|© UNICEF Pakistan/2006/Zaidi|
|A nurse attends severely malnourished Shazia Bibi, 13 months old, at the UNICEF-supported therapeutic feeding centre in Muzaffarabad, Pakistan.|
By Irene Sanchez
MUZAFFARABAD, Pakistan, 6 April 2006 – Six months after the earthquake that devastated this area in Pakistan-administered Kashmir, UNICEF is helping Pakistan’s Ministry of Health operate a therapeutic feeding centre for undernourished children in Muzaffarabad and extend health care to village communities where there was none before. These activities are intended to safeguard children’s health as the emergency phase of the quake relief effort changes to return, reconstruction and rehabilitation.
Health authorities, UNICEF and partner organizations have taken steps to protect children made even more vulnerable by months of life in camps for displaced people or still-unrepaired village homes.
As the camps close and families make their way home to outlying areas, the existence of the therapeutic feeding centre here, supported by UNICEF and the International Red Cross and Red Crescent, will offer a safety net for their children through the transition months of the rehabilitation phase.
Consequences of malnutrition
Muzaffarabad was at the epicentre of the 8 October 2005 earthquake. Following the disaster, the region witnessed a mass displacement of people who lost their homes and settled into the temporary camps. The resulting difficulties with access to food and safe water, compounded by cold winter weather and rampant infections, have affected the health and nutritional status of thousands of children – many of whom were already very poor and at risk even before the disaster struck.
A first of its kind in this underserved area, the Muzaffarabad therapeutic feeding centre has been established on the grounds of Abbas Hospital, which survived the earthquake intact and today remains a bustling facility. Consisting of two large tents, the feeding centre has capacity for 20 patients. Nurses have been specially trained and therapeutic food and equipment provided to the facility.
“Malnutrition in all its forms can have terrible consequences for a child’s life,” says UNICEF Nutrition Officer John Egbuta. “A malnourished child gradually loses all his or her energy and is then predisposed to diarrhoea, acute respiratory infection and measles. Also, physical and mental development are affected.”
As new health care facilities are established in the home communities of earthquake survivors – often in the form of UNICEF-supplied, prefabricated Basic Health Units complete with newly trained health workers – they will have an important role to play in this new phase of quake relief.
“Identification and treatment of underweight children in their own villages will help us to reduce cases of severe malnutrition in the future,” explains Dr. Egbuta.
|© UNICEF Pakistan/2006/Zaidi|
|Shazia’s mother is unable to breastfeed and has to feed her severely malnourished daughter with formula milk.|
Impact on breastfeeding
Shazia Bibi is only 13 months old. When she was admitted to the therapeutic feeding centre in Muzaffarabad, she weighed only 4.4 kg. (The ideal weight for a child of this age is 10-15 kg.) After just two days of caring and therapeutic feeding, Shazia gained 0.2 kg.
Jalila, Shazia’s mother, has five more children at home. “I worry about them,” she says, sitting by her daughter’s side. “My husband is working, but we lost our house in the disaster and now we are living with other relatives. I know my children at home also need me.”
Before the earthquake struck, Pakistan’s national breastfeeding rate was 93 per cent. In quake-affected areas, that rate has dropped in recent months as a result of the trauma of deaths and illnesses, the difficulties of displacement and inadequate food supplies – all factors that have challenged women’s ability to maintain exclusive breastfeeding for their infants.
Jalila describes how difficult it was for her to see how Shazia started to lose weight once she was weaned from exclusive breastfeeding at the age of just seven months. Her experience is a poignant indicator of how lack of food and reduced breastfeeding can put children at high risk in their first months of life.
“In our rural communities the levels of poverty and illiteracy, and the absence up to now of any basic health care facilities, also affect children’s nutrition,” says Ulfat Sajjad, a nurse at the feeding centre. “A woman who has not benefited from education may not know how to take care and feed her children.”
Editor’s note: Despite care and therapeutic feeding, Shazia couldn’t fight off pneumonia. She was transferred to a hospital in Islamabad and is now struggling for survival.
Sabine Dolan contributed to this story from New York.