Pakistan floods exacerbate child hunger and malnutrition

By Ali Ismail
2 September 2010

The UN World Food Programme (WFP) and the UN Children’s Fund (UNICEF) have warned that the floods that have been ravaging Pakistan since late July will exacerbate child hunger and malnutrition and this for multiple reasons.

Because of the continuing flooding and a lack of supplies, the vast majority of the 20 million people directly affected by the crisis have yet to receive any assistance from the government or other official relief efforts. Large numbers of people have thus had to survive on little food for weeks. Even when the waters recede, it will be difficult to get food to them because roads and other infrastructure have been destroyed.

Almost a quarter of the country’s crops have been ruined. In addition, the planting of next year’s wheat crop (which would normally begin in a few weeks) is in jeopardy in many areas because the flood waters destroyed farmers’ seeds and drowned much of the livestock used in plowing fields.

Child malnutrition was already a serious and persistent problem in Pakistan before the floods—a disaster the UN has termed the greatest humanitarian crisis in its 65-year history.

According to Pakistan’s government the flood have killed at least 1,650 people. The true figure is probably much higher, however.

Several million flood survivors have sought medical treatment since the onset of the floods and many more are in desperate need of treatment for a variety of illnesses related to contaminated water.

The UN News Service stated that, “According to the latest epidemiological data, some 3.7 million are reported to have received some form of medical treatment between July 29 and August 23. Of those, 500,000 were cases of acute diarrhea, 517,000 involved acute respiratory infections, there were 693,000 cases of skin infections and 94,000 suspected cases of malaria.”

The overwhelming majority of displaced people around the country still do not have access to clean water, placing them at risk of contracting water-borne diseases. Children are particularly at risk.

Relief and humanitarian agencies fear that a combination of water-borne diseases and malnutrition could kill tens of thousands of children in the coming weeks and months. Contaminated water leads to illness and further malnutrition, while malnutrition increases the risk of illness.

Many flood-affected Pakistanis have become increasingly frustrated by the lack of medical care available in areas hit by the floods.

On Monday, an article in Pakistan’s The News stated that stomach diseases are on the rise in the flood-affected district of Muzaffargarh, which is located in the province of Punjab and has an estimated population of 2.6 million. The article described how four members of the same family, including three young girls, died of gastroenteritis, after they were unable to get medical care.

“The parents said that soon after the girls contracted stomach-related disease they took the girls to [the] Rural Health Center Shah Jamal where no medical aid staff was present. So, timely medical treatment could not be provided to the girls and as a result all three girls breathed their last there.”

The main hospital in Muzzafargarh is struggling to provide treatment to around 1,000 flood victims. The hospital is filled to capacity and flood victims are forced to sit on the floor and wait hours for help. “I came to the hospital around dawn and I’m still waiting for my number,” Naseem Bibi told Reuters as her five year-old daughter, suffering from diarrhea, slept on the ground.

According to Martin Mogwanja, a humanitarian coordinator in Pakistan, over 70,000 children could die from severe acute malnutrition in the next few weeks. One WFP representative stated, “For the very youngest children, access to specialized food products could mean the difference between life and death in the coming weeks.” The WFP has only been able to reach 2.5 million flood-affected people with food rations in the past month, approximately one-eighth of all those who have been displaced by the floods.

Bilan Osmanjama, a nutritionist working with the WFP in the southern province of Sindh, explains, “Children under the age of five are usually the first group to suffer from malnutrition at the onset of a disaster. Other vulnerable groups include pregnant women and nursing mothers.”

Around 500,000 pregnant women have been affected by the floods, and 100,000 of them are expected to give birth in squalid conditions surrounded by contaminated floodwater in the next couple of months, endangering their lives as well the lives of their newborns, reports Save the Children.

Pakistan had a high infant mortality rate even before the floods, with 5 percent of newborns dying within the first month of life.

Osmanjama warned that may children will die unless food is delivered to affected areas as quickly as possible. “We’re now several weeks into the disaster and many children haven’t eaten properly in a long time. In almost every single camp we’ve come across, there are children with both moderate and severe malnutrition. Unless we move quickly, the rate of illness and death among young children will start to rise.”

On Tuesday, Aaj television reported that sixteen flood-survivors, including several children, had died of hunger and disease in a 24-hour period at relief camps in two districts in the province of Sindh. Another child also starved to death at a makeshift relief camp at a graveyard in Thatta District, located in southern Sindh, near the mouth of the Indus.

The floods are still ravaging much of southern Pakistan, forcing hundreds of thousands of people to flee their homes and search for food and shelter. Sindh is the worst affected province, with 19 of its 23 districts largely submerged.

Anguished parents are desperately seeking to secure food for their starving children. Speaking to NTDTV, Hussain, a resident of Jacobabad stated, “Our children are starving in the village, so we are trying to get to Shikarpur. We are not getting anything to eat. What is there to eat? Who should we turn to, to ask for help? Should we ask the government, the same government that is doing nothing for us”?

The town of Makli in Sindh has seen an influx of nearly 150,000 flood survivors from nearby Thatta since August 28. The population of the town prior to the flood was about 30,000. Residents of the town were stunned to see so many people. One older man commented, “This is like it was when Pakistan and India were partitioned and we had refugees.”

