Showing posts with label Global Acute Malnutrition (GAM). Show all posts
Showing posts with label Global Acute Malnutrition (GAM). Show all posts

Monday, 21 February 2011

POVERTY: PAKISTAN: Floods uncover evidence of feudalism’s impact on poor



 Photo: OXFAM
Land reform hampered by the fact that many politicians are also landowners

KARACHI, 17 February 2011 (IRIN) - The floods that swept across vast tracts of land from July to September 2010 covered many fields, houses and roads in a sea of swirling water - but they also played a part in exposing the depth of existing poverty and deprivation in Pakistan.
“The malnutrition we are seeing is not new. It has nothing to do with the floods; it is just that we are seeing it now as people come into contact with medical teams,” Shershah Syed, a gynaecologist who has devoted himself to caring for impoverished women requiring care during pregnancy and birth, told IRIN.
Some of the ways in which powerful feudal families - in many cases linked to the political and bureaucratic elite - acted to protect their own interests at the cost of ordinary villagers have been well documented. Feudal overlords have been accused, both in the southern Punjab and in Sindh Province of influencing decisions regarding the diversion of floodwater or the breach of over-flowing dams to protect their own land.
A judicial investigation continues into allegations that in other places protective dykes were breached by wealthy landowners to save their farms, while flooding those of impoverished - and powerless - villagers.
The more subtle ways in which Pakistan’s feudal system works against people, even in times when there is no natural disaster, are beginning to surface only now - in some cases as a result of surveys conducted to assess the plight of flood-affected people.
Vast estates belonging to feudal families stretch out across the country, sometimes covering hundreds of acres. According to the World Bank, about 2 percent of households control more than 45 percent of the total land area. Large farmers have also monopolized subsidies in water and agriculture - with the system in place contributing heavily to rural poverty, the Bank says.

Call for land reform
Throughout Pakistan, millions of peasants are working on land they do not own, giving between half and two-thirds of their crops to landlords. The poor peasants and landless agricultural workers are exploited in many ways
“In a country where about half the workforce is engaged in agriculture, the key to improving lives is an end of feudalism by implementing effective land reforms. No one should own more than 12 acres [4.86 hectares] of agriculture land,” Farooq Tariq, spokesman for the Labour Party of Pakistan, told IRIN.
“Throughout Pakistan, millions of peasants are working on land they do not own, giving between half and two-thirds of their crops to landlords. The poor peasants and landless agricultural workers are exploited in many ways. Workers often end up tied to the land, after taking a loan from a landowner and offering to pay it back by working. Sometimes whole families end up in this type of debt bondage, working to pay off a loan on which the interest keeps accumulating. This system is one of the many ways that ties the peasants to absolute poverty,” he said.
Historically speaking, land reform has been held back by the fact that many parliamentarians are themselves big landowners, and as such are unwilling to initiate a re-division of land.

Nutritional crisis
The impact of feudalism, and the poverty it gives rise to, is poorly documented, but six months after the most devastating floods in the country’s history, with Sindh Province worst hit, a provincial government report based on a survey conducted with UN Children’s Fund (UNICEF) support, has revealed a grave nutritional crisis. The survey has found a global acute malnutrition (GAM) rate of 23.1 percent in children aged 6-59 months in flood-affected areas of northern Sindh and 21.2 percent in southern Sindh - rates above the World Health Organization’s 15 percent emergency threshold level.
A severe acute malnutrition (SAM) rate of 6.1 has also been uncovered in northern Sindh, with the Sindh government estimating about 90,000 under-five children are malnourished.
According to UNICEF, SAM is an advanced state of acute malnutrition. Children with SAM need immediate treatment and are 10 times more likely than healthy children to die before they reach their fifth birthday. The survey also found high levels of malnutrition among women.
Experts working in the field, however, believe this situation is a product of entrenched deprivation, rather than floods.
"The malnutrition [revealed by the survey] was not caused by floods but by poverty; the majority of IDPs [internally displaced persons] in camps are from the lowest quintile of poverty", Andro Shilakadze, a senior UNICEF field officer in Sindh, told IRIN.
“The women of Sindh have suffered like this for thousands of years due to the feudal system in the province, and of course the mother’s health affects the child,” said gynaecologist Syed, who has performed life-saving operations in the most primitive conditions across flood-hit parts of Sindh and also runs a flood-relief camp.
“It is simple actually. Women work hard in the fields and in their homes. They receive only what is left of the food after the rest of the family has eaten. Men are served first, then the children and then the women last of all,” he added.
“It has always been like this. We women eat last, because we are least important,” Sumundri Bibi, an emaciated mother of six, told IRIN at a flood-relief camp in the southern Sindh town of Thatta.
“This is a patriarchal culture. Women suffer due to it,” Syed said.
James King’ori, nutrition cluster coordinator for UNICEF, told IRIN from Islamabad: “Women, particularly of child-bearing age (15-49), have an increased nutritional requirement to not only maintain their body growth, enable daily chore undertaking but also to support pregnancy and breastfeeding of infants. Addressing poverty in a strategic manner to benefit women is key,” he said.
But this seems unlikely to happen until there is a break from the system of uneven land ownership, and the exploitation that comes with it. “Ownership of land can quickly break the poverty cycle. We have seen examples of this in places where tenant farmers have taken control of land,” Tariq said.
“I know nothing about land ownership - just that we struggle to feed our children, and eat less ourselves so they have more on their plates,” Sumundri said.
Http://www.irinnews.org/report.aspx?ReportID=91952


