Children try iron-rich diet to prevent anemia

Leony Aurora, Jakarta

For Sri, a third grader at public elementary school 2 on Kelapa island in the Thousand Islands, nothing compares to eating freshly caught fried fish cooked by her mother.

"I like pomfret fish best," she said while watching her friends going one by one to the front of the classroom to get their blood checked.

Her school was one of six elementary schools on Panggang, Pramuka, Harapan and Kelapa Islands where children were checked for anemia by the Kusuma Bangsa Foundation last week.

Little did Sri know that her favorite food plays a big role in preventing anemia, a condition where a person has a below-normal hemoglobin count.

The survey by the non-governmental group, involving 1,717 elementary school students from grades one to six, found that 19.29 (eds: figures are checked) percent of the children had hemoglobin counts that were considered below normal.

The survey reaffirmed earlier findings that anemia is prevalent among children between the ages of six and 12. Similar surveys held by the foundation in 2000, 2001 and 2002 among elementary school students in Jakarta found that 35.1 percent, 49.5 percent and 34.1 percent of the students had anemia.

"It is disturbing that children that age already have this disease," said Adi Sasongko, chairman of Kusuma Bangsa.

Anemia reflects a lack of iron, a vital substance in the production of hemoglobin, in the diet. Hemoglobin transports oxygen from the lungs to the rest of the body.

"In junior high school, as girls start having their periods, more of them will have anemia," said Sasongko.

Because many girls face body image problems in high school, their hemoglobin counts may decline even further as they eat unhealthy diets in an attempt to lose weight.

Children with anemia have difficulty concentrating and shorter attention spans because the brain gets less oxygen than needed. They are also likely to get tired more easily than their peers.

Like previous programs, the survey in the Thousand Islands will be followed by a seminar to announce the findings to the local administration and teachers. There will also be a series of meetings with parents to advise them about what measures they should take to protect their children from anemia.

Experts will talk to the parents about the causes and effects of anemia and ask them to include iron-rich foods in their children's diets, such as liver and green, leafy vegetables.

Children need to absorb an average of 1 mg per day of iron to keep up with the needs of their growing bodies. Since children only absorb 10 percent of the iron they eat, foods high in protein or vitamin C, such as fish, oranges and peas, can help prevent anemia because those substances help the body absorb iron.

As a short-term solution, the foundation will also arrange a 12-week program for the students. They will receive two tablets of iron supplements twice a week.

"This step is intended to raise their hemoglobin count to a normal level," said the foundation's project officer, Mundi Mahaswiati.

A weekly lunch party will also be introduced. "Parents cooked the dishes, which have to include iron-rich food, and the students will eat together in class."

"Kids who do not like vegetables can be encouraged by seeing their friends eating vegetables," said Mahaswiati.

This program has been introduced at several schools in Jakarta with satisfying results. In 2001, the program was held at 13 elementary schools in Jakarta with 3,160 participants, and was able to bring down the number of students with anemia from 49.5 percent to 12.3 percent over the course of the 12 weeks.

Because the parents come away with more knowledge of the importance of iron, they are expected to continue providing iron- rich foods to their children after the 12-week program is over.

Sasongko also urged the government to implement similar programs at elementary schools throughout Indonesia. School programs to overcome anemia are more likely to succeed because students "fear" their teachers, "sometimes even more than their parents", he said.

Another advantage is that the students take the tablets together at school, under the supervision of teachers. "So we know for sure that they are taking the supplement regularly."

The government is currently focusing on preventing anemia in pregnant women. But bear in mind, stopping anemia must be done as early as possible, because anemic girls are more likely to become anemic women and mothers, who in turn will pass down the disease to their children.

"This vicious cycle needs to be stopped," said Sasongko.