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[image, unknown] NUTRITION[image, unknown]

Children’s energy crisis
Invisible malnutrition

Iceberg Hunger IF THE WORLD’S political leaders were to stroll together through a village in the developing world they would only recognise about two per cent of the child malnutrition all around them, says this year’s ‘State of the World’s Children’ report from the Executive Director of UNICEF, James Grant. So invisible is the problem of child malnutrition that in the majority of cases not even the child’s mother can see that there is anything wrong.

Despite the well-known image of the starving baby, visible and obvious malnutrition is rare. Invisible malnutrition, on the other hand, touches the lives of approximately one- quarter of the developing world’s children ‘It quietly steals away their energy,’ says the report ‘It slowly lowers their resistance to disease; it gently holds back their growth’

The main reason for the invisibility of malnutrition is that the child’s first reaction to the lack of food — to the lack of energy intake — is to reduce energy output. And by conserving health and growth at the expense of activity, the child can maintain a normal appearance. Detailed studies in Uganda, for example, have shown that even children who are regularly eating only three-quarters as much food as they actually need can still maintain weight and growth by ‘cutting out discretionary activity.’

But even as the child sits ‘resting’ in the shade for hours on end, invisible malnutrition is taking its toll. As is now widely known ‘discretionary activity’, including play and an active involvement with life going on all around, is essential to a child’s normal development. One study in Mexico has shown that by the age of three a group of malnourished children were already one year behind their well-nourished contemporaries in language development.

‘Invisible malnutrition’ also dilutes the body’s natural immunity and lowers the child’s resistance to disease. And without clean water, hygienic sanitation or health education, infection usually needs no second bidding.

A talk with the mother of a typical three-year-old in a community of the developing world, says UNICEF, would reveal that in its short life the child had suffered perhaps 6 tol6 bouts of diarrhoea, 7 or 8 infections of the upper respiratory tract, 2 or 3 attacks of bronchitis, as well as measles and conjunctivitis and maybe— depending on the exact location of the village— an attack of malaria or meningitis. The detailed health record of 45 such three-year-olds, studied in the villages of Central America, showed an average, for each child, of one illness every three weeks.

It is this mutually reinforcing relationship between invisible malnutrition and infection which is responsible for the majority of the 40,000 deaths every day among the developing world’s infants and children. ‘Together.’ says UNICEF, ‘they act like the jaws of pincers, each gaining leverage from the other around the common fulcrum of poverty, to cut through the vulnerable years of childhood.’

So important is this relationship that in probably half of all cases child malnutrition is precipitated not by the lack of food itself but by infection — especially diarrhoeal infection — which depresses the appetite and causes food to pass too quickly through the gastrointestinal tract to be efficiently absorbed. That is why a child can sometimes be malnourished when there is food in the household and adequately nourished brothers and sisters are playing outside. More usually it is the interaction between malnutrition and infection which does the damage. Studies in Guatemala. for example, have shown that even a moderately malnourished child is three times more likely to contract a diarrhoeal infection than a child who is well fed.

Just as a child defends health and body weight by cutting down on ‘discretionary activity’ at the expense of individual development, says UNICEF, so a malnourished adult can react to malnutrition by reducing his or her activity at the expense of economic and community development Most of the food eaten by an adult has to be used for the 24-hour-a-day maintenance of the body’s basic metabolism.

So even a small shortage of food can have a significant effect on activity.

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The State of the World's Children 1982-93 is published by Oxford University Press.

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[image, unknown] HOUSING
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Boxing mismatch
China’s overcrowded cities

THE housing in Chinese villages may be an example to the world (see NI 116) but the urban experience has been an absolute disaster. House building has failed to keep pace with population growth and residential floor-space per person in the cities has progressively decreased.

In 1978 each person had only 3.6 sq. meters, which is 20 per cent less than was available in 1949. And if there are no slums in Chinese cities it is only because the government keeps strict control over migration from the countryside. About a third of city dwellers live in overcrowded conditions, most in single-room tenements sharing kitchens and toilets. To wash they must go to a public bath.

Because of the growing pressure on building space many cinemas and shops are now going underground — into what were originally just air-raid shelters. In Beijing alone one million sq. metres of shelters were built in the late 1960s and early 1970s and forty per cent of these have now been converted into hotels, shops, workshops and warehouses.

The housing authorities say that the shortfall was caused by insufficient investment, especially during the third five year plan (1966—70). The Gang of Four is blamed both for the disruption of the Cultural Revolution and for its preference for investing in productive buildings.

But the government takeover of most construction activity is also at the heart of the problem. At a recent seminar in Beijing one young architect who has worked extensively on Third World housing programmes claimed that China has gone so far as to ‘destroy public participation in urban building programmes’. It allows considerable individual creativity in the country-side but not in the cities.

Characterless multi-storey boxes now proliferate. And while old cities like Beijing still preserve much of their beauty the new ones like Urumchi are totally uninspiring. Chinese architects will admit in private that state contro is the cause of much of this: the state can only employ mass-production techniques and this means prefabricated components and de-humanised blocks.

The big advantage for Chinese city dwellers is that housing of some form is guaranteed by the state. Everyone is provided with housing by the industry or office in which they work and rents account for only two or three per cent of a family’s monthly wages. This does mean, however, that the government isn’t getting much money to use for maintenance and, as the Chinese paper Renmin Riban recently pointed out: ‘Housing projects are attractive investments in other countries; in China they are the last thing that enterprises want to spend money on’.

