DHAKA, Bangladesh, 8 April 2009 - There's a sense of urgency as health workers wind their way along tiny rickety alleys, past the washing, cooking and cleaning in Kachukhet Bazaar, one of Dhaka's sprawling slums.
Their mission takes them door to door, giving out small sachets of micronutrient powder. The health workers explain to mothers how to add the powder to ready-to eat-food for infants. It contains zinc to mitigate the effects of diarrhoea, iron to prevent anaemia and iodine to enhance brain development, as well as minerals and multi-vitamins.
Mothers in the slum, who have been giving their babies the micronutrients for some months now, have started to notice the difference.
"My child is doing a lot better," said Rupa Maidul Islam as 12-month-old Nupur bounced on her knee. "She has been gaining weight since she's been getting this powder
Two-thirds of income on food
But according to a recent survey by UNICEF Bangladesh, the World Food Programme and the Institute of Public Health Nutrition, the hardest of times are still ahead for Bangladesh. For the past two years, forces beyond the country's control have conspired against the poorest.
An extreme cyclone and floods devastated crops in 2007. Trade barriers and export bans, imposed by India, doubled the price of rice in March last year.
By the end of 2008, households were spending two-thirds of their income on food - up from 50 per cent in 2000. Already, even after a good harvest, nearly 60 per cent of households in Bangladesh do not have sufficient food.
The survey showed a clear link between malnutrition and household food insecurity, as food-insecure households had higher percentages of malnourished children. Almost half of all Bangladeshi children under five years of age are moderately to severely underweight. Nearly 40 per cent of the same children are stunted.
'A silent emergency'
"Looking at malnutrition, there has been no progress since the '90s," said UNICEF Representative in Bangladesh Carel de Rooy. "That is why it's a silent emergency. That is the situation today - and during this period there has been good economic growth."
The micronutrients distributed by UNICEF and partners have helped, but a lot more support is needed. Acute malnutrition among children is dangerously close to emergency levels. Huge food price hikes last year led to a spiral of borrowing. And now the world economic crisis is leading to job losses.
Moti Kahn is one of the many victims of the economic crisis in far-off lands. Since he came back from working Malaysia, his family has had to cut back on all the basics.
Widespread job losses
"I was so embarrassed [that] I had no savings. My children expected me to give them at least one gift when I came back," he said. "They look up to me and they're dependent on me. They say: 'You've been working abroad. You must have something.' But I haven't even bought a single piece of new clothing for anybody in the family."
Mr. Kahn is not alone. In his village in the Gazipur district, a recruitment agent said he is no longer trying to find Bangladeshi workers for jobs in the Persian Gulf countries and Malaysia. He said he hadn't bothered since December, because there are just no jobs. Malaysia recently cancelled work visas for 55 000 Bangladeshis.
In response to this 'silent emergency', UNICEF Bangladesh and its partners are working to strengthen food security in the areas of greatest need. They are also working on nutrition surveillance to allow early detection of changes in child nutrition and health, and in the food-security status of vulnerable families.