By Guy Hubbard
A new report by UNICEF reveals the high prevalence of stunting in children under 5, but also outlines the tremendous opportunities that exist to make it a problem of the past.
Talking to families in their homes about nutritious diets and healthful household behaviours is part of the fight against stunting in Bangladesh.
JAMALPUR, Bangladesh, 16 April 2013 – Monsoon rains lash down in northwest Bangladesh. The rising waters flood fields and rice paddies, turn dirt tracks and paths into muck.
Saerni Shirka, clutching a small purple umbrella, braves the storm to go door to door in the rural villages around Jamalpur. A community health worker for more than 20 years, she’s on a mission to educate mothers about how best to feed their children.
High rate of malnutrition
The monsoon floods, while potentially destructive, are a vital part of the country’s rural economy. The waters carry rich silt from their Himalayan sources. When the waters recede, the soil is left fertile. The floodwaters also carry fish downriver and through villages, providing poor fisherfolk a rich source of protein – and income.
But, despite the fertile soil and fish stocks, the children of poor families here aren’t getting the nutrition they need.
Bangladesh has one of the highest malnutrition rates in the world. Forty-one per cent of children under the age of 5 suffer from moderate to severe stunting, an indicator of chronic malnutrition. Many of their parents are farmers and fishers. The farmers grow rice almost exclusively, and the fisherfolk sell off everything they catch to buy the rice.
Rice is the traditional staple food here. The nutrition it provides is not enough for growing children.
Teaching the benefits of a diverse diet
“Many families here do have access to vegetables and fish,” says Ms. Shirka. “But the main thing we’ve found is that they don’t know about the benefits of eating vegetables, fish and these sorts of things. They don’t know how the diversity of foods and nutrients will improve a child’s health. So we try to tell them why it’s important, and how it can be done easily.”
When the rains let up, she convenes a meeting of mothers. They discuss the importance of exclusive breastfeeding, hygiene and including vitamin- and protein-rich ingredients with every meal. All of these behaviours are major factors in reducing malnutrition here.
Ms. Shirka’s rounds are part of a joint initiative by UNICEF and the European Union to educate mothers and pregnant women about the importance of nutrition and a varied diet. The 41 million euro global partnership is aimed at reducing the rate of malnutrition in nine developing countries.
Breaking through cultural barriers
In addition to the void of knowledge Ms. Shirka is filling, there are also cultural restrictions and taboos governing what can and cannot be eaten. Breaking through these taboos can be the toughest part of educating mothers, and Ms. Shirka will often repeat her lessons to the same groups of mothers again and again.
Slowly but surely, she feels she’s making a difference.
“There are these false beliefs out there, these traditions, that certain foods are not good for children. Many mothers here believe that vegetables are not good for children. But, after counselling and motivating them continuously, they’re starting to do the right things, and their children are getting the benefits. They’re sick less often, they’re running around, playing, they have more energy, they’re healthy – and they’re growing up strong.”
Hitting home, at home
When the meeting ends, Ms. Shirka follows one of the mothers home for a door-to-door session. For, it’s in the family houses that the message really hits home.
Ms. Shirka conducts one-on-one nutrition sessions with mothers of young children, showing them how to cook nutritious meals. She also provides boxes of micronutrient powder to mothers of children under 2 years old – and explains how to use them.
For Chaya Rani, a mother of three, it’s been a busy, but insightful, day.
“I’ve learned a lot today,” she says, “first at the regular session with the other mothers, and then here at my home. They explained everything regarding nutrition starting from exclusive breastfeeding to complementary feeding and how to actually prepare the food. They also told us that we needed to change our ways of thinking about food.
“I believe that, if we follow their advice and their demonstrations, everyone in this village will live a healthier life,” she adds.
It’s a slow process, changing mindsets, breaking traditions and taboos. But it is vital to the health and future of the children of Bangladesh, and to the health and the future of the country, as a whole. If these traditions and taboos survive here, so, too, will malnutrition.