Thursday, December 28, 2006

Malnutrition

Today's New York Times has an article about malnutrition.

Two forms of malnutrition of global importance are marasmus and kwashiorkor. I often discuss them and their cognitive consequences whenever I write about developmental neuropsychology.

Here is the Times article:

Malnutrition Is Cheating Its Survivors, and Africa’s Future
By MICHAEL WINES
December 28, 2006
The New York Times

SHIMIDER, Ethiopia — In this corrugated land of mahogany mountains and tan, parched valleys, it is hard to tell which is the greater scandal: the thousands of children malnutrition kills, or the thousands more it allows to survive.

Malnutrition still kills here, though Ethiopia’s infamous famines are in abeyance. In Wag Hamra alone, the northern area that includes Shimider, at least 10,000 children under age 5 died last year, thousands of them from malnutrition-related causes.

Yet almost half of Ethiopia’s children are malnourished, and most do not die. Some suffer a different fate. Robbed of vital nutrients as children, they grow up stunted and sickly, weaklings in a land that still runs on manual labor. Some become intellectually stunted adults, shorn of as many as 15 I.Q. points, unable to learn or even to concentrate, inclined to drop out of school early.

There are many children like this in the villages around Shimider. Nearly 6 in 10 are stunted; 10-year-olds can fail to top an adult’s belt buckle. They are frequently sick: diarrhea, chronic coughs and worse are standard for toddlers here. Most disquieting, teachers say, many of the 775 children at Shimider Primary are below-average pupils — often well below.

“They fall asleep,” said Eteafraw Baro, a third-grade teacher at the school. “Their minds are slow, and they don’t grasp what you teach them, and they’re always behind in class.”

Their hunger is neither a temporary inconvenience nor a quick death sentence. Rather, it is a chronic, lifelong, irreversible handicap that scuttles their futures and cripples Ethiopia’s hopes to join the developed world.

“It is a barrier to improving our way of life,” said Dr. Girma Akalu, perhaps the nation’s leading nutrition expert. Ethiopia’s problem is sub-Saharan Africa’s curse. Five million African children under age 5 died last year — 40 percent of deaths worldwide — and malnutrition was a major contributor to half of those deaths. Sub-Saharan children under 5 died not only at 22 times the rate of children in wealthy nations, but also at twice the rate for the entire developing world.

But below the Sahara, 33 million more children under 5 are living with malnutrition. In United Nations surveys from 1995 to 2003, nearly half of sub-Saharan children under 5 were stunted or wasted, markers of malnutrition and harbingers of physical and mental problems.

The world mostly mourns the dead, not the survivors. Intellectual stunting is seldom obvious until it is too late.

Bleak as that may sound, the outlook for malnourished children in sub-Saharan Africa is better than in decades, thanks to an awakening to the issue — by selected governments, anyway.

[ ... Read the full article ... ]

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