Sunday, 30 January 2011

MALNUTRITION: UNICEF: Pakistan floods uncover dire nutrition situation

28 Jan 2011 Six months after the 2010 Pakistan monsoon floods hit, UNICEF and its partners face another huge challenge following new survey results from Sindh province that reveal critical levels of malnutrition among flood-affected children.
Data released today by the Sindh Department of Health indicates a nutrition crisis, recording a Global Acute Malnutrition (GAM) rate of 23.1 per cent in children aged between 6-59 months in flood-affected areas of Northern Sindh and 21.2 per cent in Southern Sindh. This rate is well above the World Health Organization's (WHO) 15 per cent emergency threshold level which triggers a humanitarian response. Furthermore, records from Northern Sindh reveal a Severe Acute Malnutrition (SAM) rate of 6.1. The Sindh government estimates about 90,000 children aged 6-59 months are malnourished.
Global Acute Malnutrition (GAM) reveals how many children in a given population are moderately and severely malnourished, and have not gained the required weight for their height. Severe Acute Malnutrition (SAM) is an advanced state of acute malnutrition. Children with SAM need immediate treatment and are ten times more likely to die before they reach their fifth birthday than healthy children. If they do survive, their development and learning is poor and their income earning potential as adults is reduced.
"UNICEF is extremely concerned about this finding and is working with the federal and provincial government authorities concerned to reach and treat these children. The floods may have uncovered the hidden face of child malnutrition in Pakistan, but we see this as an opportunity to scale up a sustained response that will benefit children in the short- and long term. UNICEF is committed to working with its partners to ensure that their needs are met," said Pascal Villeneuve, UNICEF Pakistan Acting Representative.
The Flood Affected Nutrition Survey (FANS) was conducted in flood-affected areas in all four provinces of Sindh, Punjab, Khyber Pakhtunkhwa and Baluchistan. It aims to provide updated information on the nutritional status of children aged between 6-59 months in flood-affected communities. Results are expected from the Punjab Government shortly.
To respond to the findings, UNICEF and other nutrition partners are working with the government of Sindh to carry out a robust response plan. It will focus on acute malnutrition management and prevention over a period of 18 months. UNICEF leads the Nutrition Cluster and provides nutrition supplies, technical guidance and training. It also supports nutrition programmes to nurse malnourished children and women back to health.
Six months after the devastating 2010 monsoon floods struck, UNICEF continues to act on the urgent needs of flood affected people, most of whom have gone back to find their houses and communities in total devastation. Falling temperatures during winter has made life in the camps and in damaged houses more difficult for families, and has hindered returns in the northern areas. UNICEF's response continues to adapt to the changing needs of those affected by the flood.
In the past six months since the onset of the floods, UNICEF has been providing clean water to an unprecedented 3.5 million people daily, and sanitation facilities to more than 1.9 million people.
UNICEF has worked with partners to immunize more than 9 million children against measles and polio and provide about 8.5 million children with Vitamin A supplementation. A total of around 120,000 malnourished women and children have also been enrolled in various feeding programmes. Temporary Learning Centres are benefiting around 180,000 children. UNICEF established 700 Child Friendly Spaces benefiting 200,000 children and protecting them from risks of abuse, neglect and exploitation. UNICEF also leads the nutrition, water, education and child protection clusters to ensure life-saving and life-sustaining interventions are well-coordinated, gaps are addressed, resources are maximized, and strategic information shared.
"As the Pakistan flood crisis continues to evolve and attention for the emergency fades, there is a danger that people of the world will forget that Pakistani children still need a great deal of help. Children now face the task of rebuilding their lives and homes with their families, which means that many of them will work instead of going to school. The long months with little food have compromised their ability to stay healthy and fight off diseases," Villeneuve said.
To date, UNICEF has received US$198 million in donations and pledges out of the US$251 million required. As UNICEF continues relief, return and early recovery activities, a funding gap of 21 per cent or US$52 million is still required to ensure UNICEF can respond to ongoing needs.
http://www.reliefweb.int/rw/rwb.nsf/db900SID/EGUA-8DJUNV?OpenDocument&RSS20=18-P

