Neglect and ignorance blamed for malnutrition in NTB

Luh Putu Trisna Wahyuni, The Jakarta Post, Mataram, West Nusa Tenggara

The poor health of people in West Nusa Tenggara (NTB), as seen by the high rate of malnutrition among children, is due to poor economic conditions and the high poverty rate in the province.

According to data from the Central Bureau of Statistics (BPS), nearly 30 percent or about 1,031,000 people in the province still live below the poverty line, while data at the National Family Planning Coordinating Board (BKKBN) indicates a staggering 56 percent of families classified as poor.

Despite that, with 2.7 million of its people working in the agricultural sector, NTB has a surplus of food, especially rice, and can even distribute it to other islands in large quantities.

The province yields 1,457,226 tons of dried unhulled paddy or the equivalent of 734,442 tons of rice annually, 527,497 tons of which is for local consumption, with a surplus of 206,945 tons.

NTB's regional division of the State Logistics Agency (Bulog) has a stock of 84,500 tons of rice at its disposal, and the rest is sent to other islands.

Based on the reports of the local Food Stock Agency conveyed by head of the food pricing and distribution division Dadih Permana, NTB shipped on average 300 tons of rice monthly to Makassar in South Sulawesi, Ende, Maumere and West Sumba in East Nusa Tenggara and Surabaya in East Java, from January to June, 2004.

Based on data from the NTB Agricultural Office, the rice supply during the period January to December this year, stands at 844,340 tons, of which 530,788 tons is used for local consumption, leaving a surplus of 313,552 tons.

Seen from its available rice, NTB is not facing any shortage.

It is therefore understandable that many people, including Minister of Health Siti Fadilah Soepari, were surprised to learn that the people of NTB are facing food shortages and malnutrition.

According to the minister, there are three factors responsible for the rampant malnutrition.

First, the area is prone to food shortages and crop failure. Second, food is available in the area but people's awareness of nutrition and a balanced diet as well as a healthy lifestyle is still low. The third factor is, children there are susceptible to illnesses, for example tuberculosis, which makes it difficult for them to eat.

Siti indicated that NTB might be facing the latter two conditions because the province had surplus rice stocks, and families of affected children acknowledged that they still ate rice every day.

The provincial administration has denied that the cases of malnutrition in the province are because the people are starving.

"NTB is not facing a food shortage. The malnutrition found here is not due to hunger, but more the inactive role of integrated health service posts, the lack of awareness of nutrition and the low level of education of residents," said NTB administration spokesman, Lalu Gita Aryadi.

This view was supported by the NTB Health Office.

Deputy head of the NTB Health Office, Dr. I Komang Gerudug, said that malnutrition in the province was caused by inadequate nutrition.

With more than one million people in NTB classified as poor, or more specifically the latest BKKBN data showing that 56 percent of the families in NTB are poor, it makes sense that most people cannot afford to buy the food needed to have a balanced diet.

Parents and other care givers' lack of knowledge of the need for a balanced diet is presumably another factor.

On the technical side, another problem faced by NTB is the absence of a food and nutrition monitoring team.

Komang acknowledged the lack of medical care and efforts to supplement the nutritional intake of residents lately. The role of integrated health posts, deemed the spearhead of public health care, have started to decline.

"We have almost abandoned them, perhaps due to lack of funds, lack of attention toward medical care, and instead diverted our attention to politics. On the other hand, it is difficult for us to employ personnel to run an integrated health service post, especially volunteers. How will we get the money to pay them?" said Komang.

The impact has been felt. There is no staff to do house calls, causing parents to neglect their responsibility to have their children under five weighed.

The posts, which are managed by the district administrations, are now mostly inactive as indicated in a survey conducted by non-governmental organizations in NTB.

Thirteen NGOs grouped in the Alam Sukma organization revealed their findings after conducting research on the eating patterns of local residents over several years. They found that in general, parents and other care givers were uninformed and incapable of providing nutritious food, and due to other family problems like divorce and mothers who sought work outside the province, children were being taken care of by their grandparents, aunts and other members of the family.