Anil Angarwal, CSE

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[image, unknown] THE ARMS TRADE
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How to sell a bomb
Special seminar for arms dealers

Demonstrators outside arms seminar.
Photo: Philip Wolmuth

FOR all the international protests about the arms race, it’s business as usual for the salesmen. And ever-anxious to improve their technique they assiduously attend training sessions on arms dealing. One such seminar was held in London in December last year at the Great Western Hotel — to explain to delegates how more British weapons could be sold to the Third World.

Entitled ‘Marketing to the Third World’. the seminar was organised by State of the Art Ltd., a subsidiary of the Technical Marketing Society of America It was presented by Anthony J. Dobrski (described as a ‘leading marketing expert’) who pointed out that, with the Warsaw Pact and NATO countries ‘sewn up’. Third World countries represented the only remaining open markets with healthy prospects of increasing demand and lucrative returns. With the seminar registration fee at $900 per head delegates would have expected nothing less.

The delegates from arms and component manufacturing companies were told how to assess markets, what to look for in an agent he should be ‘hungry’ but not ‘greedy’ —and how to approach government ministers. But the most important feature to look for is corruption: ‘The more corrupt a country is, the easier it is to deal with a few people — in the less corrupt Third World countries there’s more bureaucracy and it’s not so easy, there’s delays.

If delegates were worried by the idea of selling arms to corrupt regimes, they would have been reassured by the Technical Marketing bulletin, ‘Aerospace Market Outlook’, available free at the seminar. In an assessment of the implications of the Reagan Administration’s defence strategy for arms sales it pointed to less emphasis on human rights in international arms and technology transfer, which . . . seems to portend significant Foreign Military Sales growth, less encumbered by human rights considerations’. Delegates may also have been pleased to know that there is also more emphasis on regional, Third World conflicts . . . more emphasis on Chemical Warfare … and more real emphasis on a protracted nuclear war’, and ‘less emphasis on negotiating Strategic and Tactical Arms Control Agreements’.

All of which is likely to make life easier for the arms manufacturers, and shorter for the rest of us.

Philip Wolmuth

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[image, unknown] UPPER VOLTA
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Doctors orders
New regime takes a democratic direction

UPPER VOLTA now looks as though it is set on a more optimistic course as more details emerge about the regime which took over in November of last year.

The military doctor who took over as President, Jean Baptista Ouedrago, does indeed head a military government but it is encouraging to see that he is one of only two military people in the cabinet Also encouraging is the fact that two women are among the civilians who make up his ‘People’s Salvation Council’.

This was Upper Volta’s second coup within two years. The leader of the previous takeover in 1980, Colonel Saye Zerbo, had made many promises of reform but his government had in fact become increasingly repressive— particularly towards trade unionists, as we described in NI No. II7. The influential and outspoken confederation leader Soumane Touré had been arrested and imprisoned.

Releasing Touré and other political prisoners was one of the first acts of the new government. Tour6 has now been united with his family but is under military guard because of possible reprisals against him from supporters of the Zerbo government.

Although there is still a ban on political activity in the country the government has pledged itself to the restoration of human rights and the return of democratic freedom. Ouedrago says that he will hand over the government to the people as soon as the situation becomes stable: ‘the Army can’t decide alone’.

Paul Rees

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[image, unknown] REFUGEES
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Back to barter
Camps in Somalia are developing their own economic system

REFUGEES brought into special camps soon start to create a whole new world of their own. A new report, ‘Survival strategies for and by camp refugees’ by the UN Research Institute for Social Development throws some new light on this process.

It looks in particular at the distinctive refugee society among that half million people driven into Somalia from Ethiopia as a result of the four-year war between the two countries.

Theirs is a world largely without money where food has become the basis of economic activity. It seems that the food from the various relief agencies is based on a slight overestimation of needs. Children. for example, are allotted the same ration as adults. Any spare food is then traded with the outside community for commodities that have a more important cultural value— the sorts of foods that people may have eaten before they became refugees.

Grain rations, such as maize, sorghum, rice and the like are traded for small amounts of goat meat, fresh milk, or cheese. Some of the ration is sold for cash that might later buy more valued food or clothing or teaching materials for children’s education. Some may even be invested in livestock or merchandise in an attempt to begin building up an independent life again.

But, like the real world outside the camps, the resources are not always distributed equally — the refugees who manage the system get the biggest share. The rest of the refugees are divided into two groups: the ‘haves’, who receive a regular share, and the ‘have-nots’. whose access to food is uncertain. This disadvantaged group, about 10 to 15 per cent of the refugee population, appeared to the study team to be the real victims of displacement,

Unable to cope or adjust to life as refugees, these marginal families cannot manage to look after themselves. The report recommends improving the food monitoring system to ensure that everyone gets a fair share.

In the refugee society the traditional male and female roles are being transformed. Almost two-third of the families are headed by women— widows or ‘grass widows’ whose husbands are away fighting or still living in the Ogaden.

Men in the camps have ‘lost their previous major functions as providers and decision makers’, the report says. They are catered for and all major decisions governing the lives of their families are made for them by officials.’ Camp life therefore has made the males idle and redundant to a large extent.

Women, on the other hand, continue to work much as they always have: cooking, collecting water and fuelwood., washing. and rearing children.

But women are also discovering themselves as increasingly independent, resourceful and productive individuals. A female consciousness is emerging as women realize they can manage on their own.

Rowan Shirkie, IDRC

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New Internationalist issue 121 magazine cover This article is from the March 1983 issue of New Internationalist.
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