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Nigeria under siege of malnutrition: A time to act

By Chioma Obinna

Halima Ahmed was married at the age of 16. She had her first child at 18 and two years after, got pregnant the second time. Unfortunately, her husband, Ibrahim, a messenger in a private firm lost his job coincidentally. Things became tough and the family relocated to the village.

Still trying to adjust to the stark reality of the situation, crisis broke out in the neighbourhood, and Ibrahim was caught in the crossfire and killed.

Life became much more harrowing for Halima who was then three months pregnant. Her unborn child and two-year old son were entering another phase of life. Halima lost count how many times she went to bed on an empty stomach throughout her pregnancy.

To worsen her plight, her first son died from a bad case of acute malnutrition. To complete the tragedy, Halima lost her own life during labour. Records showed she was malnourished and anaemic.

Her baby survived, but had a congenital abnormality known as Spina bifida, a most common neural tube defect, that occurs when the embryonic neural tube does not close properly, exposing the baby’s brain or spinal cord to amniotic fluid. According to experts, this is usually caused by deficiency of folate during pregnancy.

On paper, the right to adequate nutrition and freedom from hunger is inalienable, but in reality do people like Halima really have access to this right?

The right to food implies that the state has the obligations to respect existing access to adequate food, protect access to adequate food and facilitate activities that strengthen people’s access to and utilisation of adequate food even during emergencies. Halima is one out of the thousands of Nigerian women that die of pregnancy related problems due to poor nutrition occasioned by lack of access to food.

Undoubtedly, food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. But Halima never had such access.

The 2011 Global Hunger Index, GHI report, —the sixth in an annual series—which presented a multidimensional measure of global, regional, and national hunger, although revealed that the world has made some progress in reducinghunger, the proportion of hungry people remains high.

The 2011 GHIhas improved by slightly more than one-quarter over the 1990 GHI,but globally, hunger remains at a level categorised as “serious.” Inaddition to presenting the 2011 GHI scores, the report examines the issue of price spikes and excessive food price volatility, which have significant effects on poor and hungry people.

According to the World Health Organisations GHI ranking, GHI puts less than 5.0 reflect low hunger, 5.0 and 9.9 as moderate hunger, but valued 19.9 a serious level of hunger.

Again, the proportion of people who are 20.0 and 29.9 are alarming, and values of 30.0 or greater areundernourishe. Unfortunately, Nigeria happens to fall inbetween 10 and 20 and contributes 5.7 per cent of hunger problems in the world.

In 2010, the GHI showed that Nigeria ranked 20th despite averaging over 0.49 per cent growth since 2000. In 2010, GHI put Nigeria at 17.8 per cent and in 2011 15.5 per cent.

The report showed that most countries, including Nigeria, were making slow progress in meeting the Millennium Development Goal targets on reducing by half the incidence of hunger and child mortality by the year 2015.

Critical observers are worried that the status of food security in Nigeria may not be unconnected with the consequence of a very long neglect of agriculture.

Today, thousands of poor farmers’ families get into the poverty and hunger trap because they have been left behind by our glittering growth which has bypassed them. Statistics available have shown that about 65 per cent of Nigerians are food insecure, with insufficient access to the amount and variety of food for a healthy and productive life.

Malnutrition is widespread. The GHI also revealed that about 40 per cent of Nigerian children under five are stunted, nine per cent are wasted and 25 per cent are underweight. Micronutrient deficiencies in vitamin A, iron and iodine are also widespread. It further shows that 2 out of 5 children in Nigeria are chronically undermalnurished. This also have siginifcant risk to in the GDP

A world Bank report also showed that malnutrition accounts for 20 per cent of reduction in productivity and GDP loss to malnutrition is between 2 and 3 per cent.

However, experts are of the view that focusing on the first two years of a child’s life andensuruing adequate nutrition for pregnant women and children wouldsignificantly reduce GDP loss to malnutrition as well as save lives.

In the view of UNICEF’s Nutrition Specialist, Dr. Isiaka Stevens Alo, malnutrition’s most devastating impact is in the womb – when the foetus can fail to develop properly and during the first years of a child’s life, when it can hamper physical and mental development.

Alo, who was spoke at a 2- day media workshop organised by UNICEF in Owerri, Imo State, to examine Nigeria’s preparedness in emergencies stressed the need to tackle problems of food insecurity strong as evidence have shown that adequate nutrition in-utero and during the first two years of life is essential for formation of human capital and undernourished children are more likely to achieve less academically and to have a lower economic status in adulthood.

Lamenting that malnutrition has become a silent emergency in the country; he without addressing malnutrition, countries may not be able to achieve the Millennium Development Goals (MDGS), especially those related to health, hunger, and poverty.

According to him, reduction of malnutrition through the provision of adequate food could decrease child mortality in Nigeria by 50 per cent and the burden of paediatric disease by 20 per cent. “Access to food and the maintenance of an adequate nutritional status are critical determinants of people’s survival in a disaster because many families and individuals are forced to leave their homes” .

He said: “Vitamins and minerals, also known as micronutrients, are critical component of good nutrition. For instance, folate (vitamin B9), iodine, iron, vitamin A, zinc, and other B vitamins including thiamin (vitamin B1), riboflavin (vitamin B2), niacin (B3), cobalamin (vitamin B12) and pyridoxine (vitamin B6) are important for healthy and productive populations.

