'Hidden hunger' affects infant development

'Hidden hunger' affects infant development

By Joe Cochrane

JAKARTA (DPA): Sitting in her makeshift wooden house along a railway track in an east Jakarta slum, Samila, the head of an Indonesian family of five, just laughed when she was asked about the last time they ate meat during a meal.

Samila, 32, who like many Indonesians uses only one name, does not have a faulty memory: The family's joint salary from scavenging through garbage cans at a nearby luxury shopping mall for plastic, aluminum or anything else of value is about Rp 10,000 a day, which is just enough to buy rice and a few vegetables.

"Meat is too expensive," she yelled as a passenger train rumbled by less than a metre from her front door. "What we earn is just enough to get by."

Nearby, Samila's daughter, Sulasi, 18, breastfeeds her infant son, who refused to eat spoonfuls from a bowl of gruel-like hot water, vegetables and rice.

As the women talked about their life - they moved to Jakarta in 1998 when the Asian Economic Crisis sent unemployment soaring in their east Java village - they were unaware that malnutrition was attacking the five-month-old boy, Jahrady, not to mention the entire family.

Malnutrition is a constant in developing countries, but Indonesia, one of Asia's "Tiger Economies" of the 1990s and fueled by 210 million people, is facing a problem of epidemic proportions.

As many as 20 percent of the country, or 52 million people, suffer from some form of micro-deficiency malnutrition, such as lack of iron, zinc, Vitamin A or iodine.

These essential vitamins are found in basic staples like red meat, eggs and iodized salt, which many Indonesians can no longer afford.

The government estimates that more than three million babies born after the 1997 economic crisis are malnourished, prompting warning bells of a "lost generation" of sick, growth-stunted children.

"It's called 'The Hidden Hunger,'" said Dutchman Ernest Schoffelen, a nutrition project officer with the United Nations Children's Fund in Jakarta.

"It's not so visible, but if you compare a child on certain development stages, like when the baby is able to hold its head up or sit up, a delay in this is a result of the lack of micro- nutrients," he said.

This form of malnutrition has a devastating affect on physical and mental development: Schoffelen said studies showed Indonesian children who were iodine deficient were lower in I.Q. by 13.5 points.

He said around half of the country's child population under 5 years old and 60 per cent of pregnant women suffered from iron deficiency, which can lead to decrease of 5 to 10 I.Q. points among children and new-borns.

Iodine deficiency causes a variety of health problems including cretinism, deaf-mutism, goiter and dwarfism, while a lack of zinc retards infant growth.

Indonesia's growing malnutrition problem is directly linked to its economic meltdown, which saw unemployment double to as high as 60 million people virtually overnight.

"That has influenced people's purchasing power with those quality foods," Schoffelen said. "People would could afford to buy a piece of meat once a week can no longer do that."

Jakarta's urban slums are packed with day laborers who lost their jobs during the crisis, so it was no surprise that anemia among infants in those neighborhoods increased by 80 percent, he said.

Indonesia also has tens of millions of adults who are malnourished, but their medical problems cannot be solely blamed on poverty, health officials said.

The government is mulling over campaigns to educate Indonesians of all income levels to vary their diets with foods such as eggs and milk, rather than solely eating rice, the national staple.

"It's habit," said Sofjan Sudardjat, director-general of livestock services at the Ministry of Agriculture. "We were (wrongly) told as youngsters not to drink milk because it could cause diarrhea, and not to eat eggs because it could cause abscesses."

He said Indonesians had the lowest consumption of meat per capita in Southeast Asia, far worse than smaller developing countries such as Cambodia and Laos.

"We fear that if the older generation is used to those habits, the younger generation will follow," Sudardjat said.

Indonesia, which is lagging far behind its neighbors in recovering from the 1997 crisis, cannot afford to let that happen. Adults who suffer from iron deficiency have less physical and oxygen capacity, and Indonesia could lose as much as US$7 billion annually in productivity, Schoffelen said.

The Ministry of Health and Social Welfare is set to launch a revised national nutrition guideline in an effort to encourage people to eat properly with an alternative main dish, besides rice.

However, such programs will likely not help Samila and her family, or other slum dwellers in Jakarta.

The cash-strapped government is spending less than three per cent of its 2000 national budget on health, which is around half the amount spent by neighboring countries. Many welfare programs are riddled by corruption, which means budgeted distributions of iodized salt and iron tablets often never reach their intended recipients.

"We get no help from the government," Samila said. "If any international aid is given to Indonesia, please don't give to the government. We will never receive it."