Malnutrition—The Creeping Sickness
By “Awake!” correspondent in the Philippines
LITTLE Nonoy’s mother was worried about him. He was small for his age and did not run around like other boys. Instead, he was lethargic and listless. He was so skinny it seemed that you could count all his bones, and yet his mother always gave him all he wanted to eat. His hair was thin, and he had swellings on his limbs. Finally, she took him to a doctor and found that he was suffering from one of the most common diseases in the world—the creeping sickness of malnutrition.
An estimate last year suggested that perhaps one eighth of mankind have this disease, while recently at the United Nations it was stated that reportedly ninety million children like Nonoy are suffering from it in moderate to severe forms. Certainly, malnutrition is a staggering problem in this twentieth century.
According to a recent publication of the Nutrition Center of the Philippines, “malnutrition is a state of ill-health resulting from the lack or excess [as in obesity] of essential nutrients that the body needs.” Most people know that food is made up of various elements such as proteins, calories and vitamins that are necessary for proper health and growth. If these are not available in correct amounts, the effects can be serious, especially among growing children.
The symptoms of malnutrition among children like Nonoy can be stunted growth, continuous decline in weight, poor mental performance and low resistance to infections, leading, perhaps, to diseases like pneumonia and tuberculosis. Among adults it can impair mental and physical development and productivity, shorten the span of working years and result in a lack of inventiveness and imagination. Goiter (lack of iodine), blindness (lack of vitamin A) and a lack of stamina (iron deficiency) are other manifestations.
A recent World Bank Country Economic Report estimated that this disease is costing the Philippines four billion pesos (about $540,000,000 [U.S.]) annually. Here, more than three million of the almost nine million children between six months and six years of age suffer from moderate or severe malnutrition. Three out of four are anemic and the same number suffer from vitamin A deficiency. Fifty percent of all deaths registered annually are of children under five years of age, and half of these deaths are due to diseases aggravated by malnutrition. Less than one third of all children in the country reach what is considered “optimum growth.”
Handling the Problem
Many individual countries, including the Philippines, are fighting back. Here a special organization is being set up to reach into the small towns and barrios (villages) in an effort to locate and solve the problem.
How do you go about finding out who is suffering from malnutrition in a country of forty-two million inhabitants? In the Philippines it is being done by concentrating on the children. Operation Timbang (“Weight”) has been launched to weigh as many preschool children as possible and in this way locate the undernourished. In one typical barrio, 5 percent of the infants up to seven months of age were suffering from third-degree malnutrition, 22 percent from second-degree and 50 percent from first-degree malnutrition. According to this scale, a well-nourished child should weigh between 91 and 110 percent of his ideal weight. A child between 76 and 90 percent is said to suffer from first-degree malnutrition; between 61 and 75 percent is second-degree malnutrition; while a youngster 60 percent of ideal weight or below is considered malnourished to the third degree.
For severely malnourished children, food intervention programs, as well as emergency treatment, are being tried. Also, there is a general program aimed at eliminating the causes of malnutrition. A severely malnourished child like Nonoy may be helped by temporary food assistance program, giving him either locally grown foods of those donated through foreign organizations. His mother may be taught how to feed her child to restore him and to prevent a relapse. She is advised to give him foods like rice, corn, root crops and sugar, boiled fish, ground dried fish, mungo (like lentils) or other dried beans, as well as cooking oil. Where possible, a badly malnourished child is taken into Malward, a hospital malnutrition ward set up especially to restore undernourished children to health. Sometimes, when the government helps to feed a child, the parents think that it is no longer their responsibility. So, developing the parents’ sense of responsibility is an important part of this program.
Dealing with the Causes
Probably more far-reaching is the effort to remove the causes of malnutrition. One of these is poverty. What can be done if there just is not enough money to pay all the food bills?
In the Bicol region of the Philippines, researchers brought in a computer to examine the program, using what is called “Linear Programming.” Feeding the computer data about all the foods in that area, they calculated the cheapest possible diet that would provide enough nutrition for a family of six. But even with very skillful shopping, the average man, with an average wage for that region, could not give his family all that they needed. According to the computer, the best he could do was to supply 82 percent of the family’s calorie needs, 89 percent of the protein needs and even less of their needs for other nutrients. Only in vitamin C and iron could he feed his family properly.
