By Carly Sheehan
THATTA DISTRICT, Pakistan, 22 November 2010 – The devastating monsoon floods that recently affected more than 20 million people in Pakistan – including 2.8 million children under the age of five – have brought many underlying problems to the surface. In a country that already had alarmingly high rates of malnutrition, the floods have made the situation worse.
|VIDEO: 11 November 2010 - UNICEF's Natasha D'Souza reports on the organization's efforts to treat children suffering from malnutrition in flood-affected Sindh province, Pakistan. Watch in RealPlayer|
Even before this crisis, about a third of Pakistan’s children were born with low birthweight. The challenge now is not just to scale up nutrition interventions but, in some areas, to establish them for the first time.
Children in Sindh province, for example, are particularly vulnerable to malnutrition. Even before the floods, stunting rates in Sindh were higher than the national average. To combat the problems of malnutrition and stunting, UNICEF and its partners screen children through outpatient therapeutic feeding programmes, where their weight, height and mid-upper arm circumference (a key indicator of growth and development) are measured.
Mobile units and stabilization centres
As part of this effort, mobile therapeutic feeding units reach communities that have no access to fixed health-care centres. The vast majority of children in such communities can be effectively treated by the mobile units, but severe cases need to be treated at a stablization centre.
|© UNICEF Pakistan/2010/Sheehan|
|A child holds his ration of high-energy biscuits, provided as part of a UNICEF-supported therapeutic feeding programme in Thatta district, Sindh Province, Pakistan.|
In Thatta district, UNICEF has established the first stablization centre in a district civil hospital to treat malnourished children with serious medical complications. The centre was set up with support from Engro Chemicals, through UNICEF, as a public-private partnership. With beds for six children and their caregivers, the centre receives nutrition supplies and medicines from UNICEF. The National Institute of Child Health trains staff at the facility.
Hameed, 2, was recently admitted to the Thatta centre, suffering from high fever and diarrhoea. “We had no idea what was wrong with him. The village doctor gave him drips, which caused swelling all over his body,” says his grandmother. Today, Hameed’s condition is beginning to show marked improvement as a result of therapeutic feeding and medical treatment.
The five other children currently being treated at the centre are suffering from a range of complications, including respiratory illnesses and severe dermatitis.
Demand exceeds capacity
The stabilization centre in Thatta is the first of its kind, and the demand for its services exceeds capacity. “At the moment, we have six children admitted here, and until now we have treated 51 patients in two months,” says Shagufta Samoo, a staff nurse at the centre. “We have had to refer children to other hospitals because we had no space.”
|© UNICEF Pakistan/2010/Shuja|
|Women and children listen to a health education session delivered by a 'Lady Health Worker' in Thatta district, located in Pakistan's flood-affected Sindh Province.|
Thatta’s Deputy District Health Officer, Dr. Khaled Navaz, explains that much more work is needed to improve the nutritional status of children – especially girls – and women. “In our society, males are given higher priority than females, so we see many more malnourished girls than boys,” he says. “More health education sessions are needed as mothers are also malnourished, and we should provide nutrition support in schools.”
Through the government’s extensive ‘Lady Health Worker’ programme, local women deliver maternal and child health and nutrition messages to pregnant women and lactating mothers. “We are telling the lactating mothers that for six months they must breastfeed and nothing else, after which semi-solid and solid food should be given,” says health worker Maqbool Ahmed.
UNICEF has provided extensive support to this programme, particularly since thousands of Lady Health Workers were themselves affected by the flooding. Meanwhile, UNICEF continues to work closely with the government, and non-governmental and community-based organizations, to deliver life-saving and sustaining nutrition supplies to children affected by the flooding.
More than three months after the monsoon rains began, however, serious underfunding of UNICEF’s emergency operations is jeopardizing its flood response. So far, only about half of the organization’s $251 million Pakistan flood appeal has been received.
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