Until two days before the ban was imposed in the Kathmandu Valley last month, there were 12 children in the Nutritional Rehabilitation Home in Sunakothi, a residential facility for severely malnourished children in Lalitpur.
But shortly after the government announced the ban orders amid a sharp spike in Covid-19 cases in the capital, the parents of the children, who came mostly from outside the valley, collected their wards and returned to their respective villages.
“We have converted the facility into an isolation center for Covid-19 patients,” Sunita Rimal, program coordinator of the program to prevent and treat malnutrition at the Nepal Youth Foundation, a non-governmental organization that runs the nutritional rehabilitation home, told the Post. “We operated a 50-bed isolation center here.”
In addition to the Sunakothi-based nutrition rehabilitation home in Lalitpur, three other such facilities in Biratnagar, Nepalgunj and Hetauda have also been converted into isolation centers. The residents of these homes, severely and moderately malnourished children, were released knowing they needed institutional care and treatment.
Doctors say that severely acutely malnourished and moderately acutely malnourished children do not receive treatment, which means they are at greater risk of dying from malnutrition.
“Only severely acutely and moderately acutely malnourished children are referred to nutritional rehabilitation centers,” Kedar Parajuli, head of the nutrition division of the Ministry of Health’s family welfare division, told the Post. “We are unaware of the latest state of malnutrition.”
There are 22 nutrition rehabilitation homes across the country. Doctors refer severely and moderately acute children to these homes.
But with the rise in Covid-19 infections across the country and restrictions on transportation and public movement, people have stopped taking their malnourished children to health facilities, thereby depriving children of much-needed treatment.
Also last year, during the first wave of the Covid-19 pandemic, several nutritional rehabilitation centers were converted into isolation facilities. And it often takes several months to clear them.
“This time, too, we struggled to prevent these centers from being used as Covid isolation centers, but to no avail,” said Parajuli. “What is worrying now is that even health workers do not take nutritional problems seriously.”
Malnutrition is turning into a silent crisis in Nepal. The country has made significant strides in reducing stunted growth in children under five. The growth lag decreased from 57 percent in 2001 to 32 percent in 2019, according to the most recent Multiple Indicator Cluster Surveys (MICS 2019).
Wasting, a debilitating disease that causes muscle and fat tissue breakdown, was 11 percent in children under five in 2001, 10 percent in 2016, and 12 percent in 2019.
The anemia in children under five is still 51 percent (NDHS 2016), which experts describe as worrying.
Doctors say child and infant mortality will increase, and years of effort and investment to reduce child mortality will be in vain if we continue to ignore the problem.
“Our nutritional rehabilitation home will not be cleared until the Covid-19 infections recede,” said Rimal of Sunakhoti’s nutritional rehabilitation home. “Until then, children who need institutional care and treatment will be disadvantaged.”
Nutritionists say the ongoing coronavirus pandemic that has gripped the nation poses a serious risk to the nutritional well-being and survival of minor children.
“We all know that the pandemic has left many people unemployed and, as a result, their sources of income have dried up and many others have no access to basic health services for fear of infection or the cessation of services,” said Dr. Atul. Upadhyay, a nutritionist, told the Post. “If this problem is not addressed in time by the authorities, another crisis could arise.”
Nepal has an international obligation to improve the conditions of malnourished children.
The country must reduce the growth lag from its current 32 percent to 15 percent by 2030 to meet the United Nations-backed Sustainable Development Goals (SDGs) 27 percent and anemia to 10 percent from over 52 percent in 2016.
SDGs – a follow-up to the Millennium Development Goals (MDGs), aim to end poverty and hunger and all forms of inequality in the world by 2030, and Nepal is committed to achieving the goals.
“Even before the pandemic, Nepal’s nutritional problems were alarming and, despite various efforts, the problems did not go away,” said Upadhyay. “At a time when the authorities are primarily focused on containing the spread of Covid-19 infections, they should not forget that nutritional problems will have a lasting impact not only on people’s health, but also on the overall development of the country.”