Tuesday, 11 January 2011

MALNUTRITION: The government of Niger and its partners determined to continue their efforts against child malnutrition in Niger

Angeline Fox: 4 January 2011
NIAMEY, NIGER,- Despite a good harvest and pastoral season in late 2010, the nutritional situation of children remains alarming in Niger where more than 15 children in 100 suffer from acute malnutrition, according to the results of the National Nutrition Survey made public on 16 December. The Niger government, UNICEF and the World Food Programme (WFP) called on the international community to intensify its efforts and mobilize all means necessary to fight against child malnutrition and its structural causes to sustainably meet the needs of the most vulnerable children.
The prevalence of global acute malnutrition (GAM) among children under five years of age in Niger decreased from 16.7 per cent to 15.5 per cent between June and November 2010, but it remains above the emergency threshold of 15 per cent – and this for five of the country’s eight regions.
The situation remains worrisome for children aged six to 23 months. More than a quarter of them are affected by this form of malnutrition.
And severe acute malnutrition (SAM), which dramatically increases the risk of death for the under-five age group, has impacted 7 per cent of children in the under-two year age category, and is present in 3.2 per cent among the under-five group, according to the findings of this new survey.
These figures reveal not only the severity of the food and nutrition crisis experienced by Niger in 2010, but also the speed and quality of the response implemented by the government and its partners. Between 1 January and 5 December 2010, 313,000 children under five suffering from SAM received care though public health facilities supported by UNICEF and nongovernmental organizations (NGOs). Some 38,000 children were hospitalized and 275,000 received outpatient treatment. These numbers represent one-fifth of all children treated for SAM worldwide.
In addition, the government, WFP, UNICEF and NGOs helped 686,000 children under two to receive adapted food rations between July and December 2010 as part of Blanket Feeding operations to prevent malnutrition among children living in 38 food-insecure districts -Niger is made up of 42 districts.
“The magnitude of resources used and efforts made by all humanitarian actors and donors have saved the lives of tens of thousands of children,” said Guido Cornale, UNICEF Representative in Niger. “This mobilization has stabilized the nutritional status of children, but this is far from enough.”
“Each week, thousands of sick children continue coming to health centres, demonstrating once again that we must resolutely confront the underlying causes of malnutrition in Niger.”
According to the government of Niger and its UN and NGOs partners, a consolidation of resources and measures for preventing and treating child malnutrition is crucial at this point. Structural policies in the areas of health, education, social welfare, agriculture, and food security must be applied quickly to avoid the disastrous consequences of climatic shocks on people in the Sahel, who are highly vulnerable to crises and epidemics.
According to Richard Verbeeck, WFP Representative in Niger, the results of this survey show that the response has been appropriate. “Without the concerted actions of the humanitarian community and the government of Niger, malnutrition rates would have been disastrous,” he said. “The battle against malnutrition is far from over and we must continue our efforts for a permanent and lasting solution to this problem,” Mr. Verbeeck concluded.
http://www.iewy.com/13116-the-government-of-niger-and-its-partners-determined-to-continue-their-efforts-against-child-malnutrition-in-niger-2.html