“Without them, children develop birth defects, blindness and an inability to learn properly, among other long-term disabilities. Each year, more than one million children under five die from vitamin A and zinc deficiencies. Vitamin and mineral deficiencies affect up to two billion people globally.”

Noting that more than half of childhood deaths in Nigeria is associated with malnutrition, Alo said: “Experiences have shown that from the emergencies reported in the country, children have been found

to suffer from malnutrition, “Which is hidden and silent, and victims not aware or the signs recognised.

“Reducing malnutrition has more impact than any other intervention. We need to focus on the three high impact actions; Micronutrient fortification and supplementation including deworming; community

management of acute malnutrition, and promotion of optimal breastfeeding and complementary feeding,” he added.

Explaining the importance of nutrition in pregnancy, he said deficiency of folate (vitamin B9) plays a key role in cell multiplication and tissue growth.

“Deficiency of folate increases the risk of giving birth to infants with birth defects called neural tube defects. Spina bifida, the most common neural tube defect, occur when the embryonic neural tube does not close properly, exposing the baby’s brain or spinal cord to amniotic fluid. “Our bodies need iodine to produce the hormones that regulate the thyroid gland.

Iodine deficiency primarily affects the developing brain. Populations with chronic iodine deficiency showed a reduction in their intelligent quotient (IQ) of 12.5 to 13.5 points.

Malnutrition: Quick facts and figures

There are 925 million undernourished people in the world today: one in seven people do not get enough food to be healthy and lead an active life.

Malnutrition accounts for 11 percent of the global burden of disease. It is the number one risk to health worldwide.

Each year it kills 3.5 million children under five years old and impairs hundreds of thousands of growing minds.

Malnutrition is implicated in about 40 percent of the 11 million deaths of children under five in developing countries; lack of immediate and exclusive breastfeeding in infancy causes an additional 1.5 million of these deaths.

Countries may lose two to three percent of their Gross Domestic Product (GDP) as a result of iron, iodine, and zinc deficiencies.

Without addressing malnutrition, the world community might not be able to achieve the Millennium Development Goals (MDGS), especially those related to health, hunger, and poverty.

Micronutrient (or Vitamin & Mineral Deficiencies, VMD) – Hidden Hunger

Vitamins and minerals, also known as micronutrients, are a critical component of good nutrition. In particular, folate (vitamin B9), iodine, iron, vitamin A, zinc, and other B vitamins including thiamin (vitamin B1), riboflavin (vitamin B2), niacin (B3), cobalamin (vitamin B12) and pyridoxine (vitamin B6) are important for healthy and productive populations.

Without them, children develop birth defects, blindness and an inability to learn properly, among other long-term disabilities. Each year, more than one million children under five die from vitamin A and zinc deficiencies. Vitamin and mineral deficiencies affect up to two billion people globally

FOLATE DEFICIENCY

Folate (vitamin B9) plays a key role in cell multiplication and tissue growth.

Deficiency of folate increases the risk of giving birth to infants with birth defects called neural tube defects . Spina bifida, the most common neural tube defect, occur when the embryonic neural tube does not close properly, exposing the baby’s brain or spinal cord to amniotic fluid.

Folate deficiency can also lead to impaired cognitive function in adults. It tends to be more prevalent in populations that consume a lot of cereals (low in folate) and few leafy greens and fruits (high in folate).

IODINE DEFICIENCY

Iodine is a mineral essential for human development and growth.

Our bodies need iodine to produce the hormones that regulate the thyroid gland.

Iodine deficiency primarily affects the developing brain. Populations with chronic iodine deficiency showed a reduction in their intelligent quotient (IQ) of 12.5 to 13.5 points.

The most commonly known sign of iodine deficiency is goiter, the swelling of the thyroid gland in the neck. It can also lead to cretinism, the most serious form of mental retardation and associated physical disabilities.

ZINC DEFICIENCY

In the human body, zinc performs many functions including healing of wounds, growth and repair of tissues, proper clotting of blood, correct thyroid function, metabolism of proteins, carbohydrates, fats and alcohol, fetal development and sperm production.

The symptoms of severe deficiency include retarded growth, diarrhea, mental disturbances and recurrent infections.

B-VITAMIN COMPLEX DEFICIENCIES

Thiamine (B1),

Riboflavin (B2)

Niacin (B3)

Pyridoxine (B6)

Cobalamin (B12)

THE B-VITAMIN COMPLEX DEFICIENCIES

Deficiency of Vitamin B12 (cobalamin) causes neurological deterioration, megaloblastic anemia (larger-than-normal red blood cells due to inhibited DNA synthesis in the RBC), and possible impaired immune function.

Severe Thiamine (B1) deficiency can result in potentially fatal heart failure or peripheral neuropathy.

Early symptoms of Riboflavin (B2) deficiency can include weakness, fatigue, mouth pain, burning eyes and itching. More advanced deficiency can cause brain dysfunction.

Niacin (B3) deficiency can result in pellagra, which causes skin rashes. Other symptoms include vomiting, diarrhea, depression, fatigue and loss of memory.

Symptoms of severe Pyridoxine (B6) deficiency include neurological disorders (i.e. epileptic convulsions), skin changes and possibly anaemia

 


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