To me, starving has always been under one big bracket. It was interesting to learn that many children are malnourished, but each level receives different amounts of public attention. I don’t think I could ever be in a position where I get to decide who lives and who dies. That’s way too much power for any human to handle, even if it’s not direct. I think that the most surprising thing to me was that the most severe cases get less attention than the mild or moderate cases. I suppose I understand; you have to save the ones that actually have a standing chance. I don’t like it, but fiscally, I get it. This brought me back to earlier in the book, it talked about essentially deciding who lives and who dies. The value of life, burnt down to a matter of who will be the most fiscally productive within a given economy. Deciding who survives, based off of who has the best chance of survival, will never sit right with me. Then again, neither does most of modern society.
According to the reading, it is in a nation’s best interest to ensure that the youngest children have the best diets. This, to put it in simple terms, is like gardening. If you have a sapling, and you want it to become a strong tree, you fertilize it, water it, and take care of it while it’s still growing. By providing the youngest members of society with proper nutrition, a nation is ensuring a larger future population of able bodied citizens. A proper diet is linked to decreased morbidity and mortality, limits stunting of growth, and assists in proper maturation which leads to strong adults for the workforce, and thus boosts the economy in the long run. Many children die every year from malnutrition related ailments such as vitamin deficiencies, diarrhea, and higher susceptibility to infectious disease (UNICEF, 1998). Given this, by not giving children proper access to nutrition, the nation would be facing a variety of problems rather than just one. In developing crowded countries, infectious disease would likely spread quickly, in part due to the abundance of young hosts with already susceptible immune systems. Additionally, diarrheal illnesses would likely spread quickly as well, due to the lack of sanitation and abundance of hosts. As can be seen, nutrition is not all black and white. There are many implications from lack of nutrition, and likewise, many benefits from access to a nutritious diet.
However, food is not the only step that needs to be taken to reduce the many problems associated with undernutrition. The author of the article points out that there are three underlying causes of undernutrition at a family level. These include food, poor sanitation and health services, and maternal and child care practices (Martorell, 1999). Of these, I believe that maternal and child care practices would be the easiest to address through a health intervention. This is due to the fact that through simple education programs and access to food and vitamins during pregnancy and infancy, the child would be receiving enough vital nutrients in the first thousand days, and would escape being set up for nutritional failure at birth. My mom worked with an organization in Guatemala that provided mothers with prenatal vitamins, clean water, formula, and parenting/nutrition education. If more programs like this could be implemented in developing countries like Bangladesh, where the prevalence of low birth weight is as high as 50%, a lot of children might be saved (Martorell, 1999).
By improving the diets of young children, we would not only be saving or improving lives, but would also be increasing the child’s chances of success later in life. As the article stated, children who are malnourished suffer from reduced intellectual capacity and lower work performance as adults. This fact points towards the idea that the environment plays a larger role than genetics. If a child is malnourished from the time they are in utero, they will not have the strength needed to learn and adapt. In simple terms, you can’t study if you’re starving. Not only that, but a brain needs nutrition to develop correctly. Without the proper vitamins, you are essentially running on empty. I personally have experienced being malnourished. I was Anorexic for close to two years, and I had a BMI of 14.0. Though this was due to mental illness, and not at all comparable to the children who have no choice but to be severely undernourished, I can attest to the fact that life is a million times harder when you don’t have nutrients to keep you running. I was anemic, I had a sodium deficiency, about every vitamin I needed in my body was way too low to do anything, and I developed heart and gastrointestinal problems because of this. I was in the ER normally two or three times a month to get IVs and be pumped full of vitamins. Running on empty took a huge toll on my body, even to this day. Children who don’t have access to ERs and IVs, or supplements and dietary support, have so little chance of ever getting out of that terrible place physically. Children in developing countries likely have diets a million times worse than what I had, as well as limited or no access to the simple medical interventions that may have saved my life.
The figure in the article did not really show one place to begin the cycle of improvement; however, I think that the best place to start is with social sector investments. When you start from the beginning, i.e kids, nutrition, education, etc, you get a population of healthy, able bodied working adults who contribute to the economy. Once you’ve done this, the rest of the boxes will follow. In other words, investing in social sectors is like laying the foundation of a house. You can try to build the roof first, but it will just keep falling in on itself until you address the underlying problem. In order to address the problems that stem from lack of nutrition in childhood, such as lower IQ, less ability to work, and higher rates of mortality and morbidity, you have to start at the beginning. For example, by providing expectant mothers and young children with vitamins such as zinc, folic acid, or vitamin A, diseases such as cretinism, anemia, and vitamin A deficiency, as well as various intellectual impairments, could in large part be avoided or reduced significantly. Additionally, lasting health effects, such as diabetes, insulin resistance, hypertension, lower energy, and much more, could be cut significantly by preventing malnutrition in children (Martins et al, 2011).
In conclusion, investment in social sectors, improved child nutrition, and base level interventions, such as improved water, food, and sanitation access, can greatly improve overall quality of life, and in turn, lower morbidity and mortality. While reading this article and researching further, I was shocked by how simple a solution that could save millions of lives goes far under executed. My only idea as to why goes back to the value of life. Donors and governments want a public pay off that is quick and easy, but with investing in children, the return on investment takes years. Whether on purpose or simply as a side effect of their choices, the people in power get to decide who’s life is worth more. I have always wondered if their choices would change if they met the people they are letting live or die, in person. The whole situation reminds me of something my ecology professor said the other day, “We do not truly care until we understand.” His example was having students spend time in nature so they would be more passionate about it and thus more protective when it comes to environmentalism. Conversely, I wonder if by having donors, government officials, and medical professionals spend time with the children whose lives rest in their wallets, they might decide that a child’s life is worth a whole lot more than they originally thought.
References
Martins, V., Toledo Florêncio, T., Grillo, L., Do Carmo P Franco, M., Martins, P., Clemente, A., Sawaya, A. (2011, June). Long-lasting effects of undernutrition. Retrieved October 11, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137999/
Reynaldo Martorell, “The Nature of Child Malnutrition and Its Long-Term Implications.” Food and Nutrition Bulletin, 1999, 20(3): 288–292.
United Nations Children’s Fund (UNICEF). The state of the world’s children 1998. Bringing science to bear. Oxford, UK: Oxford University Press, 1998.
Double Sided 