Malnutrition commonplace in a rice surplus province

Luh Putu Trisna Wahyuni, The Jakarta Post, Mataram

Cases of child malnutrition are again surfacing in West Nusa Tenggara. The Jakarta Post's Ni Luh Putu Trisna Wahyuni digs deeper into the issue that has made national headlines.

Widespread incidence of malnutrition in West Nusa Tenggara has added to the long list of health problems faced by the province's four million people.

At least 487 children under five-years old have been recorded as suffering from malnutrition up until May 31, and 10 of these had died.

Four of the 10 dead succumbed at home, despite free treatment being provided at hospitals. Families prefer to take care of their sick children at home because they cannot afford to attend to them while they are in hospital.

Malnutrition is a disease resulting from an acute deficiency of protein and carbohydrate in the diet.

Sufferers usually die as a result of these deficiencies or because their bodies are no longer capable of warding off disease.

"If a child's abdomen is bloated, legs swollen and body becomes thinner, then he or she is positively malnourished which is known in medical terms as marasmus and kwashiorkor," said deputy head of the West Nusa Tenggara Health Office, Dr. I Komang Gerudug.

However, it takes several weeks or months for an undernourished child to acquire the disease.

In the early stages, a sufferer usually faces inadequate quantities and quality of nutrition intake.

Mothers should breast feed their infants until the age of six months. But that is not the case in this province where most babies do not get enough mother's milk for various reasons, such as mother's also being malnourished, the high maternal mortality rate, or mothers who leave their children behind to become migrant workers. The cause of the disease is multifarious.

If sufferers are not immediately treated, they will gradually become malnourished.

Due to their inability to heal themselves and their weak immune systems, many sufferers eventually succumb to diarrhea and malaria.

Their condition will deteriorate due to various contagious diseases both acute and chronic.

"There are still numerous contagious diseases in the province, especially those that infants are susceptible to, like pneumonia and diarrhea. Both illnesses can aggravate the condition of infants. Besides acute diseases, there are also chronic diseases such as tuberculosis and malaria," said Komang.

Malnutrition is nothing new or strange in West Nusa Tenggara.

Actually, many such cases are found in this province where 60 percent, or about 2.7 million, of people aged over 15 work in the agricultural or plantation sectors.

Data from the province's health office indicated that there were 1,544 malnourished children in 2004, with no deaths recorded.

"Perhaps there were deaths, but we never received any reports," said head of the health and nutrition department at the health office, Dr. Mari'e Sanad.

The rate of malnutrition in the province is cause for concern as it is higher than the national average. The national average is 8 percent of the total number of children under the age of five, while the number of undernourished children reached 10 percent of the 500,000 under-fives in West Nusa Tenggara.

The total number of under-fives suffering from malnutrition in the province is most likely more than this, because many cases go unnoticed or unreported.

Head of the West Nusa Tenggara Health Office Baiq Magdalena disclosed that only 50 percent to 60 percent of children under- five had ever been brought to an integrated health service post to receive health care.