By: Sawan Khaskheli
BADIN: Sharifan Saand, a peasant woman in village Jumo Saand, near flourishing town Tando Fazul, Hyderabad district, carrying her five-year old daughter, said the baby does not show healthy growth despite family’s efforts to provide required food and medical treatments.
The mother has four other children as well — all as weaker as per standard growth. The reasons are different: lack of exclusive breastfeeding, inadequate complementary feed, unhealthy childcare practices, lacking diverse food, living in unhygienic conditions, unsafe drinking water and above all consuming Manpuri (a form of chewable like a gutka).
Sharifan’s husband works at a brick kiln unit on daily wages basis and can hardly earn Rs 2000—2500 per week. Irony is that the husband also chews Manpuri, spending a major share of their daily income.
Each manpuri costs Rs 20 to 50, depending on its quantity and quantity.
Sharifan Saand, 35, is among a large number of lactating mothers who is regularly chewing Manpuri, which not only causes health risks, but also impacts the lactating infants.
Lactating mothers often do not know the dire consequences of chewing Manpuri as it contains tobacco and other harmful ingredients.
Jumo Saand village comprises around 60 family, most of them agriculture farmers or working at brick kiln units located near the village.
She had come to a Basic Health Unit (BHU) in Tando Fazul town, where a nutrition assistant Mr. Gianchand, was dealing with such a patients, who said he often received a large number of patients daily, who suffer from poor diet, malnutrition and stunting.
“I have observed that the ailing children have many health problems because of having improper diet, which is required for their growth according to their age,” he said. Malnutrition is a common problem among the growing children — both girls and boys, he added.
A number of children in the surrounding villages are weaker in health, undernourished and short-heighted. The main reason is malnutrition of mothers.
Fahmeeda Almani, another mother in her late 30s in village Sono Khan Almani in the same neighbourhood, said her son is two-years old and suffering from perpetuated fever. The mother was unaware about the deteriorating health of the child, who herself looked weaker.
Malnutrition among children is a common problem in the urban as well as suburbs of Hyderabad, the second largest city of Sindh province. Hyderabad district is the most productive in terms of agriculture, horticulture and forest economy.
Elderly women recalling the blissful days of the past said they used to work in agriculture crops, performing different tasks and lived healthy lives. But now the emerging changes in this economic sector, including machinery have put women out of work.
A recent UNICEF report says in Pakistan, 38 percent of children under the age of five years are stunted. The situation is particularly worse in Sindh province, where it has affected approximately 50 percent of children- the number is increasing.
The most direct causes are inadequate nutrition. The people do not know how the nutritious food consumption could be helpful to live a healthy life.
The National Nutrition Survey (NNS) 2018 data indicates that Sindh province has the highest number of underweight children.
Management and Development Foundation (MDF), a research-based non-governmental organization (NGO) has initiated the work in collaboration with Sindh government’s Accelerated Action Plan (AAP) which is funded by the World Bank to reduce stunting and malnutrition among children under five years and pregnant and lactating women (PLWs).
Khairunnisa Daudpota of MDF said the organization has hired 794 community health workers (CHWs) for uncovered areas of Hyderabad district, both in rural and urban areas. These CHWs have to identify the cases of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) through screening and refer to the health facilities for their treatment.
“We focus on all such segments of the population that are nutritionally vulnerable and on whom stunting prevention strategies could be most responsive,” she said.
While visiting areas coming in the vicinity of Tando Fazal, Hyderabad district it was observed that minor children do not have proper diet to maintain their natural growth. Most of them were suffering from stunting.
Sharing achievements, she said after their intervention many women have improved their diet, which may help their babies’ healthy growth. She believes that the community ownership over their interventions seems helpful as women are cooperating and getting supplementary diet for their children to recover and avoid any loss.
Ms. Daudpota said they have proposed a number of interventions under various sectors, some of which have a direct and immediate impact on the prevention of stunting. The actions include awareness regarding infant and young child feeding, balanced diet, immunization and child health care, as a proper care is a better option to resolve the health issue related to children and mothers.
By: Sawan Khaskheli