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Some of you may remember the NY Times article on malnutrition in Africa – Erin blogged about it back in December. There is some good news on that front coming out of Zambia. They have decided to move forward with a fortification program that will add micronutrients – especially Vitamin A and iron, but also folic acid and zinc – to prevent damage from malnutrition. Most of the children of Zambia ARE eating at least one meal a day. Sadly, for much of the population, that meal consists only of nshima, basically thick corn porridge made only with cornmeal and water. Very filling, but certainly not “complete”, lacking adequate protein, vitamins and minerals. Mr. Ward Siamusantu, who manages the country’s “Maize Meal Fortification Programme” recently said “A few doses short of vitamin A or iron, and you throw away a child’s ability to do their best in life. Impaired children will grow up to be impaired adults, costing Africa billions of dollars in lost productivity.”
The NY Times article said the following:
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.
Nearly 6 in 10 (children) 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 children at are below-average pupils — often well below.
”They fall asleep,” said Eteafraw Baro, a third-grade teacher. ”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 (sub-Saharan Africa’s) hopes to join the developed world.
Micronutrient deficiencies debilitate minds and bodies. According to UNICEF, the lack of iron alone is so widespread in adults that it is lowering overall labour productivity, resulting in estimated losses of up to 2 per cent of GDP in the countries most affected.
“We became concerned when the latest government research revealed that 66 per cent of all Zambian children under five years of age suffer from vitamin A deficiency and 63 per cent lack enough iron,” Mr. Siamusantu said.
As a side note, Vitamin A is essential for eye health and proper functioning of the immune system. Inadequate intakes are further compromised by increased requirements for the vitamin as children grow or during periods of illness, as well as increased losses during common childhood infections. As a result, vitamin A deficiency is quite prevalent in the developing world and particularly in countries with the highest burden of under-five deaths.
While most people know that vitamin A deficiency can lead to blindness – it is in fact the leading cause of preventable childhood blindness – many are unaware that even before blindness occurs, vitamin A deficient children face a 23% greater risk of dying from ailments such as measles, diarrhea or malaria. Although many countries have not been able to assess the true level of deficiency due to technical and financial constraints, the World Health Organization estimates that 100 to 140 million children under the age of five may be living with dangerously low vitamin A stores. More than four million children worldwide exhibit signs of severe deficiency.
“The beauty of (Zambia’s) project is that we don’t ask people to change their habits,” says Amanda Marlin,the communication manager for the foundation Global Alliance for Improved Nutrition (GAIN). “People resist big diet changes. We enhance whatever is already an important part of their diet.”
This was a lesson Zambia had to learn, confirms Mr. Siamusantu, who said the country at first fortified sugar with vitamin A, but found that sugar “was not commonly consumed and we realized it was better to go for the staple food, maize meal.”
Another problem they encountered, sadly, was resistance to the idea because of fear that it was a “Western plot”. Some people worried that this was a ploy by Western governments to experiment on them. The CEO of the Millers Association of Zambia said consumers openly worried and wondered why the Western governments did not make *their* people eat fortified food. There were rumours that this would cause infertility. Through education campaigns, people now know that even in America and Europe, they eat fortified food. I have visions of “Wonder Bread” dancing before my eyes. Almost all of our food is fortified here in the US – milk, flour, prepared foods, even “enhanced” eggs.
Sometimes the smallest changes can bring long-term benefits. I salute the millers of Zambia that are willing to fortify all the maize (corn) that passes through their refineries and hope that country sees quick results in the health of its children. I also hope they will be able to fortify the grain in the most rural areas of Zambia, an area that will not be served by this new program.
