'I don't know what nutritious food is'

'I don't know what nutritious food is'

Luh Putu Trisna Wahyuni, The Jakarta Post, Mataram

Thirteen-month-old Muhammad Azmi, feeble and with a swollen
stomach, is crying in his mother's arms. He is one of the many
unfortunate children in West Nusa Tenggara suffering from
marasmus, chronic undernourishment resulting from calorie and
protein deficiency.

The second child of Saleh and Suli, residents of Presak
Sidakarya, Lingsar district in West Lombok regency, was four
months in the womb when his father went to Malaysia to seek work.

Upon the departure of her husband, Suli moved in with her in-
laws, which is normal on Lombok island.

Although her husband works in the more prosperous neighboring
country , Suli said he sent home money only twice. "I used it up
for the child's birth and other needs. He has not returned home
as yet," said Suli, who works as a farmhand during the planting
and harvesting seasons with her in-laws.

"If there is no work tilling other people's land, then I just
sit around idle," said Suli, who usually gets Rp 5,000 (52 U.S.
cents) for sowing rice seedlings on a one hectare plot, and gets
15 kilograms of unhulled rice for stripping the husks of 100
kilograms of rice during harvest time.

The elementary school graduate acknowledged she had no
difficulty in obtaining rice. For side dishes, she only has to
look for vegetables easily available in the surrounding areas.

"Rice is still our staple food, but only eaten with boiled
vegetables, such as cassava leaves or long beans. They're easily
available, and there's no need to pay for them," Suli said.

She said the villagers rarely ate tofu, tempeh or fish, and
use firewood to cook. "We only eat meat during festivals," said
Suli. Rice and boiled vegetables with sambal (chili paste) is
very appetizing and is the family's favorite dish, she said.

"I don't know what nutritious food is. For us, eating rice and
vegetables every day is already nutritious. I only learned of the
meaning of nutrition when Azmi became ill and had to be brought
to the hospital," she said.

Azmi eats the same food as his mother every day. "Azmi's
favorite is rice and boiled cassava leaves," she said.

It was only after Azmi's health deteriorated significantly he
was taken to the doctor, who later referred him to the hospital.

When Azmi was first taken to hospital, he only weighed some
eight kilograms, with his abdomen severely bloated and his legs
swollen.

After undergoing treatment for 16 days in Mataram General
Hospital, his weight had fallen to seven kilograms but the
swelling of his abdomen had subsided. However, his health was
still poor, and he suffered from a high fever and persistent
coughing.

Rice-rich West Nusa Tenggara hit the headlines recently after
media reports disclosed that 487 children were suffering from marasmus.
Ten of them died as a result. The real number of children with
marasmus is estimated to be much higher as many cases are not
officially reported to the province's health office.

According to www.emedicine.com, marasmus is one of the three
forms of serious protein-energy malnutrition (PEM). The other two
are kwashiorkor (KW) and marasmic KW. According to the World
Health Organization, 49 percent of the 10.4 million deaths
occurring in children younger than 5 years in developing
countries are associated with PEM.

Other families with malnourished children lead similar lives
to Azmi's family.

Nurul Janah, a 10-month-old malnourished baby girl, only
weighs four kilograms. She lives in a house with plaited bamboo
walls in a densely populated area of Karang Pule, Mataram, where
the houses are tightly packed together with almost no space
between them.

Nurul is the daughter of M. Sai and Rumenah. Rumenah is a housewife,
while her husband works as a cidomo (traditional horsecart)
driver who sometimes does odd jobs.

"My husband earns only between Rp 5,000 and Rp 6,000 daily. We
normally eat rice with vegetables, but rarely eat fish, unless my
husband earns extra money," said Rumelah.

Nurul, who is just starting to consume solid food, eats the
same food as his parents. "Besides mother's milk, I also feed her
rice porridge," she said.

As her health deteriorated, Nurul first experienced a high
fever before her temperature dropped below the normal level.
Gradually, she became thinner.

In both cases, neither Suli or Rumenah realized their children
were malnourished. All they knew was that their children were
ill.