By Iqra Najmi
Originating from Gharo, Lachmi, a mere two months old and weighing a meager eight kilogrammes, was brought to our clinic by her deeply concerned mother. The mother conveyed her inability to breastfeed Lachmi due to her inability to afford regular meals. Lachmi’s condition underwent thorough evaluation, culminating in a diagnosis of Severe Acute Malnutrition (SAM). To address this critical issue, Lachmi received a regimen of 12 sachets of Ready-to-Use Therapeutic Food (RUTF) over several weeks. Remarkably, upon her return, Lachmi displayed significant improvements in her overall health, showcasing a remarkable 20 percent increase in her Mid Upper Arm Circumference (MUAC) and weight.
However, Lachmi’s story is not an isolated case, as malnutrition in Pakistan has been on an upward trajectory for numerous years.
VULNERABLE CHILDREN
The 2018 National Nutrition Survey unveiled a troubling statistic: 40.2 percent of children under the age of five in Pakistan suffer from stunted growth. This indicates that nearly half of the country’s young children face this dire challenge. The data also divulges that 29.8 percent are underweight, while a concerning 30 percent fall victim to wasting, defined by a low weight-to-height ratio.
It’s important to note that the international community has set a threshold of 15 percent for emergency wasting. Disturbingly, Pakistan’s current wasting rate stands at an alarming 17.7 percent. The implications of unaddressed malnutrition could be catastrophic if immediate action is not taken.
A GLIMPSE INTO PAKISTAN’S MALNUTRITION SCENARIO
Malnutrition silently plagues millions of vulnerable individuals within Pakistan, particularly women and children. The repercussions are manifold, including compromised immune systems that leave individuals more susceptible to diseases. Furthermore, cognitive development takes a hit, perpetuating a cycle of poverty and hindered progress.
Startling data from the World Health Organisation (WHO) reveals that a staggering 45 percent of children’s deaths globally are linked to undernutrition. This condition creates a deficiency in essential minerals and vitamins, potentially leading to severe health ailments in the absence of proper nutrition.
Unicef highlights that approximately 10 million children in Pakistan are grappling with stunted growth, a condition that profoundly affects their height development relative to their age.
DIGGING INTO MICRONUTRIENT DEFICIENCIES
The underweight status of many children could stem from micronutrient deficiencies, a result of insufficient vitamins and minerals. These nutrients play a pivotal role in crucial bodily functions, including the production of enzymes, hormones, and other vital substances necessary for growth and overall development.
A recent 2023 report published by the Office for the Coordination of Humanitarian Affairs (Ocha) paints a somber picture: one-third of children aged six to 23 months in Pakistan suffer from moderate acute malnutrition (MAM).
The situation was further exacerbated by the devastating floods of 2022, which tragically escalated malnutrition rates among children. Ocha’s survey in 15 flood-affected districts during 2023 revealed a distressing trend—wasting among children in these areas surged compared to the pre-flood scenario, which was already at critical levels.
INTO THE REALM OF INTERVENTIONS AND EXPERIENCES
The Malnutrition Programme, kickstarted in 2012 in Gharo, stands as a beacon of hope in the quest to identify and aid children afflicted by SAM. The Community Outreach Programme, overseeing 490 households, collaborates with the malnutrition initiative. Children are screened using a basic health questionnaire and physical examinations. Those identified as malnourished receive referrals to the Shine Humanity Gharo Clinic, where comprehensive care is administered.
Standardized survey tools are employed to pinpoint and screen children suffering from SAM and MAM in Gharo. Skilled nurses assess crucial factors like weight, height, and upper arm measurement, categorizing children into varying malnutrition levels. Based on the findings, a specially formulated food plan is prescribed—food that requires no preparation and can be easily consumed, resembling a paste. Parents are then directed to return for follow-up assessments after several weeks, with treatment often spanning six weeks.
During the month of June, we identified and initiated treatment for 11 malnourished children, each undergoing a personalized regimen. Those in the ‘Red Zone,’ encompassing children grappling with SAM, are provided specialized food for a month, followed by a series of assessments to monitor progress. This holistic approach includes a malnutrition assessment questionnaire, physical examination, and a MUAC assessment.
