“When I was born my mother could not eat anything but tiny fish and tea made from herbs for one whole year,” says Dr Bhounsouane. “She was so weak that she could hardly walk. Post partum food taboos (phit kam) are a major problem in Laos for women,” he said.

Food taboos compromise breastfeeding Credit: Donna Kelly/IPS

Depending on ethnicity, taboos can last two weeks or a year, can exclude some meats, some vegetables and fruits only, or be extensive and debilitating.

This is borne out by many people and the practice is not confined to the smaller ethnic groups. A women carrying her baby from hospital in Vientiane fainted at the smell of a certain taboo vegetable, and had to be readmitted.

An Australian married to a Lao was horrified when after the birth of their child, her family insisted she lie over a bed of hot charcoal for two weeks and eat only roast chicken and rice and drink tea made from tree bark.

The ‘hot bed’ is said to close and repair the birth canal. Women fear that non-compliance will lead to illness in their children or death of the new mother. The ‘hot bed’ is considered as an opportunity to rest and regain strength, particularly women who are weak from the debilitating effects of poor nutrition and hard work.

Food taboos not only debilitate recovering women but compromise the amount and quality of breast milk. Breast feeding is often delayed until the women leave the ‘hot bed’. In the meantime the baby is given pre chewed rice by relatives, a practice identified with undersized children and infant death.

Sally Sakulku, director of U.K. NGO Health Unlimited, was at first sceptical of the dire consequences if food taboos were broken. “But when I worked at Mahoset (the major hospital in Vientiane) I saw many women being admitted with post partum anaphylaxis. Some died. It seems to be a real and unpredictable problem in Laos. I admit that I listened to my mother-in-law, and avoided a lot of foods when I had the kids.”

“I agree it needs more investigation, but it’s the mother-in-laws that have all the power. We need to educate them. Only then can women’s health improve,” said Shui Meng Ng, a sociologist and ex-UNICEF staffer.

Women and men of the Katu group in Lao’s south could identify and use over 700 separate sources of food, Jutta Krahn discovered while doing doctoral research. Her groundbreaking work indicated that traditional diets which included dry-land rice, herbs, insects, roots and tubers, forest fruits, wild animals and birds, were not only diverse, but yielded all the nutrients needed for health and well-being, particularly for women and children.

Modern Katu now eat more paddy rice and less forest foods, and are showing previously unknown vitamin and micronutrient deficiencies.

Since the 1970’s when logging and forest destruction gained commercial scale, ethnic groups such as the Katu have had their food sources seriously eroded.

“As climate change bites deeper, we will need more Katu type knowledge rather than less,” Dr Sean Foley, a human ecologist, told IPS. “Forest systems, high in biodiversity are going to be far more resilient to climate change than for instance rice, which demands water. Allowing forests to be cut for short term economic gain might be sentencing Laos to long term hunger.”

Dr Krahn from the Department of World Food Economics at Bonn University is critical of both agricultural and land use policy in Laos. She was unavailable for this story, but her writings are clear.

Krahn suggests that new food security strategies are required. Her starting point “would be the ethnic groups, their diets, and food cultures because the government and donor agencies focus too much on food production especially wetland rice.”

Hunting, swidden (slash and burn) and foraging are seen as signs of underdevelopment, of backwardness and deprivation rather than another food security choice, she wrote along with Arlyne Johnson of the World Conservation Society. To date major agricultural projects are largely focused on wet rice and livestock that favour men.

Foraging is deeply entrenched. People still forage in city gardens as they pass, snipping off edible tips and flowers. Swidden and forest foraging entail highly sophisticated forest farming of food and medicinal plants usually led by women, based on plant conservation skills acquired over hundreds of years.

Krahn’s concerns were borne out last year when donor agencies including the World Food Programme, filled a major wetland in southern Laos in order to increase rice production. What they failed to question was the role the wetlands had in local diets.

They saw a swamp; the women saw snails, fish, water weeds, frogs, eels, and edible roots to be eaten and bartered for rice. Filling the wetland resulted in protein and micronutrient malnutrition for the rice farmers, whose supply of other foods had gone, and hunger and dependency for the people who neither had goods to barter nor food to eat.

Two years ago the government announced that wetlands encircling the national capital Vientiane, were to be developed by the Chinese into a new industrial city. Thirty thousand poor urban Laos, in particular widows depend on the wetlands for food and income to buy food.

After rare public outcry, the government conceded, making far less land available. Nevertheless, the wetlands are being incrementally developed.

