Monday, 4 April 2016

Fighting malnutrition in Indonesia: ‘My children are crying for life — not death’

A few months ago, 2-year-old twins Randy and Rendy Tabun looked fragile, lethargic and thin. The twins suffered from severe acute malnutrition and remained firmly planted in their mother’s lap, unable to stand or walk on their own.

A local nurse in their village of Nitneo village in Kupang District in eastern Indonesia took notice and the boys became two of the first patients enrolled in a new programme to treat severe acute malnutrition.

Across Indonesia, malnutrition is a serious public health problem. More than 12 per cent of children under the age of 5 are acutely malnourished. Severe acute malnutrition affects 1.3 million Indonesian children and moderate acute malnutrition affects 1.6 million. With these figures, Indonesia ranks fourth in the world in the number of children suffering from acute malnutrition.

According to criteria from the World Health Organization, the prevalence of acute malnutrition is critical in six provinces in Indonesia, including Nusa Tenggara Timur in the eastern part of the archipelago, which is where the boys are from.

Acute malnutrition develops when children are unable to eat enough nutrient-rich food or suffer from diseases such as malaria, diarrhoea, pneumonia and HIV. A lack of proper nutrition at an early age can impair the immune system and increase the duration and severity of infectious diseases, and ultimately — if not treated — cause death.

Children like Randy and Rendy are given a nutrient-rich paste known as ready-to-use therapeutic food, which is a medical treatment for severe acute malnutrition. They are also given medicine to treat any underlying health problems.

UNICEF is working with the Ministry of Health, local government authorities and Action Contre La Faim to introduce these new services to identify and treat children with severe acute malnutrition.

The programme also seeks to build the capacity of health workers and community volunteers to counsel mothers on breastfeeding and complementary feeding so that their children are less likely to become malnourished in the first place. Randy and Rendy’s parents had seen the difference this makes for themselves because at 6 months of age their exclusively breastfed daughter was already bigger than her malnourished elder brothers!

During the first two days of treatment, the boys cried and refused to finish the packets of nutritious-rich paste, preferring their usual tea and biscuits. But their mother persisted — going so far as to place the packets directly in front of their bed so that it was the first thing the little boys saw when they woke up in the morning.

It worked.

It was not long before the two boys started calling out for the packets. And one month into the programme regimen, the boys are noticeably healthier and stronger. Randy, the older twin, is able to walk, while Rendy is able to stand and is learning to walk.

The twins’ father had earlier shown hesitation about any health intervention, but he is now a supporter, asking about the boys’ daily intake when he arrives home from work.

The boys’ mother said the improved health outcomes have shown that persistence pays off. “My children are crying for life — not death,” she said. “So I must help them live by what I believe.”

For little Randy and Rendy, the programme means a chance for a brighter, healthier future.