Nigeria’s oil picture masks the reality on the ground. Only now is the country’s place in malnutrition crisis becoming clearer. In this report, Isioma Madike, highlights the fact that pregnancy and infancy are the most important periods in the fight against this scourge. They are critical periods as mothers and babies need good nutrition to lay the foundation for the child’s future development
Naked kids with wrinkled frames are common sights in most Nigerian neighbourhoods. Their pictures usually cast a dark shadow over a rising Nigeria, where millions of children have inadequate nutrients that nurture their tiny bodies. Many of them are skinny, listless and sick in their localities.
If they survive, they will grow up shorter, weaker and less smart than their better-fed peers. Some of them weigh 5 kg, about half of what they should. Others are light as a leaf. Out of ignorance, their mothers jabbed their rib-protruding stomachs, infrequently.
They live mostly in the remote areas and are usually within the age bracket of two years. Most of them are pipe-stem thin with rather large teeth jut from a somewhat perpetual open mouth etched on a face with skull-tight skin and buzz-cut hair. They often grit their teeth when they talk.
In the northern part of the country are many of such sights. In Kano, for instance, one-year-old Aminat, who weighs a little above 6 kg and rests on a bed next to her equally malnourished mother, is one of such kids. The little girl and her poor family live on Warri Road, in Sabongari area of the ancient city.
“You see her arms? They are almost the width of my thumb,” said Zainab, as she carried her flabby, emaciated daughter with one palm. “She is too weak. She can’t even sit by herself,’’ the distraught mother added.
The sight of other women holding their severely malnourished children as they stand outside their homes in Sokoto, Kaduna, Katsina, Gombe, Kebbi and Maiduguri are also inviting. Poor hygiene, low public health spending, little education and awareness have not helped. The Boko Haram insurgents, which has left only the aged in the farm as well as the age-old customs discriminating against women such as child marriage have equally contributed, but are far harder to tackle, said experts.
In the South, especially the South-south states of Akwa Ibom, Delta and Bayelsa, the story is not different. Though, rich in oil and agricultural produce, their children have not benefited from robust dietary foods due mainly to ignorance and traditional beliefs.
The South-east states are not left out in this orgy of wants. Also rich in agricultural harvest, the children are left to wallow in malnutrition as foods produced are mainly sold out, living the kids to lack in need. “Enugu is a typical example in this regard. Because of belief system, parents are known to consume more meat and fish,” Nwachukwu, a resident of Nsukka area of the state, said.
Also, the Middle-Belt region, particularly in Benue State, the acclaimed food basket of the nation faces the same dilemma. Just like in the North-east, the incessant crises in Jos, Plateau State, and the continuous rioting herdsmen threat have equally put the children in danger of having appropriate nutritive foods to support their growth.
The South-west has a different kind of nutritional problem. The domains of the wealthy, especially in place like Ikoyi, Victoria Island and VGC in Lagos State, are stocked with overfeed children. The result is acute obesity, which is hurtful and could ignite some health challenges almost immediately or in future.
However, it has been observed that most of the malnourished children come from Nigeria’s poorest groups where literacy is poor and poverty high. Their mothers are themselves often undernourished, forced into early marriage when they reach puberty, and give birth to underweight babies with weak immune systems.
This is not surprising. In many Nigerian neighbourhoods are children whose bones are popping out of the body. The sunken eyes, drooping faces, swollen bellies, chapped lips and wrinkled skins are common place in most states of the federation. This, incidentally, is the physical description of a child, who is malnourished.
Due to lack of food and insufficient health supply, many children in Nigeria suffer from this heartbreaking disease. Though, no longer news to a vast majority of the people, many who live in big cities with posh houses and cars, still have plenty of chances to come across the malady. In rural areas, they are considered to be low and windows are usually shut when they beg for some money for their survival.
But, Nigerians, as a minimum, deserve a life free from hunger, considering her resources. Unfortunately, both poverty and hunger have continued to haunt the country’s landscape. Hunger is both a cause and consequence of poverty, as people on low income tend to have worse diets, while people who lack adequate nutrition struggle harder to extricate themselves from poverty.
