10-16 July 2015 #766

Local is best

Instead of micronutrient additives for children living in earthquake shelters, we should promote nutritious local foods
Aruna Uprety

When the National Planning Commission carried out a post-disaster needs assessment last month, its final report underlined the need to use local indigenous foods wherever possible to overcome malnutrition among children and infants living in temporary shelters.

That was a welcome statement, however that is not what is happening. In fact, the reason nutritious local foods are not being used is because we are inundated with so-called ‘emergency’ food supplements and micronutrient additives.

Children everywhere are nutritionally vulnerable when disasters strike not just because of the lack of proper diet, but also because of poor hygiene, sanitation and physical stress. Post-earthquake children in the 15 worst-affected districts suffer from deficiency in the intake of iron and other trace elements in their diet because of emergency dry foods like biscuits and noodles they have been eating.

In Sindhupalchok a parent told me recently: “We have food, they have given us enough noodles to last us a year.” This is worrying. Children brought up with this diet will refuse to go back to their healthy staple of grain, vegetables and meat which carry all the energy proteins and micronutrients their growing bodies need.

The Ministry of Health and Population (MoHP) has taken steps to address this problem. Combat those challenges through the community management of acute malnutrition including Infant and Young Child Feeding (IYCF), counselling, breast milk substitute code monitoring, and establishment of Outpatient Treatment Programmes (OTPs) in health facilities in the affected districts.

Another worrying aspect of emergency food relief is the distribution of supplementary Micronutrient Powder even though donor surveys have found that its use in normal settings over the past five years in 20 districts haven’t produced any of the anticipated nutritional outcomes that benefit health and population of children. Indeed, one report says: ‘Large and strong experimental research has shown that in populations where malnutrition is common and so are diarrhoea and pneumonia among children micronutrient powder aggravates diarrhoea.’

Mothers I have met in the districts have also said the children don’t like the taste of the powder and they confirmed that children had diarrhoea after consuming it. Our argument against Micronutrient Powders in Nepal is that we already have nutrient-rich food but this fact is ignored by those who bring in these supplements from outside and pressure local communities to use them.  

Why don’t donors pay as much attention to traditional foods available locally which have all the micronutrients children need? These are easily available and much cheaper. An Ethiopian doctor once told me how his country was able to reduce malnutrition among children by making flour from dry sprouted soya beans and chickpeas. Being full of protein, vitamins, calcium and other micronutrients, it helped Ethiopia overcome malnutrition among children.

The Nepali diet has sprouted beans, and this could easily be distributed to earthquake affected areas instead of imported supplements of dubious efficacy.

In emergency situations, nutrition interventions tend to focus on the treatment of acute malnutrition through therapeutic feeding and food aid. But it should not be blanket use, and interventions should be based on the need of the child. Assistance may also be required to help restore local food production and community access to safe and nutritious foods, and we have enough experience in that here.

For instance, we have sesame (til), flax seed (alas), peanuts, many local green vegetables and pulses rich in micronutrients which can be used for children as well as for adults. Research on the preparation of carrot mixed baby food in 2009 published in Food Research Bulletin by the Department of Food Technology and Quality Control revealed that using locally-available wheat, maize, soya bean, carrot powder, ghee, sugar and water provided adequate micronutrients. But such locally-produced formula have not been promoted by MoHP, and the question is: why not?

Aruna Uprety is a nutritionist.

Read also:

You eat what you sow, Sahina Shrestha

‘Children prone to malnutrition’

Having to eat is not enough, Mallika Aryal

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