Maldives “lagging behind” on tackling malnutrition

The Maldives is “lagging behind” in addressing malnutrition, a senior medical expert has said, as the country continues to work towards meeting the UN’s Millennium Development Goals for health.

Public Health Programme Coordinator for the Center for Community Health and Disease Control (CCHDC), Dr Fathmath Nazla Rafeeq, told Minivan News that malnutrition in the country was “quite alarming” considering the number of medical advances made in the country over the last few years.

Her comments, made on World Health Day, relate specifically to fears over the national promotion of healthy diets, including issues of vitamin deficiency in expectant mothers and children, to the consumption of high-calorie junk food and energy drinks by young people.

According to figures published in 2009 by the World Health Organisation (WHO), 17.8 percent of children under five years of age were found to be underweight in the Maldives according to international standards for ascertaining health in young people. The same figures found that 6.5 percent of children were classed as overweight in the country. 20.3 percent of children in the same age group were found to be suffering from ‘stunting’, a term describing children suffering growth retardation as a result of poor diet and infection.

Hunger for information

Co-founder of the NGO Advocating the Rights of Children (ARC), Zenysha Shaheed Zaki, believes parents and schools across the Maldives require greater access to trained nutritionists, reflecting a demand for education on healthy eating.

ARC is focusing on overcoming a widespread cultural prevalence for convenience foods in the country by promoting healthier lifestyles – particularly among younger people.

Dr Fazla said that the government continued to rely on NGOs to helping to promote healthier lifestyles across the country’s atolls.

“The state cannot do this alone. Therefore we welcome the support of NGOs to improve health across the country,” she said.

Though not all educational programmes relating to nutrition in the country in recent years have succeeded, the CCHDC claimed in certain cases children were able to teach their own parents about the need to cut down on junk food like french fries and other dietary offenders, as a result of their own learning.

Dr Fazla said there was also a strong concern about the amount of high-calorie junk food being consumed by school-age children.  She also said that the number of expectant mothers suffering with anaemia – a condition that can have health impacts for children later in life – also needed to be addressed.

Energy drinks

Dr Fazla stressed that beyond just dealing with food intake, the government continued to be concerned about a growing trend among parents providing children with caffeinated energy drinks. There was, she said, a common misunderstanding that such drinks were the same as sports drinks designed for rehydration after physical activity.

“We understand that some parents are under the misconception that sports drinks are the same thing as energy drinks,” she said. “Right now we are looking to address concerns about giving energy drinks to children.”

Rather than solely treating nutrition as an education issue, Dr Fazla claimed that wider national issues of food security and supply were also important to the debate about the quality of the nation’s eating habits.

Supply issues

Supply issues are hampering efforts to encourage healthy eating in the Maldives, said Dr Fazla.

“There is a perception among some people that when we encourage people to eat fruits, these be products like apples and oranges – things grown in in other countries, rather than locally available produce like papaya,” she added.

“We also have to think about affordability. I can go to tell someone to buy vegetables, but for products grown on farms say in India there are a lot of variables like shipping costs that impact the prices of such goods.”

Dr Fazla stressed that projects were underway to try and encourage a wider variety of agriculture, but issues of food security and availability should not be understated.

She was ultimately optimistic the country could succeed in fostering a culture of healthier eating among young people, and the rest of the nation.

“We should be able to overcome the challenges of how to feed our young properly,” she claimed.

Awareness issues

ARC yesterday launched a new website for its HEAL campaign, originally launched in April last year, designed to introduce young children to a five-point program designed to promote healthier lifestyles.

According to ARC co-founder Zenysha, the NGO is educating parents and schools to replace fast foods and flavoured soft drinks with fruits and vegetables, water and a generally more active lifestyle. Efficient promotion of ARC’s message remains a major challenge, she said.

“Raising awareness [of healthy eating] among young people is a key challenge we face right now. There are a few nutritionists in the country, but the ARC has had to get two nutritionists from New Zealand to help with our work,” she said. “There is a lot of demand among parents and pre-schools for dietary advice and information. We have had nutritionists meeting with parents at pre-schools in Male’, Hulhumale’ and Villingili – events that were popular, but people are still demanding more advice.”

Children were often wary of being taught lessons, Zenysha said, so ARC was attempting to combine education with games and activities to raise awareness about the importance of healthier eating.

The HEAL plan emphasises the importance of healthier snacking, such as yoghurt or dried fruits and nuts, eating a mix of different coloured fruits and vegetables, avoiding processed foods like sausages and burgers, and aiming for at least an hour a day of physical activity.

Drinks are also included, with parents being asked to reduce their children’s consumption of added-sugar drinks such as packaged juices and flavoured milk, by favouring bottles of water and lower fat or skimmed milk.

Though the HEAL campaign was launched back in April 2011, the launch of the new website this weekend represents an ongoing collaboration with nutritionists to promote a national discourse on the need for healthy eating.

Zenysha said information on the website was at present solely provided in English, though attempts were underway to provide Dhivehi translations.

ARC said it was also looking to schools to try and have a single day each week where children are invited to bring lunches and snacks consisting solely of fruits and vegetables.  Water would also be encouraged in place of added-sugar drinks.

Meanwhile, ARC said it had been invited by a large number of groups and organisations around the country to attend events in order to promote the HEAL campaign, providing games and activities to help parents and children better understand the need for nutrition.

After a festival held last year to promote its nutrition message, Zenysha said the NGO was now looking to hold a similar, much larger event to promote child nutrition in 2012.

ARC had now been in operation for two years and was seeing strong support from government, fellow NGOs and the private sector, though difficulties were still felt in attracting active volunteers, she said.

“While we have lots of interests in our campaigns, we are a relatively small team, so getting trained volunteers for our projects can be difficult,” she said.

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