TONGWAI, Lao People’s Democratic Republic (February 13, 2013) — The rice is in harvest. As ears ripen, the landscape turns from green to gold. Farmers are hard at work, harvesting, threshing and pounding the grains.
Rice is a staple food for over half of the world’s population. Nowhere is rice more ingrained in diet and culture than here, in Southeast Asia.
The Lao People’s Democratic Republic has one of the highest consumptions of rice per capita in the world. In rural areas, rice provides 80% of calorie intake. Even the word ‘eat’ translates directly as ‘eat rice’.
But while it is a rich source of energy, rice doesn’t contain all of the nutrients for adequate nutrition. An over-reliance on rice has left children here among the most undernourished in the region. Thirty-one percent of children under five are underweight, and 48% are stunted in the Lao People’s Democratic Republic. Malnutrition affects both the physical and cognitive development of children. More than 1/3 of deaths of children under five years old in developing countries, like the Lao People’s Democratic Republic, are attributable to it.
Sing Sanyalad is the deputy head of Tongwai health center. He diagnoses and treats malnutrition on a daily basis.
“Parents aren’t feeding their children properly because they don’t know about nutrition,” he explains. “And when the children get sick, they don’t know why.” He adds, “That’s why it’s important to screen every child in rural villages for malnutrition.”
Sing and his team are part of a cadre of more than 200 health workers across the three provinces most heavily affected by malnutrition who identify and treat severely malnourished children. Based in health centers, they also provide outreach to distant villages. There, they work closely with community volunteers who use mid-upper-arm circumference tape to diagnose malnutrition early.
Today, the team have come to do malnutrition screening in Bantongyao village, part of the catchment area of the Tongwai health center. Through the screening, they diagnose nine children suffering from moderate acute malnutrition and two from severe acute malnutrition.
One of the latter is 11-month-old Mord, who’s been brought here by his aunt. His story is typical of many children under five in the country. After having been breastfed at the beginning of his life, he was moved on to rice. Now, rice is all he eats.
“When we find cases of severe acute malnutrition,” says Sing, “we provide two weeks’ worth of ready-to-use therapeutic food, which we receive from UNICEF. After two weeks, we do a follow-up with the patient to see whether or not the weight has improved.”
Mord’s aunt, Eaya, is given the two-week supply and advised how best to feed her nephew from now on.
“The doctor advised me about my nephew’s health,” she says. “He told me that he’s malnourished and that he needs to be treated and checked again in two weeks’ time. He told me that if he continues to be malnourished, it will affect his health. So from now on, in addition to the paste, I will add meat, eggs, fruit and vegetables to his food to make it rich and to make him healthy.”
The screening and treatment are part of a program in partnership between UNICEF, the European Union and the Government of the Lao People’s Democratic Republic. The program aims to treat those who are suffering from malnutrition—but also to educate communities about its causes.
In the long term, education is key. As part of the program, members of the Laos Women’s Union have been trained by UNICEF partner Health Poverty Action to teach pregnant women and mothers about proper nutrition and hygiene. Each month brings new lessons and new advice.
“Before, many women and children suffered from malnutrition,” explains Vone, head of the Navienhong village branch of the Laos Women’s Union. “Even though there was lots of food in the village, mothers didn’t know how best to feed themselves and their children. They didn’t know which foods were good for them. I went to the district headquarters for training, and now I give the women here health education. I teach them about nutrition and hygiene practices. Since I started this, I’ve noticed that there is less sickness in the village and that children are much healthier and better nourished.”
It’s this growing awareness of nutrition that the European Union, the government and UNICEF hope will change eating and feeding habits in the Lao People’s Democratic Republic. And it’s this growing awareness they hope will end malnutrition.