The scary picture is the same all over. Illiteracy or lack of awareness has, indeed, taken its toll on Nigerian kids. Mothers, in most communities, according to investigation, do not breastfeed their children well, chiefly because of ignorance or lack of nutrients in their own bodies. They often rely on offering buffalo milk and contaminated water, making their children prone to illnesses like diarrhea, which prevents nutrient absorption.
Incidentally, many of these families live on less than $1 a day, which can hardly afford anything beyond local foods like corn mill (tuwo) in the North and palp (akamu) in the South. These foods are devoid of much-needed protein and other nutrients. For the children, their mothers’ plans mean little unless they put enough of the right food in their stomachs.
Almost as shocking as Nigeria’s high prevalence of child malnutrition is the country’s failure to reduce it. This is in spite of her supposed wealth. “It is a national shame. Child nutrition is a marker of the many things that are not going right for the poor masses,” said a nutritionist, who identified himself simply as John.
But, it does appear that the country’s efforts at reducing the number of undernourished kids have been largely hampered by blighting poverty where many cannot afford the amount and types of food they need. In addition, shoddy management of food stocks, over reliance of carbohydrate-rich food that fuel and fill the poor rather than truly nourish them in the country’s poorest rural settings, according to findings, have not only added to the problem but have worsened it.
Studies have shown that every one out of three Nigerian child is malnourished, while almost half of the child population in the country dies because of this. The country’s GDP maybe high, but majority of the children under five years of age is immensely underweight. They have no source of gaining their weight back or stay healthy, as rich people or even the government is not taking enough actions to mitigate this.
Despite the starvation crisis in some parts of the world, they somehow look good next to the malnourished Nigerians. This obviously leaves many wondering how ignorant the country is trying to be towards the poorer strata. One of the major reasons for this is because the mothers are under-weight themselves. They have to work all day even during their pregnancy, and with the very little food they get, they eventually drain out.
The foetus, however, eats up whatever they want when they are in the womb, but the lack of nutrition while they are growing up hits them as early as the age of two. The ones who suffer this cannot afford vitamin and iron tablets and thus grow weaker and weaker. If they are lucky, they do not have to suffer for a long time.
This is because many of such children could be reach and save through life-saving malnutrition treatment powered by the community-based treatment of acutely malnourished children in some parts of the country. At present, over a million children have been reached with more than 200,000 lives saved in recent past, according to government and its partner on child issues, the United Nations Children’s Fund (UNICEF).
Exclusive breast-feeding has also been recommended as the best method of feeding infants in the first six months of birth. Though, findings have shown signs of growth faltering in kids because women, introduce their babies to artificial milk. This unknowingly denies the newborns colostrum, the first yellowish milk produced by the breast which contains vitamins, minerals and protein that provide substantial amount of antibodies.
“Breast milk is composed of colostrum for the first few days. This colostrum is very rich in protein, phospholipid, cholesterol and immunoglobulin. Effective brain development requires good amount of protein. To be able to mount good defensive mechanism, we need immunoglobulin; hence colostrum in the first few days is beneficial to the babies,” said, consultant family physician, Dr. Sodipo Oluwajimi.
Former national president of Nigerian Medical Association (NMA), Dr. Osahon Enabulele, also said that many women do not believe that their babies can do without supplementary fluids. Every woman, Enabulele said, can breast-feed. Unless there is something seriously wrong, the doctor insisted, a mother’s breast are capable of producing sufficient milk.
Recent studies have equally shown the beneficial effects of breast-feeding in preventing morbidity and mortality from diarrhoea in infants. Its promotion activities are carried on world-wide in order to fulfill the World Health Organisation (WHO) and UNICEF recommendations that infants be exclusively breast-fed for about six months. However, the introduction of complementary foods and continued breast-feeding ought to run into the second year.
