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| Sunday, 30 March 2003 |
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Malnutrition and hygiene: Sri Lanka falls into 'Disastrous' category by Carol Aloysius Sri Lanka has been categorised as a country with one of the highest levels of child malnutrition and poorest levels of hygiene in the world. The Water Supply and Sanitation Collaborative Council (WSSCC), in a special media publication titled 'A guide to investigating one of the biggest scandals of the last 50 years', says that contrary to popular belief that malnutrition was invariably linked to poor diets, hygiene had "everything to do" with the widely prevalent symptom of child malnutrition found in over 120 countries. It justifies this claim by means of a chart which categorised the 120 countries with high child malnutrition rates according to how they stood in the "Hygiene League". They were classified as, "Generally good", "Poor", "Very Dangerous" and "Disastrous". Sri Lanka falls into the very last category. According to the chart, Sri Lanka also has one of the highest levels of child malnutrition in the world, with Madagascar and Vietnam a close second. Other countries that shared this dubious distinction included the Democratic Republic of Korea (with the highest level of child malnutrition (60.0%), Afghanistan (48.0% child malnutrition), Bangladesh (47.1% child malnutrition), Nepal (47.1% child malnutrition) and India (47.0% child malnutrition). All of them have been classified as countries that have "Disastrous" levels of hygiene, endorsing the WSSCC's claim that the two are closely linked. The WSSCC points out that the child malnutrition rates as shown on the chart, "provide an approximate guide to the level of hygiene and the degree of exposure to infection", and suggests checklists that can help evaluate government performance and sets out a Hygiene Code to which every family should adhere to, in order to reduce the prevailing rate of child malnutrition. The adverse effects on health arising from a lack of good hygiene and sanitation especially in developing countries is further underlined by the Executive Director of WSSCC Gourisankar Ghosh in a hard hitting editorial in the same publication when he states that lack of safe sanitation is the world's biggest cause of infection. "The issue has been shrouded in embarrassment for too long. Hygiene - helped by safe sanitation and water supply - is what transformed health and productivity in industrialised countries. It is one of the world's longest running scandals that the same has not happened in the poor world". He also asks: "Why after fifty years of promises, do a hundred million people in slums and shanty towns still defecate in the open air or in plastic bags? Why does faecal matter still contaminate water, food, hands and homes so that infection and disease are everywhere?' The answer lies in the lack of education about good hygiene practices and the absence of basic sanitary facilities such as dust-free environments, good water supply and electricity. These gaps in a country's infrastructure, the WSSCC points out, will lead to frequent illnesses (a major cause of child malnutrition) including diarrhoea, cholera and gastro enteritis that undermines a child's growth. These diseases take away the appetite of young children besides inhibiting the absorption of nutrients and burning up calories in fever. This is why children commonly become malnourished between the ages of six months and two years when the daily calorie requirement amounts to just 2 or 3 % of the calories that most poor families consume, it adds. And do Sri Lanka's health officials agree with this view? Speaking to the Sunday Observer, a health spokesman said, "I agree that we have unacceptable levels of child (and maternal) malnutrition, even though our record of low infant and maternal mortality rates is the best in the region. One of the major causes for child malnutrition stems from our unhealthy environments and lack of knowledge of personal hygiene on the part of adults and children, which lead to all kinds of illnesses. Most of these illnesses and diseases enter the body of children through germs and parasites. There is no doubt that unswept compounds, dirty floors, uncleared garbage, smoke from wood fires, vehicular emissions along with contaminated food and fluids and unclean objects that children put into their mouths are the chief culprits. They cause diarrhoea. worm infestation, hepatitis A, as well as allergies and respiratory problems such as bronchitis and asthma. "Diarrhoea and respiratory infections are on the increase today because of this. Dirty teats, unwashed milk bottles, unwashed fruits and vegetables, flies, cockroaches and lack of personal hygiene (i.e. not washing hands with soap and water after going to the toilet) have jointly contributed to the mounting incidence of fevers, and diseases that have in turn led to malnutrition and subsequently stunting and wasting in young children", the health spokesman said. The Sunday Observer learns that the Health Department has now launched a "healthy environment" program to raise awareness of the importance of clean environments and personal hygiene. It has also introduced several interventions aimed at reducing the high level of malnutrition both among children and mothers. The program will be further intensified next week when the focus will be on "Healthy environments for children" on World health Day. |
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