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Malnutrition on the frontline: A health worker’s story

As a health worker in one of Laos’ remote northern villages, Ounkeo Xaythangded has seen too many children suffer because of a lack of food.

Ounkeo is the head of the mother-child and nutrition department at Nonghet District Hospital, the main health centre in a region that has some of the highest rates of malnutrition in Asia.

In her 14 years at the hospital, Ounkeo (pictured above) has seen many cases of children becoming sick and not developing properly because they are not getting the food they need.

“Children who do not get enough food are always sick,” she says. “They always have problems with their stomachs. They get fever. It takes longer to treat them compared to a healthy child. They are unhappy, they are always upset.”

The case that sticks in Ounkeo’s mind is a 20-month-old baby who died at home because she was not getting enough food.

The baby’s mother brought her to the hospital showing signs of malnutrition and Ounkeo and her staff helped treat her, but her mother kept returning.

“The child kept getting sick and coming to the hospital, before eventually dying at home,” Ounkeo says.

Every time a child dies it is a tragedy, but nutrition-related deaths are particularly tragic because they are preventable.

Laos has some of the highest rates of malnutrition in Asia. As many as three-quarters of children are unable to reach their physical, intellectual and productive potential.

They are underweight, wasting, or their growth is stunted. When a child does not get the right kind of nutrients early in life, the development of their brain and body can be permanently affected.

In Laos, children are born hungry. Malnutrition can start before birth.

Two in five pregnant women living in remote villages are malnourished, suffering from high rates of anaemia, due to a poor and unchanging diet.

ChildFund supporters are helping monitor children’s health by providing equipment to health centres

ChildFund Australia health advisor Tracy Yuen says some traditional practices contribute to the problem.

“We are focusing on rural and remote areas where access to services and health education is particularly challenging,” she says.

“In these areas, over half of the children are stunted; a product of poverty, lack of health and nutrition knowledge, and culturally engrained food habits.

“A number of local food taboos mean that women often eat only sticky rice in late pregnancy and early post-partum.

“It’s a diet that starts depriving the developing foetus from necessary vitamins and minerals for growth even before birth. In some cases, mothers feed masticated sticky rice to newborns, in the tragic misbelief that it is better than breastmilk.”

When children begin eating solid foods, their diet lacks variety, according to Ounkeo.

“I tell parents that their children should eat six groups of food but most of the children do not get this variety,” Ounkeo says.

“They are only eating vegetables and they do not get enough calcium. They don’t drink enough milk, especially when they are very young.”

Tracy visited Laos recently and recognised a clear need to increase health and nutrition education in remote communities.

“Despite suffering incredibly high levels of stunting, Laos possesses very few nutrition experts – in fact, there are no tertiary level courses for people to even be trained,” she says.

ChildFund’s nutrition projects in northern Laos works in two districts about 50km apart, and covers over 20 villages.

“We are combating these habits by training local people to become health volunteers. We teach them how to monitor children’s growth, and to lead nutrition education sessions for mothers and children,” Tracy says.

“I was fortunate to join a growth monitoring event where our volunteers were able to practise their new skills after being trained in the classroom just days before.”

ChildFund’s generous supporters have also helped provide measuring boards and scales, hanging basket scales for weighing babies, health record books for each mother to keep, and educational materials and posters.

Parents of young children who are malnourished are encouraged to join support groups where they learn how to start home gardens and receive seeds.

Many parents use these seeds to grow vegetables that can feed their children, and sell surplus produce at markets so they can buy essentials like medicine and school materials.

“Healthy children are happier children,” Tracy says.

“They are able to go to school, play with their friends and achieve their full potential in life.”

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