Food insecurity fuels malnutrition

JUST looking at Chipo Rukwese from Dzivaresekwa Extension in Harare, you wouldn’t know she is six years old.

Wongai Zhangazha

You would think she is younger. Her arms are wafer-thin, her head practically a skull, a bony structure looking like a skeleton with deep-sunken eyes.

She has thinning hair and a protruding tummy. A sad and painful sight.

You don’t have to be told that there is something medically wrong with her. A well-nourished child should have clear soft skin, bright white eyes and teeth and thick shinny hair.

Chipo suffers from chronic malnutrition and is now stunted — too short for her age and weight — a condition caused by persistent inadequate and unbalanced diet in early childhood.

The sad thing is that Chipo dreams of being a doctor when she grows up. However, according to social scientists, malnutrition in the early stages of child can lead to impaired cognitive development and a greater risk of illness and death.

Her mother, Anna Rukwese, who has four other kids and works at a brick-moulding company in Mt Hampden, says she exclusively breastfed her daughter up to six months, despite being always away working to make ends meet.

When she started giving Chipo solid food, Rukwese could only afford to give her daughter a poor diet everyday of sadza and green leafy vegetables, which was sometimes just boiled because she had no money to buy cooking oil. At times, her family lives on one meal a day.

Chipo is one of the tens of thousands of children suffering from chronic malnutrition in Zimbabwe. More than 1 000 children in Harare are on the Harare City Council child supplementary feeding programme at council clinics and schools.

While there has been a general improvement in the lives of many Zimbabwean children in the last five years, according to government statistics, the country still faced nutritional problems among children.

The Zimbabwe Vulnerability Assessment Committee (ZVAC), led by the government with support from various partners and the World Food Programme (WFP), in its recently published 2014 rural livelihoods assessment report stated that 6% of the rural population, equivalent to 565 000 people, will be in need of food assistance between January and March 2015 — a decrease from the 2,2 million food-insecure people during the same period this year.

Zimbabwe’s 2013/2014 agricultural production is estimated to be 1,45 million metric tonnes — an increase from 798 500 metric tonnes produced in the previous agricultural season.

Despite the decrease in the number of people needing food assistance due to an improvement in production levels, the ZVAC report states that food and nutrition security remains fragile and subject to natural and economic shocks in Zimbabwe, with chronic and persistent rates of undernourishment.

The report states that one-third of Zimbabwe’s children are stunted. Additionally, the country continues to face economic stress with implications for food security, especially for vulnerable groups in rural areas.

Nutritional problems among children was also raised in another report, the Multiple Indicator Cluster Survey (MICS) recently launched by the Zimbabwe National Statistics Agency (Zimstat).

The national household survey was conducted between February and April this year.

The report said Zimbabwe needs to do more to ensure that children are provided with food that is high in nutrition.

The 2014 MICS collected data on nutritional status of children by measuring height and weight of children under five in sampled 17 047 households in urban and rural areas.

According to the survey, 27% of the children are stunted, 11,2% of children are underweight, 3,3% are wasted and 3,6 % overweight.

“The percentage of stunting initially increases with a child’s age, with prevalence highest between 18 and 35 months, and declines thereafter. The prevalence of underweight is highest among children age 18 to 23 months, while children aged 12 to 17 months are likely to be wasted. Children under six months are likely to be overweight,” reads the report.

Harare City Council director of health services Prosper Chonzi said the Zimstats statistics on nutrition reflected the situation in Harare.

Said Chonzi: “It is true that Harare is experiencing quite a number of cases of malnutrition among children, not only under the age of five, but even older. Underweight is mostly due to poor eating habits by people. You find that some only have tea and bread without any other food that are high in nutrition.”

He said this group of children was more evident in newly resettled places, which include Hopely, Dzivaresekwa Extension, Caledonia and Hatcliffe Extension.

“Regarding overweight in Harare, we have seen it mostly in private schools where the children just eat and sit and watch television without any exercises,” said Chonzi.

