Fred Ezeh, Abuja
sanjay Kumar Das, is the team leader of nutritionist dispatched to northeast by United Nation Children’s Fund (UNICEF) to respond to nutrition emergency in the region. In this interview, he painted a gory picture of the situation in Borno, Yobe and Adamawa states.
What is the state of child nutrition in Borno and other northeast states?
It’s still in a horrible and pathetic state that requires urgent local and international attention. In fact, the nutrition situation in the region has long assumed emergency situation and there is need for collaborative effort to salvage the lives of children in the northeast particularly Borno state. In simple term, nutrition intervention is urgently needed to be scaled up to rescue the situation.
What do you mean by “emergency situation”?
There is global threshold and other parameters that are used by the World Health Organisation (WHO) to determine whether a country or a particular location has nutrition emergency. The parameters are there in the three northeastern states. They have reached the global threshold. WHO declares nutrition emergency in a country or a location if malnutrition record of children under the age of five reach 10 per cent. Currently, there is high record of Severe Acute Malnutrition (SAM) among children under the age of five in northeast. 11 per cent of children in Borno state are severely malnourished. 13 per cent are in Yobe state while Adamawa state accounts for six per cent of SAM in northeast.
How did we get to this point?
It’s a cumulative effect of many factors. However, there have been cases of malnutrition in northeast but not at the current level. This time, the matter was worsened by prolonged activities of Boko Haram insurgents that resulted in destruction of communities, farmlands and other sources of livelihood, thereby forcing thousands of people into different Internally Displaced Persons (IDP) camps with poor living conditions. The implication is that displaced people don’t farm anymore and their normal lifestyles altered. The worst thing is that people in these places are illiterates who have poor knowledge of hygiene and diet. They don’t take hygiene serious and that has been responsible for periodic disease and epidemic outbreak.
How effective is your approach to the issue of malnutrition in these states?
Our interventions and that of other local and international partners, and the states government have been effective and that could be seen in the improved records available. In last two years, we have seen a consistent drop in the number of SAM cases. In 2018, an estimated 440, 000 boys and girls of under the age of five in three northeast states of Borno, Adamawa and Yobe, suffered SAM. In 2019, we projected an estimated 317, 000 to suffer SAM. The figure is expected to drop to 258, 950 children in 2020. Obviously, the figure has been on the downward trend and that could be attributed to increased access to drugs, hygiene and Ready for Use Therapeutic Food (RUTF) which had played great role in improving the nutrition in the war ravaged areas. We are hopeful that more children would not fall back into SAM after treatment.
How many children were treated of SAM so far in these states?
For 2019, we have treated over 165, 000 children of SAM. We are working on some measures to prevent new cases of SAM. We are working assiduously to ensure that children that are down with SAM are given adequate attention starting with the provision of RUTF and those who are out of SAM are closely monitored to ensure they don’t fall back again.
How true or otherwise is the allegation of misuse or sale of the RUTF by mothers and other caregivers?
We have no documented evidence to justify the allegation. However, our workers have repeatedly seen the RUTF being sold in shops within and outside this region. We have also seen being used for purposes other than what it was meant for. We are partnering with community and religious leaders to monitor people that are allegedly engaged in such act. Poverty, hunger and illiteracy play great role in this regard. If not, how can mother whose child is malnourished thought of selling food provided for child for a “change”? If she knows that importance of RUTF in a malnourished child, she won’t even think of doing that. She will take the matter seriously and administer the food and drug as prescribed. RUTF is not only a food but a combination of several supplements that help to boost the brain and physical development of a SAM child.
How much has been spent in response to the nutrition crisis in northeast?
So far, UNICEF and states government agencies have committed millions of dollars in nutrition intervention in 2019. However, N5 billion is urgently needed to facilitate the procurement of 259, 000 cartons of RUTF for SAM treatment. So far, funding has been secured for over 29,000 cartons and there is funding gap of N4. 4 billion for the procurement of 229,636 cartons of RUTF. The influx of new IDPs have exacerbated already poor nutrition situation. The affected communities’ coping mechanism is still low and any shock will result in further deterioration of nutrition status. We have suggested a robust contingency plan in that regard. However, there is a budget of N18. 5 billion from UK Department for International Development (DFID) to be spent on nutrition in next three years in the northeast.
What are the long and short term effects of malnutrition on a child?
Malnutrition has a long term devastating effect on child because, in most cases, it strikes them at their developmental age. It shortens the lifespan of children and destroys, totally, their cognitive abilities. In addition to that, it makes them less useful and prone to ailments even after they had recovered from SAM. Any child that suffered malnutrition hardly enjoys academic excellence or record impressive performance in any intellectually competitive environment. They don’t develop well, physical and mentally. They are 11 times more likely to die compared to their normal peers. They have high risk of diabetes, obesity and several other ailments at adult age. As it stands, malnutrition is a serious threat to future of northeast Nigeria because the children who are supposed to sustain whatever legacy that was left behind are malnourished and could hardly defend themselves, academically and otherwise.
What are economic consequences of malnutrition?
It is huge. For instance, an estimated 2.5 million boys and girls under the age of five suffer SAM annually in Nigeria, even though larger percentage of the figure is in the northeast. Aside the effect on quality manpower, it has been confirmed that malnutrition takes 16 percent of Nigeria’s Gross Domestic Product (GDP). This is in addition to other economic cost on Nigerian economy.
How supportive is the states government in this fight against malnutrition?
They are trying within the available resources. They are responsible for the success of our intervention programmes in the region. They take the lead particularly in the coordination of the humanitarian activities and other programmes. We don’t expect otherwise because the states stand better chance of benefitting from a healthy children, both in short and long term. It’s only healthy children that can contribute to manpower and socioeconomic development of a state.
What are some of the challenges you encountered in course of this intervention?
Our major challenge has been inability to access some communities due to the strong presence and activities of these insurgents. For instance, protracted access constraints and insecurity worsened malnutrition situation in Rann, Yobe south, Magumeri, Jere and Konduga Local Government Areas. Many children are dying there for lack of adequate attention. Another major challenge is illiteracy and socio-cultural practices which are greatly contributing to the malnutrition.