addition of micronutrient/s to food items which are widely consumed by specific at-risk groups. Fortification is the cost effective and sustainable and can be implemented relatively quickly. Foods commonly fortified included salt, flour, milk, cookink oil, fats and a variety of other foods. Micronutrient Supplementation-involves the distribution of pharmaceutical Vitamin A, Iron, or Iodine supplements. It is an effective but relatively costly strategy. Dietary Diversification -through Nutrition Education - Requires change in food selection and eating habits as a result of education usually requiring improvements in incomes and much time to achieve, and public health measures, such as immunization and control of infectious diseases. 2. Malnutrition versus Vegetables
Some 94 percent of the children of Bangladesh suffer from malnutrition; and more than 600 children die each day from malnutrition-related causes. It is not only the major food components like carbohydrates, proteins and fats that are deficient in the diet of an average Bangladeshi but also the vitamins and the minerals.
The average calorie intake is estimated at 1900 kcal against 2200 kcal required. The intake of micronutrients like Vitamins A, B2 and C is only about 50% of the requirements. Similar are the cases with minerals like iron, calcium and iodine. Some studies revealed that 35% of our children are severely stunted, 30% moderately stunted and 14% are wasted. Yet again HKI studies showed that 30,000 children become blind every year due to deficiency of vitamin A.
It was, therefore, not surprising that Bangladeshi youths in 1982 were ten centimeter shorter in height than they were in 1937 (UNDP Report, 1995). Bangladesh is perhaps the only country in the world where the body height is on the decline. Nobody can tell how much the stunted growth affected the mental and/or intellectual development of our younger generations.What vegetables can do?
A diet made up of mainly vegetables and other plant crops can supply all the needed nutrients with the exception of vitamin B12 (Bressani, 1983). Vegetables are excellent sources of vitamins, particularly vitamin A (carotene), vitamin B1 (thiamine), B2 (riboflavin), vitamin B7 (niacin) and vitamin C (ascorbic acid). Leafy vegetables have a relatively high protein content, in particular lysine. This implies that they can be a good supplement to cereal grains (Bressani, 1983). However, vegetables are seldom used as protein sources. Their primary nutritional role lies in their contribution of vitamins and minerals to the diet.
Vegetable production and intake in Bangladesh
In Bangladesh there is a huge gap between vegetable production (estimated at 1.5 million tons) and the estimated requirement (about 10 million tons). Concomitantly, there is a huge gap between vegetable intake per head per day (50-70 g) and the minimal requirement (200 g). A thumb rule estimate showed that BADC, which has made organized attempts for vegetable production in the public sector, could only cover some 32% of the total projected area under its 9 Horticulture Development Centres and 22 Agro-service Centres in 1996-97. This points to the unexplored vegetable production area in the country. In the private sector, however, vegetable production area is gradually increasing as vegetables are now being grown more and more on a commercial basis as against the traditional subsistence production in the backyard.
Our rural people have traditionally grown about 100 vegetable crops (Hossain, 1999) and these have mitigated the needs for vitamins and minerals. With the emphasis on cereal production and the disappearance of fallow lands, many of these vegetables are on their way out. Also a good number of these have been neglected as 'non-aristocrat' food items and many remained and still do remain outside the mainstream research and development agenda. Ironically, some of these 'non- aristocrat' food items are now being recognized as highly nutritious. For instance the Arum (Colocasia) leaf or the Kharkon (Typhonium tribolium) leaf, Sweet gourd (Curbita maxima) are now recognized not only just as respectable food items but also as nutritious foods providing protective measures against a number of ailments.
Bangladeshi Jute (Corchorus capsularis, Corchorus olitorius) Leaf as MedicineLast Modified: August 24, 2004.