MALNUTRITION: What is malnutrition?

Diana Nabiruma : 15 December 2010

Malnutrition manifests in two forms; under-nutrition and over-nutrition.
Under-nutrition, according to a booklet titled Malnutrition: Uganda is Paying Too High a Price, “occurs when the body fails to get the right quantities and proportions of nutrients for it to maintain health and proper function.”
In Uganda, under-nutrition mostly occurs in children and it presents with stunting (child being too short for their age) or too thin for their height (wasting). The most severe forms of wasting are marasmus and kwashiorkor.
A nutritionist at Mwanamugimu unit of Mulago hospital says that although signs of marasmus and kwashiorkor are obvious, child caretakers are usually in denial or ignorant of the fact.
According to this nutritionist, caretakers instead blame witchcraft when their children show signs of malnutrition or think their children are simply fat.
As if to demonstrate the point, the day we visit the unit, a father taking care of his daughter bugs the nutritionist to have his child moved to a ward with stabilised children.
“Ono simulwadde. Mutusindike eri,” he says meaning, “This one is not sick. You should send us to the other ward”. However, the child looked wasted, something even the sunny dress she wore couldn‘t hide.
Nutritionists point to poor sanitation and hygiene (which cause diseases like diarrhoea), teenage pregnancies and frequent pregnancies (pregnancies and lactation require high amounts of nutrients which are sometimes not met), poor feeding habits where people feed on only staple foods (usually containing carbohydrates and proteins), poverty and a lack of prioritisation of nutrition by the government as the major causes of malnutrition.
And despite Uganda being a food basket, the nutritionists say all regions are afflicted. Case in point, south-western Uganda has the highest number of stunted children.
Over-nutrition, on the other hand, is a condition that occurs when the “body gets more nutrients than it needs, to the point that the person becomes unhealthy.“ The condition usually presents with obesity and is common in urban areas.

Measures
It is said that malnutrition starts from the womb; when a mother feeds poorly, the child also feeds poorly and it is estimated that one in every 10 children born in Uganda is already malnourished.
This puts the child at risk of dying from diseases like malaria, diarrhoea and HIV/AIDS. The estimated number of child deaths as a result of diseases closely related to malnutrition is 47%.
Overall, 60% of deaths in child deaths are attributed to malnutrition in all its forms (low birth weight, underweight and Vitamin A deficiency). Clearly, there is need to address the problem to reduce child mortality.
In addition, curbing malnutrition would reduce on mental retardation, brain damage and physical disabilities in children. These occur because of an Iodine Deficiency Disorder (IDD), largely found in children from mountainous areas in western Uganda who eat locally mined salt as opposed to iodised salt.
The mothers in these regions also face the same problem, putting their children at the risk of having lower learning abilities, poor speech and hearing disabilities.
In 2009, 2,100 children were born as cretins as a result of IDD in mothers, while those who lack Vitamin A could suffer blindness.
As a measure, Uganda, through the National Development Plan of 2010-2015, hopes to achieve sustainable economic development through increased agricultural productivity, improved health and survival and improved human capacity development through education.

dnabiruma@observer.ug
http://www.observer.ug/index.php?option=com_content&view=article&id=11357:what-is-malnutrition&catid=58:health-living&Itemid=89