CHILDHOOD WITH ANXIETY: Thousands of children don’t survive infancy
By Orton Kiishweko
Dennis Amani, 4, the third born in a family that lives on earnings from casual labour in Mkuranga District, Coast Region, looks innocent.
His eyes beam with innocence, but a sense of desperation hangs around his lifestyle and movement as he can hardly move with ease.
His mother, Ms Sharon Amina, is relieved that her son has not been attacked by malaria for months now. But it is the child’s stunted stature and gait which are symptomatic of a simple but powerful irony.
The irony is that while 3.5 million children in the world die prematurely because of malnutrition, 2.6 million people are at risk of dying prematurely because of obesity.
According to nutritionists, if there was a fair distribution of resources, then deaths from malnutrition would all be averted. This translates into 6.1 million lives being saved the world over.
However, in Tanzania alone, 578 children die in every 100,000 births. And, according to the chairperson of the Medical Women Association of Tanzania (Mewata), Dr Marina Njelekela, that situation should be addressed urgently before a generation is wiped out.
For reaching four years, however, Baby Amani has reason to smile. In Tanzania, for every 100,000 babies born, 578 die before reaching five. Baby Amani could easily have been one of them.
The Day of the African Child being marked today has as its theme: "Africa Fit for children: Call for Accelerated Action towards Child Survival." Nutritionists and children's activists who spoke to The Citizen want a new era to start.
This is the era where children should receive utmost attention from infancy in terms of what, when and how they eat.
As such, the managing director of the Tanzania Food and Nutrition Centre (TFNC), Dr Godwin Ndossi, relates the survival of children to national development saying:
"Shaping a child at all fronts will give us a generation in whose hands the future development of this country belongs."
With children suffering from hunger like four-year old Dennis Amani, the nutritionist defines it as insufficient food intake. This is blamed for causing malnutrition among many a child in Tanzania.
According to him, children like Amani could be stunted or underweight (too short for age) as a result of insufficient food intakes and/or infectious diseases. He also attributes these to lack of vitamins and minerals.
Already, the 2005 Demographic Health Survey shows that in Tanzania, 1.4 million children are underweight, 2.4 million stunting and 193,000 under five wasting. Worse still, 4.2 million children, according to the THDS, are anaemic.
But Dr Ndossi says the financial crisis, coupled with rising food prices, could weigh heavily on families' abilities and households to have proper nutrition for themselves and their children.
This, he says, could undermine the country's progress towards the Millennium Development Goal (MDG) one and four. This is to reduce hunger and child mortality rate by two thirds.
It is keeping the country off track in the quest of achieving the target by 2015, he notes
However, chances of the country achieving this have been hampered by low resource allocations. For example, information has it that as TFNC requested funds amounting to Sh8 billion this year, it will be granted around only Sh2 billion. The main reason is the global financial crunch.
The demographic survey also warned that the country was not on the right track in cutting the number of underweight children by half. This is mainly because under weight children were 1.2 million in 1992 but had risen to 1.4 million in 2005.
Dr Ndossi ties the stake of children's health to poverty as it hinders families' access to food.
He says malnutrition is the single greatest cause of child mortality in Tanzania, and contributes to over one half of the deaths.
"Such children have poor resistance to infection and recovery from diseases, with the majority of them 8.4 times more likely to die than a child who is well nourished," he says.
Education
As they grow up, the nutritionist goes on, such children tend to perform have poorly at school as the lack of iodine and iron reduces their ability to learn.
Moved by the fact that hungry children cannot concentrate at school, Prime Minister Mizengo Pinda recently led a ‘Hunger walk' to mobilize funds for the cause.
Hunger reduces the capacity to work and productivity. The decreased body size and inadequate dietary intake make people tired and weak.
According to nutritionists, lifelong income earnings for malnourished children are reduced by 12 per cent.
Another stunning revelation is that deficiencies in iron, vitamin A and folic acid are estimated to cost the country every year over Sh700 billion, which is around two per cent of the country's Gross Domestic Product (GDP).
"In the bigger picture, that is how malnutrition is a major impediment to the country's economic growth and development," he says.
