BACKGROUND
Since the first group of refugees arrived in Thailand in 1984, the TBBC food basket has evolved from only 50% rice to a full food basket. Over the years, opportunities for the refugees to supplement the food basket have decreased substantially, and the refugees are now dependent on food aid. This briefing paper outlines the main elements of TBBC's nutrition programme in the camps.
TBBC FOOD BASKET
Fortified blended food (AsiaMIX) has been introduced into the food basket to address dietary deficiencies which is offset by a reduction in rice.
The TBBC Food Basket provides:
an average of 2210 kcal per person per day (average of adult and child rations) and is 74% carbohydrates, 9% protein, and 17% fat (% of kcals) adequate amounts of most vitamins and minerals and an easily used weaning food following the introduction of fortified flour to the ration in 2004
SUPPLEMENTARY/THERAPEUTIC FEEDING PROGRAMMES
Supplementary and therapeutic feeding is supported and guided by TBBC and administered by the health agencies in the camps.
target groups include pregnant and lactating women, acutely malnourished children and adults, TB/HIV and chronically ill patients, including disabled persons, and infants unable to breastfeed. supplementary feedings are distributed as dry, take home rations that are prepared in the home and therapeutic feeding is hospital-based. new statistics and nutrition surveys identify programme coverage and average length of stay in programme to determine efficacy.
NURSERY SCHOOL FEEDING
TBBC support school lunches in most nursery schools in most camps at 3 baht/child/day, plus oil and AsiaMIX. Meals include meat, fruits and vegetables in addition to rice.
VITAMIN A
TBBC oversees the procurement (via UNICEF) and distribution of vitamin A supplements to the camps for prevention and treatment of vitamin A deficiency. target groups for prevention include children <12 years and lactating women coverage is targeted at 95%
NUTRITION STATUS
TBBC supervises and reports on annual nutrition surveys on children under 5 years of age in all camps in collaboration with health agencies. All agency staff participating receive refresher training and supervision during the survey. Nutrition issues in the camps are as follows: acute malnutrition is within acceptable limits (<5% of children under 5 years, WHO criteria) chronic malnutrition is moderate to very high (between 25-48% of children under 5 years, WHO criteria) acute malnutrition is due mainly to social issues (care practices) or new arrival status, and chronic malnutrition is mainly due to child weaning/feeding practices, micronutrient intake, and recurring infection.
Beriberi
Beriberi continues to be reported. Following revision of the case-definition and medic training, rates have steadily declined. Beriberi is no longer used as a programme indicator.
Angular Stomatitis (AS)
Clinical detection of AS is included in nutrition surveys as a more sensitive indicator of micronutrient deficiency in children. AS is found in most camps.
NUTRITION TASK FORCE
TBBC leads the Nutrition Task Force with the health agencies to identify and address issues and coordinate nutrition-related education and other activities in the camps.