Millions malnourished in Pakistan despite abundance of food

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KARACHI, March 24, 2019 (BSS/AFP) – A frantic mother cradling her seven-
month-old baby rushes towards the special paediatric ward in a desolate
Pakistan town, his eyes are blank and he is smaller than most newborns.

He is starving in a country that has no shortage of food, but which has one
of the highest infant mortality rates in the world and where malnutrition is
rife.

The infant weighs just 2.5 kilograms — the average for a healthy child of
that age is almost three times that.

His case is not unique for the doctors at the Mithi Civil Hospital in
hunger-stricken Sindh province where millions survive on less than $1 a day.

Of the 150-250 patients who come in each day, roughly one fifth are
suffering from malnutrition, Dr Dilip Kumar, head of the paediatric
department, tells AFP.

Inside the ward, nine other malnourished infants are crying inside glass
incubators. A young mother, Nazeeran, clutches the hand of her toddler.

“Her weight is dropping, even though we consulted many doctors,” the 25-
year-old says.

The International Food Policy Research Institute (IFPRI), a poverty and
hunger watchdog, estimates around one in five of Pakistan’s more than 200
million people are malnourished.

And yet, the nation is not short of food — in fact, according to the US
Department of Agriculture, it is projected to export 500,000 tons of wheat
from May 2018 until April 2019, and 7.4 million tons of rice in the same
period.

Dawn, the English-language daily newspaper, even reported a potato glut
earlier this month.

– Extreme deprivation –

The issues, experts say, are socio-economic — that is, just because food
is available, does not mean people can access it.

“There are four key pillars of food security in Pakistan: The first is
availability, then accessibility, utilisation and stability,” says Dr Ambreen
Fatima, senior research economist at the Applied Economic Research Centre of
the Karachi University.

In Tharparkar, where Mithi Civil Hospital is, all four are lacking, she
explains, adding that in other parts of the country they are present only to
varying degrees.

“Pakistan is quite well off in wheat production,” comments Dr Kaiser
Bengali, a veteran economist, who has done field research on poverty and
hunger in the country, but adds that much of it is sold for export.

This means ordinary people in the country may not have access to it, and if
they do they may not have the resources to pay for it.

“Affordability is the biggest challenge here in Pakistan,” he says.

Karachi is Pakistan’s financial capital, but Bengali says he has seen
alarming examples of poverty and deprivation there.

“In our surveys we came across the kids who had never eaten an apple, and
when we offered him an apple he was reluctant to take the bite wondering
whether it was an edible thing or not,” Bengali reveals.

“In another case a family had never had eggs in their whole lives,” he
adds.

A survey of the state-run Planning Division in 2017 found that 40 percent
of Pakistan’s population lives in multi-dimensional poverty.

That means they are not just short of money, but are also facing a shortage
of basic needs, including health, clean water, and electricity, among other
factors — all of which can impact their access to food.

– Cycle of malnutrition –

“Poor physical infrastructure, particularly in the remote rural areas
throughout Pakistan is also a limitation on access to food and influences
market prices,” according to a recent statement from the Food and Agriculture
Organization (FAO).

“This is also linked to inadequate water and sanitation, education and
health service delivery, which together with the lack of awareness of
appropriate dietary intake contributes to greater food insecurity and
malnutrition.”

Tharparkar district is frequently highlighted in Pakistan’s media because
of its high rate of child deaths, with politicians blaming the situation on
drought — but economists and physicians say that is not the sole
explanation.

“Causes of malnutrition are multiple pregnancies, young-aged marriage, iron
deficiency in mothers, (lack) of breastfeeding, weak immunization, and early
weaning,” Dr Kumar insists.

Bearing large numbers of children from a young age takes its toll on
women’s health, but also impacts the well-being of the foetus and ability to
breastfeed a newborn.

In Pakistan, only 38 percent of babies are fed breast milk exclusively
during their first six months in line with UN recommendations.

This low figure is blamed on local traditions, the heavy workloads of
mothers and powerful marketing by the milk industry.

Many mothers are told to feed their newborns tea, herbs, which can stunt
growth. Some are unnecessarily persuaded to use formula instead of breastmilk
by doctors.

This can introduce health problems if the water use to make it is unclean,
or if poor families scrimp on the amount of powder to create the drink.

Sindh’s high number of child deaths are the result of a vicious poverty
cycle that begins with malnourished mothers, agrees Bengali.

He adds: “An infant is not fed with wheat or solid food.”