Half of Indonesia's under-fives lack Vitamin A

Debbie A. Lubis, The Jakarta Post, Jakarta

Up to 10 million children, or half of the country's total of 20.8 million children under five, suffer from vitamin A deficiency, making them vulnerable to blindness and infection- related death.

Most children with vitamin A deficiency live in areas with high levels of poverty, in refugee camps, or in regions with a scarcity of food resources containing vitamin A.

"Children are more likely to suffer from vitamin A deficiency if they are malnourished or if their parents forbid them to consume protein-rich food like fish or eggs," Minister of Health Achmad Sujudi said here over the weekend.

In order to address the problem, the government would provide free vitamin A supplements in community health centers (Puskesmas) and infant health centers (Posyandu) in the areas concerned in February and August.

Vitamin A is found in all animal liver, eggs, meat and milk products containing milk fat. In addition, green leafy vegetables, and many yellow and red fruits contain substances that can be converted into vitamin A in the body.

Sujudi said that vitamin A deficiency in the early stages gave rise to symptoms like dry and rough skin, reddish hair, and vision impairments.

"Children soon die because they are less able to resist infection due to decreased immunity," he said.

Vitamin A deficiency would also impair the ability of the white blood cells to fight infections such as measles, diarrhea, tuberculosis and pneumonia, as well the body's ability to fend off intestinal worms.

Vitamin A deficiency had several early warning signs and symptoms, including night blindness, meaning that children could not see in dim light and frequently stumbled into things.

Sujudi said that some 60,000 children with vitamin A deficiency were displaying Bitot's spots, a condition in which the mucous membrane covering the eye (the conjunctiva) became affected by foamy, whitish patches that diminished sight even in broad daylight.

Another symptom was dryness, and slight roughness or wrinkles in the mucous membrane, which was normally moist, smooth and shiny. Changes in the tear ducts also led to reduced moistness in the eyes. If the mucous membrane became damaged, a child would be unable to see properly and could go blind.

Rachmi Untoro, director of community nutrition at the Ministry of Health, said that the best way to prevent vitamin A deficiency was through nutrition education promoting the consumption of vitamin-A-rich food, and the consumption of large dosses of vitamin A.

She urged mothers to bring their infants and toddlers to Puskesmas and Posyandu in every district to get free, high-dose vitamin A supplements in February and August.

"Blindness is a seriously irreversible change. It is therefore important for us to recognize and treat any symptoms of vitamin A deficiency," she explained.

Sujudi said children who were already displaying the symptoms of vitamin A deficiency should take the vitamin A supplement three times: immediately after deficiency was detected, the next day, and again after two weeks.

Rachmi said that parents should provide a well-balanced diet that was rich in protein for their children.