For many in the West, The Hunger Games is a box-office hit and a bestselling novel. For most Pakistanis, however, hunger games are no work of fiction. While several million Pakistanis are starving where only eight per cent of the children receive minimum acceptable diet, the government in Islamabad is finalising the budget, which if previous budgets are any indication, is unlikely to address hunger and misery that has spread to every nook and cranny in the country.
Madam, malnutrition is a pathological condition resulting from deficiency of one or more nutrients and has a wide range of clinical manifestations. Children are amongst the worst-affected groups. In 2001, it was noted that malnutrition caused 54% deaths in children living in developing countries.1 The World Health Organization through the Millennium Development Goal 4 has recognized that improved nutrition is crucial in reducing the under-5-years mortality,especially in the developing countries.2
Laying its special emphasis in our part of the world, the percentage of malnourished children is highest in Asia with 70% of undernourished children living in this part of the world. In South Asia, one out of two preschoolers is underweight and has stunted growth.3 In Pakistan,33.03% (CI= 27.96-38.54)of children under the age of 5 are underweight, 53.38% of the children are stunted and wasting has been reported in 11.52% of the children,4 which clearly shows that the nutritional status in this country is poor.Goiter caused by iodine deficiency is also common with the highest cases reported in Pakistan, India and parts of Indonesia.3
Marasmus, Kwashiorkor or Marasmus Kwashiorkor will probably develop in a child who is malnourished for a prolonged period of time leading to an increased mortality. Children who are undernourished are more susceptible to the effects of infectious diseases compared to children who are adequately nourished.1 Infections can in turn lead to more undernourishment as food intake is decreased during infection and this turns into a vicious cycle.
One of the possible causes of such status could be declined production of food.1 Many landscapes that were once fertile are deemed barren due to environmental pollution caused by mankind. This in turn leads to less land that is available for farming and ultimately food production per acre is insufficient to touch base with other countries. Poverty, unawareness, population growth, political instability, loss of food stock due to poor harvest and natural calamities are some of the important factors causing malnutrition amongst children. Malnutrition in Pakistani children has been directly linked to illiteracy of mothers, low family income and larger family size.5 Maternal undernourishment is also a contributing factor to babies being born with low-birth-weight.1 The increased basal metabolic rate due to acute and chronic illnesses may also precipitate the pre-existing malnutrition.
The National Nutrition Survey 2011 released here has indicated that stunting, wasting and micronutrient malnutrition are endemic in Pakistan. The report said the increasing rate of chronic and acute malnutrition is primarily due to poverty, high illiteracy rates among mothers and food insecurity.
The survey was conducted by the Aga Khan University’s Division of women and child health, Pakistan’s Ministry of Health and UNICEF. The last such survey was conducted in 2001-2002, according to federal planning minister Ahsan Iqbal who said task forces must be formed to address the situation.
The survey found widespread micronutrient deficiencies among women especially in those pregnant — 51 per cent surveyed were anaemic; 46 per cent had vitamin A deficiency; 47.6 per cent had zinc deficiency; and 68.9 per cent had vitamin D deficiency. Anaemia was high at 50.4 per cent in other women too.
Among children under five, 43.7 per cent were stunted in 2011 as compared to 41.6 per cent in the 2001 National Nutrition Survey. Children under five also suffered from: anaemia-61.9 per cent; iron deficiency-43.8 per cent; vitamin-A deficiency- 54 per cent; and zinc deficiency 39.2 per cent. In the Saarc, Pakistan has the second highest stunting rate for children under five years- 43.7 per cent. About 32 per cent of the children were underweight. The elderly population too was not spared with over 53.9 per cent not having normal weight.
Last week, a four-rotor unmanned drone took off from a pizza outlet in the populated Lower Parel area of Mumbai, as part of a test mission to deliver pizza to Worli, which it successfully accomplished.