Kerala: Manna for malnourished tribals

THIRUVANANTHPAURAM: If the child-killer phenomenon called ‘severe acute malnutrition’ (SAM) has receded in tribal settlements in Attappady and Nilambur, it is mainly because of the popularisation of a ready-to-use food that can be fed easily to the malnourished child by the mother or an anganwadi worker.

While there were over 500 children afflicted with severe acute malnutrition (SAM) and moderate acute nutrition (MAM) in these areas in 2013, the number has now dwindled encouragingly to 30. Over 5,000 children in these tribal belts are under the surveillance of the state.

The mother is at the centre of the state’s nutrition programme in Attappady, giving her the access to easy-to-use nutritional food. A Kudumbashree tribal unit in Attappady is well-equipped to manufacture a ready-to-use therapeutic food (RUTF) that adheres to WHO standards. Such a WHO-accepted ‘energy-dense’ food is manufactured successfully only in one unit in the country, in a hospital in Mumbai with IIT Mumbai’s technical inputs.

The risk of death for SAM children is nine times higher than a normal child. Those at the lowest end of MAM spectrum will only be marginally better than a SAM child, the difference in weight a mere 600-800 gm. It requires only a fever, or the passing of stool twice, for the MAM child to fall into SAM group.

“We found that birth weight of babies in Attappady increased after mothers were fed the food. Now the weight of a newborn is a healthy 2.5-3 kg,” said Dr Manoj of National Rural health Mission. “Almost all the children under surveillance, too, have shown great improvement,” he added.

Earlier, the nutritional mix provided to children in affected areas could be administered only in NRHM’s nutritional rehabilitation centres, and not in homes, as the mix is not ready-to-use and needs some technical know-how and a chemist’s mix-and-match skills, which cannot be easily passed on to every tribal mother or anganwadi worker, to prepare.

Consequently, this nullified the community’s role in nutrition. The non-involvement of community is cited as one reason why relapse (children freed of SAM slipping back to SAM) is high in tribal areas. This food has now empowered the community.