Feeding people aftera tragedy

Rosalee Brown - DIETITIAN'S DESK

A healthy nutritional status hedges against many acute illnesses and chronic diseases. This truth is strikingly evident in crisis situations such as in disasters where injury and reduced food intake are the order of the day.

Small pockets of malnutrition are a reality in rich countries but are widespread in poor ones such as Haiti. This country has high levels of chronic malnutrition, with levels of stunting in the under-five age group reaching as high as 32 per cent in 1995, though this was a marked improvement of eight per cent on the 1978 figure. There are micro-nutrient deficiencies and many other indicators of chronic malnutrition in the population (FAO data).

The nutritional status speaks to the overall health of the population as nutrition and health are inextricably linked and a nation's inability to feed its population is an indication of its capacity and vulnerability in other areas. This vulnerable nation is now more at risk for increasing levels of malnutrition among survivors of this apocalyptic earthquake. It is important immediately after an emergency to provide water and food to save lives, but an urgent nutrition-intervention plan is necessary.

Dry rations and safe water

We have already seen that in Haiti, the general feeding programmes have started. There are guidelines for these programmes in disaster situations. The minimum standard requires:

Average daily requirement of 2,100kcals, preferably in dry rations, where safe water and the ability to prepare meals are compromised.

These rations should ensure cultural acceptability in food choices as much as possible.

Food-aid targeting should identify the most vulnerable areas and households or groups.

Then there is the selective feeding programme (SFP) which includes specific vulnerable groups. The SFP includes supplementary feeding programmes and therapeutic feeding programmes. The selective programmes target those at risk, such as infants and children, elderly, pregnant women and so on and the therapeutic programme targets those severely malnourished and critically ill individuals. The information available to us at this time indicates some level of general feeding, but there is urgent need for the other phases to start if we are going to save more lives.

Food security problems

In addition to feeding programmes, the food security problems must be eventually addressed. "Food security exists when all people at all times have physical and economic access to sufficient safe and nutritious food for an active life" - World Food Summit Plan of Action.

A nutrition plan should look at reducing food insecurity and subsequent dependency on these food programmes. The plan should focus on building, resuscitating and sustaining the national agricultural programmes.

One benefit of this tragedy should be invaluable data for an improved plan for disasters of similar magnitude in the future.

Rosalee M. Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email: yourhealth@ gleanerjm.com.