“There are various programmes we are undertaking to monitor the nutrition status in Harare with focus on pregnant and lactating women because it is very important to look after them. We have specific programmes for children under five and we also have school health programmes where children are given supplementary feeding.”

The report also states that one in 10 of the most recent live births in the last two years preceding the survey weighed below 2,5kg at birth and that babies who weigh less than 2,5kg at birth are considered to have a higher risk of early childhood death.

Last year at the launch of the Zimbabwe Food and Nutrition Security Policy, the government noted that malnutrition currently accounts for more than 25% of deaths among children under the age of five.

Comparing with the Zimbabwe Demographic Health Survey (ZDHS) of 2010-2011, the nutrition statistics of the 2014 MICS results do not show much of an improvement.

The ZDHS of 2010-2011 found that stunting affects more than 30% of all Zimbabwean children under five, one of the highest rate in the world.

The problem was said to be prevalent in 10 districts located in the four provinces of Matabeleland North, Mashonaland Central, Manicaland and Masvingo.

Although the stunting rate in Zimbabwe is still lower than in other sub-Saharan African countries, Unicef’s Situational Analysis on the Status of Women and Children released in 2011 states it has increased over the past 15 years by nearly 40%.

The report stated that one in every three Zimbabwean children suffers from chronic malnutrition or stunting. Stunting contributes to more than 12 000 child deaths each year.

Social scientist Tendai Mugove said the issue of nutrition should be tied to food security in the country.

Mugove said: “The erosion of communities’ capacity to feed themselves has an impact on the quality of food that is consumed. As such what we may be seeing is evidence of the inability of communities to feed themselves.

“It is also a sign that communities have not been able to adopt the changes that have come with new foods on the shelves. We have a situation where families are fed without looking at the nutritional value of the food.”

He said the nation has also failed to assist as most corporates and individuals only react quickly when politics is involved.

“It is also vital to look at what we are doing as a nation to feed the communities and at the same time educate the people on nutritious foods. The statistics also show that even after becoming food secure, we need to go further and make sure that the quality of the food is better than what we have now.”

“It interesting to ask what happened to the issue of small community gardens. This brings us back to the erosion of resilience. It’s time we revive these by capacitating communities.”

According to WFP, food production in Zimbabwe has been devastated by a number of factors including natural disasters and economic and political instability. Recurrent drought, a series of poor harvests, high unemployment (estimated at more than 80%), restructuring of the agriculture sector and a high HIV and Aids prevalence rate — at 14,7%, the fifth highest in the world — have all contributed to increasing levels of vulnerability and acute food insecurity since 2001.

This situation has necessitated large-scale humanitarian food relief operations in the country.

WFP says a malnourished person finds their body has difficulty doing normal things such as growing and resisting disease.
When a person is not getting enough food or not getting the right sort of food, malnutrition is just around the corner.

Even if people get enough to eat, they will become malnourished if the food they eat does not provide the proper amounts of micronutrients — vitamins and minerals — to meet daily nutritional requirements.

Disease and malnutrition are closely linked. Sometimes disease is the result of malnutrition, sometimes it is a contributing cause.

In fact, malnutrition is the largest single contributor to disease in the world, according to the UN’s Standing Committee on Nutrition (SCN).

Malnutrition at an early age leads to reduced physical and mental development during childhood. Stunting, for example, affects more than 147 million pre-schoolers in developing countries, according to SCN’s World Nutrition Situation 5th Report. Iodine deficiency, the same report shows, is the world’s greatest single cause of mental retardation and brain damage.

Undernutrition affects school performance and studies have shown it often leads to a lower income as an adult. It also causes women to give birth to low birth-weight babies. The first two years of life are a critical “window of opportunity”. In this period, it is possible to prevent the largely irreversible damage that follows early childhood undernutrition.

There are two sides to eliminating malnutrition: sustaining the quality and quantity of food a person eats; and ensuring adequate health care and a healthy environment.

WFP’s role in fighting malnutrition is to give malnourished people the food and nutrients they need, but also to prevent it, by acting where there is the threat of malnutrition.