Karachi
Prof Aisha Mehnaz, an eminent pediatrician and chairperson of the Department of Pediatrics, Dow University of Health Sciences and Civil Hospital, Karachi, has voiced concern over increasing levels of malnutrition in Pakistan.
The News conducted an interview with her on Saturday about the likely impact of the rising inflation and the withdrawal of subsidies on the vast majority of the people of Pakistan, particularly the poorest of the poor. Excerpts follow:
Q: Given the fact that 30 percent of Pakistan’s population is condemned to live below the poverty line and inflation is at the highest ebb, how can the common man combat malnutrition?
A: Pakistan is the 6th most populous country in the world with a population of over 178 million and has some of the worst health indicators in the world. Fifty percent of its population comprises children, and 31 percent of them are under five years.
Ninety-four out of 1,000 children do not reach their 5th birthday and 78 out of 1,000 do not complete even the first year of life.
Pakistan has one of the highest levels of under nutrition and malnutrition in the world. In Pakistan, 30.3 percent of children under five years are underweight, 40.9 percent are stunted, 16.8 percent are severely wasted and 62 percent are anaemic.
The super floods of 2010 and 2011 have further worsened the situation. Our nutritional programmes have failed to address the problem because the root causes of poverty, illiteracy and socioeconomic deprivation have been largely ignored .The common man lacks the knowledge to combat malnutrition. Though the rapidly deteriorating economic condition is much to blame, in my opinion it is the poverty of knowledge regarding food and its nutritive value that is the main cause. Very few people have the knowledge that food grain available at home such as rice and lentils, if cooked with plenty of oil with addition of vegetables such as spinach and potato etc. can become a very wholesome and balance diet. Fruits such as dates and bananas are not only rich in energy but are a good source of vitamins and minerals such as potassium, thus a very healthy food for those living in warm climates such as ours.
Q: Please enlighten The News on the importance of breastfeeding and injurious effects of bottle feed.
A: Breast milk is the inherent birthright of every child. Mothers who deny breastfeeding are violating the rights of the child as well as God’s command. In the Holy Quran it is clearly stated that babies should be giving mother’s milk till two years of life. Breast milk is species’ specific, i.e. human milk is good for human child and cow’s milk for calves.
This is because of the fact that human child is in the process of maturation even after birth and his systems such as renal system is still immature. Giving whole cow’s milk will place an electrolyte load on yet immature kidney of babies. Unlike human child, cow’s young one begins to graze soon after birth and their renal system is mature. Mother’s milk is thus tailor-made to the species of its own kind. Besides providing nutrition, human milk has anti-infective properties by virtue of which babies are protected from infections. Breast milk is the first vaccine a baby needs to be given even before the BCG and polio vaccine.
Regarding bottle feeding a number of studies have shown a direct correlation of bottle feeding with diseases such as diarrhea, ear infection, asthma and allergies.
A recent study published in a reputable journal has shown that children who are breastfed have a much higher IQ level compared with children who were given animal milk or were bottle-fed. This shows a direct effect on brain growth and intellectual performance in children fed on human milk.
Q: Ninety percent of diseases are waterborne. Given the fact that most of Pakistan’s population is condemned to drink contaminated water, what steps should be adopted to make water safe?
A: It does not need very sophisticated means to purify water. Simply boiling the water, particularly, the drinking water and hand-washing, observing all the essential steps of hand-washing will decrease the waterborne diseases considerably. The government should also ensure water purification and decontamination of water supplied to the population. Vaccines against some waterborne infections such as typhoid and rotavirus are available and these should be included in the EPI programme of Pakistan and particularly be given to children.
Q: Health and education has always been a low priority in Pakistan. Given the fact that health budget is minuscule, how can we meet challenges in the domain of health and education?
A: Unless health and education is given priority, we cannot imagine a healthy and educated Pakistan. If the government is not willing to take a positive step, then philanthropist and non-governmental organisations (NGOs) should play a proactive role. This does not mean that the state will be exempted from this. Thus the onus will still lie with the government.
Q: Don’t you agree that participatory development can help meet the abovementioned challenges, especially when we are forced to withdraw subsidies?
A: I think to some extent it will; at least, it will be a good beginning.