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Through concerted efforts, we strive to break the chains of malnutrition, ensuring a healthier and brighter future for the young generations of Pakistan.
The remote landscapes of rural Pakistan often find themselves devoid of essential healthcare services, leaving its inhabitants at the mercy of inadequate primary healthcare facilities and limited resources. The year 2013 marked a turning point with the establishment of our Gharo clinic, a beacon of hope for the local populace and neighboring villages. This initiative, backed by substantial evidence, has proven the remarkable efficacy of Ready-to-Use Therapeutic Food (RUTF) in combating acute malnutrition among children. Our approach is nothing short of a symphony, orchestrating the harmonious integration of RUTF, breastfeeding, and meticulously crafted home recipes to comprehensively nurture a child’s health.
A Symphony of Healing
The results witnessed within our clinic’s walls have been truly astonishing, unveiling a tapestry of transformed health and well-being among the young population. The brilliance lies in the seamless fusion of targeted interventions, a potent concoction that battles acute malnutrition while bolstering overall child health. This mosaic of success stories showcases the power of a multifaceted strategy, dispelling the darkness of malnutrition and nurturing brighter futures.
Shining Light on Success
Allow us to introduce Rohak, a young soul of one year and eight months, who recently crossed the threshold of our clinic. Through our meticulous assessment, it became apparent that he was ensnared by severe malnutrition, his fragile body carrying a weight far below the healthy spectrum at just five kilogrammes, instead of the expected eight. The prescription was clear: our ready-to-use sachets held the promise of a healthier life. Yet, challenges lay ahead.
A Battle Against Poverty and Ignorance
As we navigate the intricacies of addressing malnutrition, a stark reality emerges. The life-saving RUTF, a dense paste teeming with vital micronutrients, possesses a limited window of efficacy—12 weeks to be precise. Yet, the clutches of poverty lead many parents to distribute this precious resource to all their offspring, regardless of malnutrition status. A disheartening irony unfolds as this invaluable paste, meant to rejuvenate the malnourished, is treated as a sweet indulgence, overshadowing its true purpose.
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A Call to Government and NGOs
This battle against malnutrition extends beyond the confines of our clinic, reaching the corridors of power and the hands of compassionate NGOs. The government’s pivotal role in this crusade cannot be understated. Urgent interventions are necessary to vanquish malnutrition, anemia, and stunted growth that plague the nation. NGOs and dedicated social workers, particularly in regions like Tharparkar, must rally to save countless lives. The clarion call for focused efforts on family planning, advocating breastfeeding, embracing cost-effective yet nutrition-rich dietary choices, and promoting immunization echoes loud and clear.
Nurturing Minds: The Essence of Early Intervention
The ticking clock of childhood development necessitates early action. The astonishing truth reveals that a child’s brain is 80 percent developed before the first steps into kindergarten. Within a child’s inaugural year, the brain doubles in size, expanding to nearly 80 percent of its adult counterpart by the age of three, and a staggering 90 percent by age five. This cognitive powerhouse thrives on energy, commanding a whopping 20 percent of the body’s energy despite occupying a mere two percent of body weight.
A Nation’s Pledge
Our society’s response to this crisis of malnutrition stands as a testament to our collective conscience. Neglecting the foundational growth of our children’s minds and bodies casts a shadow of disgrace upon the nation. As we strive to brighten the futures of our youngest, let us pledge to turn the tide against malnutrition, steering the course towards a healthier, more vibrant Pakistan.
In the face of Pakistan’s growing child malnutrition crisis, urgent and collective efforts are imperative to reverse the tide. The future of the nation’s youth hangs in the balance, and addressing malnutrition requires a comprehensive approach that spans healthcare, education, and policy changes. It is a moral imperative to ensure that every child has the opportunity to thrive and reach their full potential, as a healthier and nourished generation paves the way for a stronger and brighter Pakistan.
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