But then, emerging problems like HIV/Aids, rising food prices, and the economic down-turn are likely to worsen children’s nutritional status as they paint a gloomy picture of the coming year.
A 2003 research by Lancet Child Survival Series notes that under-five deaths could be prevented in developing countries.
This could be through universal coverage with individual interventions such as breast feeding, sleeping under insecticide treated mosquito nets, water sanitation and Vitamin A supplementation.
For lasting solutions to the problem of malnutrition in households, it cites sufficient nutritious food for all family members and quality health care services.
Basic interventions
According to the chief of Health at UNICEF offices in Dar es Salaam, Dr Abdulai Tinorgah, the agency addresses child mortality through key initiatives as advice on nutrition.
He relates high mortality rates to malnutrition, noting: "A total of 60 per cent of child deaths have a significant relationship with malnutrition."
However, he adds that child malnutrition in a population is usually quiet and people are used to reading it as statistics.
Currently, over 90 per cent of children in the country are reached for vitamin A supplements, saving 30,000 child deaths annually.
Another nutritionist at Hellen Keller international, Mr Joseph Mugyabuso, puts it vividly that children who do not have enough vitamin A in their food are more likely to suffer serious illness, blindness and die.
"Every child aged six months to five years should take a Vitamin A supplement every six months of which each dose is Sh25,"he says. He adds that the Vitamin A supplement every year saves the life of 30,000 children in Tanzania.
A report from Keller international shows that as a result of bi-annual vitamin A supplements for children in the country since 2001, some 2644 children were saved from death in Kagera, 2220 in Mwanza, 2850 in Shinyanga, 1738 in Mara, 1850 in Dodoma, and 728 in Singida regions.
Other regions where lives were saved through June and December campaigns were Manyara (680), Tabora (1512), Kigoma (1738),Kilimanjaro (304) and Arusha (322).
Perhaps recognising the attitude of some parents, he emphasises that exclusive breastfeeding for the first six months of age is the best way to ensure that babies have sufficient Vitamin A.
The DHS estimates of 2004/05 and 1999 suggest that mortality was 139 for rural children compared to 108 for their urban peers.
There was also a probability of three to four times higher for an under five dying in Mtwara or Lindi than in Kilimanjaro or Arusha.
The future is not so bright, after all, according to Ms Mary Materu of the Centre for Counselling, Nutrition and Health Care.
She says the global financial crisis and rising prices affect the ability of low-income households to provide care for their children.
But she says breast milk is a low-cost and undervalued resource to provide food security and nutrition for babies.
To her, optimal breastfeeding can prevent one in eight child deaths. But they need a variety of additional foods until they reach two years and beyond.
Why do the children die?
For the fact that less than 14 per cent of children in the country are exclusively breastfed up to nine months, UNICEF's Dr Abdulai Tinorgah says it is a lost opportunity missed by the children.
According to the UNICEF nutrition manager, Ms Harriet Torlesse, the current National Strategy for Growth and Reduction of Poverty (NSGRP), or MKUKUTA in its Kiswahili acronym, does not address nutrition adequately, noting: "We need to address this issue in the next MKUKUTA."
Poor families have been reported to face malnutrition because of soaring food prices and the recession towards the end of last year.
As such, the recent tabling of the 2009/10 budget by Finance minister Mustafa Mkulo, which pegged the Agricultural budget at Sh666.9 billion, showed an increase of 30 per cent up from last year. All this aims at increasing food availability in the country.
To UNICEF's Harriet Torlesse ,the issue of nutrition for children is apparently more important than it has been in the last ten years, in the face of the prevailing economic crisis.
"It is important for our political leaders to champion for children's rights better than before," she notes.
But as Dr Ndossi notes, for these measures to make a significant impact, nutrition services should be available at the grass roots.
As a relieved Sharon Amina bids bye to yours truly, she couldn’t have
agreed more: "I want to see my child on a standard balanced diet but I haven’t got the money."
Urging rich nations at a meeting of the Group of Eight's development ministers not to cut back on aid, the World Food Programme announced last Saturday that high food prices have pushed 105 million other people into hunger in the first half of 2009. This has raised the total number of hungry people to over one billion.