Childhood malnutrition begins from the womb, according to UNICEF. Protein Energy Malnutrition (PEM), Iodine Deficiency Disorder (IDD), Iron Deficiency Anemia (IDA) and Vitamin A Deficiency (VAD) are the four nutritional problems confronting many under five children in Nigeria, especially in the rural areas. In spite of all the health teaching, human and material resources expended in the fight against childhood malnutrition in the country, infant and under-five mortality rates continue to increase unabated.
Nutritional deficiencies are said to contribute to the high rates of disability, morbidity, and mortality in Nigeria, particularly among infants and young children with several data suggesting a crisis in the nutrition situation of the country. Numerous regional surveys portray a sorry state of nutrition in Nigeria.
Some of the causes of childhood malnutrition in this part of the world include poverty, infection, diarrhea, poor feeding practices, cultural food taboos and large family size. Others are educational status of mothers, shift to early introduction of artificial milk, unavailability of nutritious foodstuffs at affordable prices, lack of nutrition rehabilitation centres and poor monitoring and supervision of community health workers.
Eleven million Nigerian children are suffering from malnutrition, the Country Representative of the UNICEF, Jean Gough, has revealed. Gough, who declared that poverty and ignorance were mostly responsible for this malady in most developing countries of Africa, added that UNICEF was ready to provide information on nutrition of children to women.
According to her, children are supposed to be precious gifts in every family, the hope of the future. But, this seems far from being the case in Nigeria as many under age five suffer stunted growth as a result of malnutrition. The Country Manager, Nigeria and Regional Representative, West Africa, Global Alliance for Improved Nutrition (GAIN), Dr. Larry Umunna, has also noted that “malnutrition has become a public health concern in Nigeria as micronutrients were absent in staple foods.”
In like manner, the Regional Fortification Coordinator, Helen Keller International, Burkina Faso, Mawuli Sablah, has disclosed that Nigeria alone represents five per cent of global underweight problem. Sablah noted that WHO recommended micro nutrients such as iron, folic acid, Vitamin A, Vitamin B12 and zinc to be included in every consumed food.
Also speaking on the issue, President, Nutrition Society of Nigeria, Prof Ngozi Nnam, quoting statistics, said about 37 per cent of Nigerian children were stunted, 29 per cent underweight and 18 per cent wasted while micronutrient deficiencies were also high. She said: “While we are grappling with the challenge of under nutrition, the incidence of obesity and related manifestations of over-nutrition are beginning to emerge at relatively significant levels.”
For Dr. Chris Isokpunwu, Deputy Director/Head of Nutrition, Federal Ministry of Health, malnutrition is one of the underlying causes of under-five mortality rate in Nigeria, contributing 53 per cent of infant mortality. While blaming malnutrition on low level of exclusive breastfeeding of Nigerian children under the first six-months of life, Isokpunwu urged mothers to scale up nutrition before pregnancy and during pregnancy till age two of a child’s life in order to empower their mental development.
Dr. Abimbola Ajayi, Director of Nutrition, Lagos State Ministry of Health, also said: “We are often told that we are what we eat. Not just that, food is what makes you and nutrition comes out of food and one thing we also know is that, if a person is not adequately nourished, the person is practically in no place to do much of anything.
“We can make complimentary foods from our locally available foods in such a way that they will be adequate in nutrients. Complimentary foods must be filled with key vitamins, minerals, the right energy and other essential nutrients to bridge the gap between what is provided by breast milk and nutrients needed by your growing baby,” he stated.
Also, UNICEF’s Chief Nutritionist, Arjan de Wagt, said that 55 per cent of child deaths are attributed to malnutrition in Nigeria. He added that malnutrition of a mother could result in disability of a child or miscarriage.
However, one in four of the world’s children are said to be stunted by the ravages of malnutrition, while the bodies and brains of one in three children in developing countries are damaged by undernourishment. Iodine deficiency, a form of malnutrition caused by a lack of specific nutrients is said to affect one-third of schoolchildren in developing countries and is associated with a loss of 10 to 15 Intelligence Quotient (IQ) points.