'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.