HEALTH: Malnourished City Children in Danger

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

MEXICO CITY, Oct 13 1999 (IPS) - Malnourished children in major cities of the developing world face grave health problems because of increasing levels of air pollution, warn public health officials.

Children are the most vulnerable segment of the urban populace and greater numbers are likely to fall ill as a result of continually breathing poor quality air, they say..

Recent studies have revealed, for instance, that pollution in the developing world has been responsible for 50 million cases of chronic cough in children aged below 14 years.

“Air pollution affects all children, but is especially bad for those who lack adequate nutrition,” says Devra Davis, a leading US public health researcher.

Children who do not have sound nutrition levels tend to “absorb and retain pollutants” for a longer period, because their immune systems are not as strong. The hapless victims are underweight children who have an inadequate caloric intake and suffer from micro nutrient deficiencies, a study co-authored by Davis reveals.

In countries such as Egypt, where 45 percent of the population are urban dwellers, one in every 10 infants born in 1997 had a low birth-weight and, in the same year, 15 percent of all children under the age of five were found to be malnourished.

In Bangladesh, where 20 percent of the population live in urban areas, the picture was even more grim: half the number of infants born in 1997 had a low birth-weight, and more than half of the children under five were malnourished.

Furthermore, findings by the World Health Organisation (WHO) point to the impact that air pollution has on the under-nourished children of the urban poor. In Bangladesh, reported infant mortality rates in urban slums far exceed the average experienced by the rural poor.

In the mid-1990s, major population shifts from rural areas to major cities in the Third World focussed attention on health issues – particularly a mushrooming problem of malnourished children.

This sudden concentration of large populations resulted in the “urban health crises” of the developing world, observes J. Wang’ Ombe, of the department of community health, University of Nairobi, Kenya.

Poor people who live in the slum areas have no access to adequate health services and they experience frequent epidemics of communicable diseases like cholera, Wang’ Ombe says.

His studies reveal that the children of slum-dwellers have “very poor health because they are not immunized and are malnourished” and they often fall victim to the heavily polluted environment in which they live.

At the moment, an estimated 174 million malnourished children under the age of five are living in urban and rural areas of the developing world from both the urban and rural areas who are malnourished; and 54 percent of the 12.2 million deaths that occur among children under five is due to malnourishment.

As a result of their poverty, parents in Third World cities have become more reliant on plant sources to feed their children, which has produced such problems as protein-energy malnutrition, nutritional anemias, vitamin A deficiency and iodine deficiency among others, health officials say.

In India, public health experts are worried that the current trend towards more economic liberatisation will aggravate an already alarming situation of child malnutrition in the major cities.

“Before liberalisation, not only was there widespread hunger and under-nutrition but, reflecting this, extremely high morbidity and mortality levels in the population, especially among the poor,” says Mohan Rao, a professor of public health at Jawaharlal Nehru University, New Delhi.

Nearly 30 percent of all deaths in India currently occur among children under five years, compared to less than five percent in developed countries, Rao says.

The total infant mortality rate is at the “unacceptably high level” of 79 per 1,000 compared to that of India’s southern neighbour, Sri Lanka, which has 17 deaths per 1,000.

“Given that unemployment levels have increased, and that the period of liberalisation has been marked by unprecedented increase of food prices, it can be surmised that levels of hunger and under- nutrition (among children) also has increased,” Rao says.

Such a scenario has been noted by the World Bank, even as it continues to advocate more economic liberatisation. The bank acknowledged the link between dangerous levels of pollution and malnourished children in its recently released World Development Report 1999/2000.

Air pollution, which is closely associated with urbanisation and industrialisation in developing countries, seriously impinges on the health of children and adults alike, the report says.

“Pollution particularly affects those already suffering from malnutrition and infectious diseases,” it adds.

By way of example, the report refers to the Indian capital, New Delhi, where “the incidence of bronchial astham in the 5-6 age group is 10-12 percent, and air pollution is one of the major causes.”

To help malnourished children cope with the hazards of air pollution, health experts suggest interventions such as targeted food and specific micronutrient supplementation, food fortification, and nutrition education.

Davis stresses the need for immunisation programs and, to protect vulnerable city children, adds that governments must implement energy reforms.

“Air quality can be improved in a very short period of time, through the adoption of cleaner energy forms,” she says. “For instance, within one year of reducing lead in gasoline, there also is a drop in the amount of lead in children’s blood.”