According to IRIN, “They all need food and water. Hundreds of people line the main roads, waiting for a private donor’s vehicle with flour or water to pass by; everyone scrambles for the few bags that are tossed out and the scene quickly turns violent. ‘We have become like animals, but hunger brings out the worst in every being,’ said a displaced man watching a fight with tears in his eyes.”

On August 29, many families decided to leave Makli out of frustration due to the lack of food available to survivors. “There is nothing here,” said Sher Mohammed. “We know we will die if we stay longer. No one is giving us any food.”

Hunger is an even greater problem outside of the relief camps. A minister in the Balochistan government pleaded for emergency food aid for flood survivors in Naseerbad District. The minister stated that many survivors were “crying for food.” There have been reports of an equally desperate situation in flood-affected areas in the northwestern province of Khyber-Pakhtoonkhwa (KP).

Speaking to IRIN, Abdullah Khan, a survivor from Swat stated, “Anything I receive I give to my children. Sometimes their mother, their grandparents and I eat nothing…They are growing weaker and my five-year-old daughter has high fever.” Khan went on to state that the floods have “even wiped out the berries or grasses we could otherwise have eaten.”

UNICEF is appealing for $80 million to combat child hunger and malnutrition. Deepak Bajrachariya, chief field officer for UNICEF, told IRIN that, “There is malnutrition and it could worsen because right now there is not enough food. We are arranging to provide high-protein biscuits and other items to try and combat this.”

Child malnutrition was already a serious problem in Pakistan long before the floods. Pre-flood data revealed 77 million of Pakistan’s 175 million people suffered from hunger and 45 million were malnourished. In the province of Balochistan, 27 percent of children under the age of five were malnourished. In Punjab, the province that is home to the majority of Pakistanis, 17 percent of children under five were malnourished, and in KP, 13 percent.

According to Bilan Osmanjama, the Sindh based nutritionist with the WFP, “Malnutrition rates in Pakistan were already high before the floods. The National Nutrition Survey in 2001-2002 put the acute malnutrition rate at 13 percent, which is alarming. Then in 2008, food prices shot up around the world and this had a major impact on how much and how well families were able to eat. That’s one reason WFP had such a strong presence in Pakistan before the floods.”

36 percent of Pakistani children were underweight before the current floods. Researchers claim that up to 44 percent of children of rural children in Pakistan are stunted. Stunted growth is a reduced growth rate in human development. The principal cause of stunted growth in children is malnutrition in early childhood. The effects of stunted growth are nearly always permanent. The vast majority of stunted children never regain the height and weight lost due to stunting. Many die premature deaths because their vital organs do not develop completely during childhood. Stunting also impacts negatively on cognitive development.

Soaring food prices are likely to exacerbate the hunger and malnutrition even in areas not directly hit by the floods. Inflation will become a growing threat to the well-being of Pakistani workers and fuel social unrest.

Over the past several weeks there have been numerous spontaneous protests over the failure of the authorities, beginning with the Pakistan People’s Party-led national coalition government, to organize proper relief. Nowhere has the incompetence and callous indifference of the Pakistani elite been more graphically shown than in Sindh. The authorities there had several weeks to prepare for the rising water surging down the Indus from the north. But as elsewhere, there was no properly coordinated effort in Sindh to protect levees and evacuate people in a timely fashion.

On Wednesday, Northern Ireland’s UTV reported that hundreds of protestors in Sindh were continuing to block the Indus Highway, one of the country’s main roads. “The people here are angry and believe they are being ignored or forgotten. They blocked the road with stones and their bodies out of desperation.

“They said they wouldn’t move until the government did something to help them and their families. There is anger here, but there is more fear and frustration.” The protestors finally departed when the local district police chief promised to provide aid for the protestors and their families.

There have been numerous reports about Pakistani authorities setting up fake relief camps and reports concerning fake relief agencies. This has only generated more disgust for the government among flood survivors and workers and toilers around the country. Sections of the press are increasingly apprehensive about the political fallout from the government’s manifest failure to provide relief to flood-affected people. Washington is also following developments closely and providing just enough aid to make sure that the government, led by the deeply unpopular President and PPP boss Asif Ali Zaradari, doesn’t lose control of the country, as this would pose a major threat to US interests in Pakistan and Afghanistan.

Iqbal Khwaja, a veteran journalist for Dawn stated that there was an urgent need for Pakistani authorities to restore the people’s trust in public institutions. In reality, the vast majority of Pakistanis had no faith in the country’s institutions even before the floods. In 2008 the military was forced to relinquish power to a PPP-led civilian government that has continued the previous regime’s neo-liberal policies, while imposing IMF austerity measures, and deepened Pakistan’s support for the US occupation of Afghanistan, including by waging massive counter-insurgency operations in the country’s northwest.

Pakistanis are struggling to make it through the most devastating natural disaster in the country’s history, and for the most part, they are doing it on their own and with the help of their families and friends. For countless Pakistanis, there is no “relief” to be found even in the relief camps. Reporters for IRIN visited one relief camp in Sindh over the weekend. The situation they described there is not very different from the bleak situation at relief camps around the country.

“Politicians arrive, look around, and drive away. There are very few tents, and some are aligned to political parties. Police and soldiers watch the crowd but no one seems to be in charge. Men, women, children and babies sit on the ground under open sky in the rain and heat; many succumb to exhaustion as the temperature climbs above 30 degrees Celsius.”

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