Thursday, 11 November 2010

MALNUTRITION: YEMEN: Child malnutrition alarming in conflict zone

SANAA, 1 November 2010 (IRIN) -
Health workers are finding worrying levels of child malnutrition in Yemen's conflict-hit northern governorate of Saada, particularly in districts that have seen the worst of the fighting.
A UN Children's Fund (UNICEF)-supported survey carried out by the Ministry of Public Health and Population released earlier this month showed that almost half of the 26,246 children aged 6-59 months who were screened in five districts in western Saada were suffering from global acute malnutrition (GAM).
"In one area, the proportion was as high as three out of four children. Overall, 17 percent of the children screened suffer from severe acute malnutrition [SAM] and 28 percent from moderate acute malnutrition," a UNICEF statement said. [ http://www.unicef.org/infobycountry/media_56582.html ]
"Malnutrition is the main underlying cause of death for young children in Yemen, and therefore this grim situation could spell disaster for the children of Saada," said Geert Cappelaere, UNICEF representative in Yemen. "As winter approaches, thousands of children are at serious risk if we are not able to act immediately."
Across Yemen, 15 percent of children aged under five suffer from GAM. But the protracted conflict in Saada between government forces and Houthi-led Shia rebels seems to have worsened the situation in the north.
GAM and severe acute malnutrition (SAM) are the principal indicators used in nutrition surveys. Prevalences of GAM and SAM are based on the proportion of children aged 6-59 months whose weight and height categorize them below a certain score. [ http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5821a4.htm ]
Diarrhoea, nausea
Four year-old Ahmad Mohammed Hajouri weighs 11.5kg, roughly 7kg less than the average weight of a normal healthy child at the same age.
"Ahmad has been suffering diarrhoea and vomiting for more than one month now. No food remains in his stomach for more than 10 minutes," his father Mohammed Hajouri from al-Malaheedh District in western Saada, told IRIN.
The family returned home in June 2010 after spending almost 10 months in al-Mazraq Camp I for internally displaced persons (IDPs) in Haradh District, in Hajjah Governorate. They lost one of their children two months ago.
"My daughter Salma died last Ramadan [August 2010] at age three after suffering diarrhoea and nausea for more than three months. Now, we fear that Ahmad may die like his sister," the 40-year-old mother, Khairya, told IRIN.
"We don't have money to take Ahmad to one of the hospitals in the capital Sanaa, or to afford better treatment since the medicines we receive here did not help him heal. He is losing weight by the day," she added.
"Food assistance not enough"
Intermittent fighting since 2004 is not the sole cause of the problem. In rural Yemen as a whole, there is lack of awareness about proper nutrition; bread and tea is a typical breakfast and dinner meal for both adults and children.
"Several children come to us in an advanced state of malnutrition, and therefore their treatment becomes costly and takes several months. Parents don't give their ailing children the right food to remain healthy, nor do they take them to hospitals early enough," Shihab Mohammed, a doctor at the government-run al-Salam Hospital in Saada city, told IRIN.
Samia Mohammed, a former health awareness campaigner at al-Mazraq Camp I, whose population mostly came from western Saada, said hundreds of children were already malnourished on arrival at the camp. "Their mothers were malnourished too," she said.
"Food assistance alone is not enough to address malnutrition," said UNICEF's Cappelaere, adding that major efforts are needed to support household food security, change existing feeding customs and ensure safe water, sanitation and hygiene for populations affected by the conflict.
Despite a ceasefire in February 2010, the extremely volatile security situation has impeded access, and limited the reach of humanitarian agencies.
"UNICEF therefore calls upon all parties to the conflict in Saada as well as the international community, including the Qatari mediation delegation currently visiting Yemen, to ensure that immediate access for humanitarian actors is granted to the entire governorate of Saada to ensure children can receive necessary life-saving assistance," Cappelaere said.
Http://www.irinnews.org/report.aspx?ReportID=90945

Wednesday, 15 September 2010

MALNUTRITION: KENYA: Malnutrition levels in northeast stubbornly high

13 September 2010 (IRIN) - Malnutrition levels in pastoralist districts of northeastern Kenya have remained high, despite recent rains that boosted livestock productivity, the mainstay of the local economy, officials said."There could have been improvements in the nutrition situation for individuals, but it will be difficult to see an impact at population level, given the various factors that affect nutrition," said Joyce Owigar, a nutritionist with the World Food Programme.The Ministry of Health and its partners recently found Global Acute Malnutrition (GAM) levels above the UN World Health Organization's 15 percent emergency threshold in Mandera Central Districts, Wajir South and Wajir East. Mandera West recorded GAM rates above 25 percent. "Due to the high illiteracy levels that characterize this region, most people, especially women, [do not] ensure that children receive a balanced diet. This makes malnutrition a [common] occurrence," the ActionAid Kenya northeast region coordinator, Enrico Eminae, told IRIN.This view was echoed by the Kenya Food Security Outlook for August report: "Improvements in household food security have not translated into a decisive reduction in rates of child malnutrition in the northeastern districts." [ http://www.fews.net/docs/Publications/Kenya_FSOU_August_2010_final.pdf ]Eminae called for alternative income sources and a change in eating habits. "To generate income, milk, beans, green-grams and eggs are sold to buy maize, wheat flour and rice. In the process all nutritious food is sold to buy and consume only starch," he said. "Most people in this region prefer foods that can be prepared with the least effort, time and water. These are mainly starches, [such as] corn flour, rice, spaghetti and wheat flour." Because livestock numbers have gone down, the pastoralists no longer have the milk, meat and blood that used to constitute their diet. Health facilities are also few and far between. Water remains scarce and migrating herds mean children are left without access to milk."The biggest problem in this region is continued poor development, which is best seen in the lack of and deterioration of infrastructure and services," noted Benoit Collin, head of the European Commission Humanitarian Aid Disaster Risk Reduction programme. "One approach to the complex problem in this region is to increase availability and access to natural resources, especially water."According to Owigar, disease "and malnutrition have a synergy, such that an increase in one will also lead to an increase in the other".
Http://www.irinnews.org/report.aspx?ReportID=90458