As the food crisis in East Africa continues, children face more than just hunger. The crisis also exposes them to greater risks of contracting infectious diseases, stunted growth and impaired learning abilities. They may survive this drought but they would have to live with the long-term damage that malnutrition has inflicted on them.
When a child is malnourished, it means her body doesn’t have enough supply of nutrients for her to be able to function normally. Broadly defined, malnutrition can mean being underweight or obese. In situations of food scarcity however, severe weight loss is the most evident manifestation of this condition. The child begins to waste away; first losing fat, then muscle. Her immune system also loses its ability to fight off infections and she becomes more vulnerable to diseases like measles, diarrhea, pneumonia and malaria. While these diseases are dangerous even for healthy children, they are potentially fatal to a malnourished child.
Marasmus and kwashiorkor are the two most common types of malnutrition among children. Marasmus occurs when there is severe shortage of protein and calories due to lack of food in general. The child becomes extremely thin; her bones and joints become more prominent with the rapid loss of fat and muscle, and her vital organs are weakened. Kwashiorkor occurs when there is not enough protein, which means the child could be taking in calories but the diet lacks protein-based food and other micro-nutrients. The most visible symptoms of kwashiorkor are the swollen belly and swelling of arms, legs and feet as well as changes in skin and hair color.
Preventing malnutrition is critical in the first two years of age. The World Food Program calls this the “window of opportunity.” Studies have found that when children don’t get adequate nutrients in the first two years of life, they suffer irreversible damage well into adulthood. Undernutrition causes direct damage to the brain and motor development. This affects their cognitive skills and physical size later in life. Malnourished children tend to have lower performance in school, and they don’t attain their optimum height and lean body mass. Women who were undernourished as children tend to have babies with decreased birth weight.
Nursing severely malnourished children back to health requires intensive treatment that goes beyond basic food aid and feeding programs. For children below five years old, the first phase requires 24-hour care for a week for the treatment of infections, rehydration and therapeutic feeding of specialized formulas. The second phase is rehabilitation which involves daily care for five weeks, and aims for weight gain and transition to solid foods and local diet.
News reports say that over two million children in the Horn of Africa are malnourished and about half a million of them are in a life-threatening condition. How many of them are able to access the kind of treatment they need? How will they be able to cope with the long-term effects of malnutrition?
© UNICEF/NYHQ2011-1033/Kate Holt. On 14 July, a woman sits with her severely malnourished child in the paediatric unit at the District Hospital in Lodwar, capital of Turkana District, in Rift Valley Province. Another malnourished baby lies nearby.