(*This is the second of a two-part series on chronic malnutrition in Laos. Part one focuses on structural reasons for the crisis.)

Ki is seven years old but looks more like three. His legs are bowed and skull misshapen. He looked at me with a blank stare. The health worker, Kheo, suggests rickets.

50 percent of Lao children are undersized Credit: Donna Kelly/IPS

Rickets and beri beri or thiamine (B1) deficiency are still far too common 19th century diseases in 21st century Laos.

The boy gets enough sun. It’s the other nutrients, calcium, phosphorus and dietary oils that are lacking. He is the worst effected of 93 other kids in his village who suffer chronic micronutrient deficiency. His mother is herself severely stunted, being less than 150 cms tall.

Ki’s people are hunters and foragers from the Annamite Ranges in Laos. His father said the village was moved to enable the Vietnamese and Lao military to mine gold high in the mountains. Soon they moved again to make way for Vietnamese-run plantations.

When they landed in the valley of Attapeu, in Lao’s south, the villagers knew virtually nothing about farming. They still don’t. Instead they continue to search for food in the rapidly receding forest, taking hungry children on up to 12-km hikes.

Lao’s rapidly growing population (2.8 percent per annum) the majority (85 percent) of whom are rural, suffer chronic food insecurity and hunger. It is generally agreed that 50 percent of Lao children are undersized, becoming stunted adults. Around 30-50 percent of children are underweight, girls being generally less affected. Since they help their mothers with searching for food, they get to eat as they forage.

Amongst women, 40 percent, of whom have been found to be anaemic, childbirth complications and generally poor maternal health are the outcomes.

In 1990, a Thai survey reported an infant mortality rate (IMR) of 116 per thousand births. Almost 20 years later a survey undertaken by the public health unit of the Theun Hinboun Power company revealed an IMR of 200 in the immediate community, representing a significant worsening.

“Populations are growing, land area is shrinking. It’s that simple,” said Dr Sean Foley, a human ecologist.

An insatiable hunger for land that is driving economic growth has usurped Lao’s tradition of land being informally owned by women. The greatest threat to women’s power and resources in the rural areas is posed by land legislation.

Lao’s rural transition has involved collective and traditional structures being transformed into privatisation led by individual land ownership. The state is exploring every possibility to enrich its treasury, and land tax offers substantial contributions.

A series of land certification projects resulted in a lot of land being registered by the ‘head of household’ which by some ill-thought out logic is usually a man. As land tax is based on production, farmers are pressured to plant as many cash crops as possible with an emphasis on rice and less on a variety of foods as grown by women.

Darryl Bullen, until recently head of public health with the Theun Hinboun power company, identifies dams as a cause for hunger. There are more than 60 hydropower projects in the pipeline. A senior minister envisages Laos as the “battery of Asia”.

“Dams really make life hard for people,” he says. “They get moved off land they have farmed. The relocated people generally get crappy land. So they go hungry.”

Lao has a new nutrition policy and draft strategy, created in a flurry after donor concern surfaced, but as this story indicates, some doubt that food policy can influence the reckless profiteering at regional and national levels. Nor will policies make the soil more fertile or the landscape less mountainous or easily change long held beliefs.

Listed as one of the least developed nations, revenue from taxation is low and average per capita income dismal. But evidence of wealth is appearing. A Lao supplying the Beijing Olympics with Lao forest timber owns one of the number of Lamborghinis to be seen in Vientiane. He plans an indoor swimming pool in his palatial house.

Land is cheap in Lao. Vietnamese and Chinese plantation owners pay as little as 5 U.S. dollars per hectare over 10 years to raze forests and plant rubber and eucalyptus. To mitigate fuel prices rises, biofuels are also being grown. Toxic and unreliable jatropha, occupies thousands of hectares of potentially arable land.

Kickbacks for granting land concessions and hotel and casino licenses are said to be huge.

In June 2009, 200 hectares of prime riverfront land were granted to a Korean company for a golf resort. In July, the Governor of Sekong province admitted to the Vientiane Times there was insufficient land left to feed the people of the province.

The Lao government is investing large amounts of money and national pride in the December 2009 South East Asian games. The four lane commemorative road is breaking up before it is completed.

The driver taking me south looked disdainfully at statues, the only residents of a huge triumphal park near the SEA games site. “That’s what is taking food from our mouths. When we can eat stadiums and statues we will be fat.”

(*This is the first of a two-part series on chronic malnutrition in Laos. Part two focuses on cultural factors including food taboos.)