To help to solve this problem, families and communities in the countryside are being encouraged to become more self-sufficient by growing food on any small plot of land that they may have. Schools are urged to undertake gardening projects, both to educate the children and to increase the quantity of food available to the community. At the same time, the government wants to move poor families who live in the cities out of the slums and set up businesses and cooperatives through which they can earn more money.
An educational campaign also is under way in the schools, through the news media, and so forth, to explain just what foods are necessary for a family. Foods are divided into three groups: body building, energy giving and regulating. The regulating foods are rich in vitamins and minerals, and are helpful in preventing sores, night blindness, anemia, goiter and beriberi. Typical body-building foods in the Philippines are meats, fish, milk, beans, nuts and eggs. Energy-giving foods include rice, corn, bread, noodles, coconut oil, sugar and root crops like camote (sweet potato). Among regulating foods are green leafy vegetables, yellow vegetables like calabasa (squash) and carrots, as well as such fruits as mango, guava, melon, papaya and banana.
Proper preparation of food is important. So housewives are being encouraged to wash vegetables thoroughly before peeling, and to cook them immediately thereafter, so that all the water-soluble minerals are not lost.
Young nutritionists trying to teach cooking to experienced older housewives are not always well received. At one cooking demonstration, a lola (grandmother) exclaimed: “Why should I start cooking differently at my age? I brought my children up cooking food my way, and now I cook the same way for their children, and they like it. If I change now, maybe they won’t eat what I cook. Then they’ll get thin and you’ll have a bigger problem!”
Sometimes parents will not believe that their children are malnourished. When, as in one region, 80 percent of the preschool children are found to be malnourished in one way or another, malnutrition seems to be accepted as normal.
Often, too, parents like Nonoy’s mother will underestimate the protein needs of a child. In fact, the extreme protein deficiency disease called “kwashiorkor” reportedly gets its name from an African word meaning “the sickness of the older child when the next baby is born.” When the child is weaned—very often because there is now a newer baby needing the mother’s milk—the only food that he gets may be watered-down milk or rice water. Sometimes he will not get solid food until after his first year. Of course, when the child’s stomach is filled, and he may not feel hungry, the mother, who certainly loves her child, does not realize that he is becoming malnourished.
In a certain case, a family might sit down to a meal of fish and rice (good body-building and energy-giving foods). The men of the family, however, get most of the fish, since they have to work in the fields, while the children merely get a little to help down the rice. Such parents do not understand that children need body-building foods for proper growth and mental development.
Even though hundreds of millions of pesos are scheduled to be spent by the central and local governments, in addition to money originating with contributions from private organizations and foreign aid, the problem of malnutrition may be getting bigger. The birthrate in the country is quite high. Hence, part of the drive against malnutrition has involved the encouraging of family planning.
What Can the Individual Do?
What can be done by a person living in an area where there is malnutrition? The general advice given is to be balanced. One should accept counsel and not let time-honored practices block new ideas. A person should eat a variety of the foods available, and should remember that growing children need body-building foods. Hence, they should have their proper share of the family food supply. This especially applies to pregnant and nursing women.
If there is garden space, use it to add to the family food supply. Perhaps you can grow some vegetables or fruit, or maybe raise chickens. A wage earner should also make the best use of his money, possibly buying a little less rice, but more body-building foods. And certainly he should avoid buying a radio and a television set on the installment plan, while the children are eating just plain rice!
Christians here in the Philippines are very encouraged by the promise of Jesus Christ: “Keep on, then, seeking first the kingdom [of God] and his righteousness, and all these other things will be added to you.” (Matt. 6:33) They know that by putting spiritual things first in life, it is possible for them to be content with sustenance and covering. (1 Tim. 6:6-8) The Bible also instructs them to avoid waste and to be industrious in providing life’s necessities. In addition, they face the future with optimism, looking ahead to the time when God will see to it that maladies, such as the creeping sickness of malnutrition, exist no longer.—Isa. 25:6-8.