There is nothing more painful, debilitating and cruel than a child suffering from malnutrition. I have met far too many malnourished children - from tiny babies whose bones protrude through their skin to toddlers who are stunted because they lacked enough breast milk, adequate nutritious food and clean water during the crucial first 1,000 days of life.
Today, over 20 million out of 157 million boys and girls in the Middle East and North Africa are without access to the nutrients they need to develop to their full potential. It’s a vicious cycle. Without proper nutrition, they are at added risk of being out of school and becoming less productive adults unable to invest in the development and growth of their own children, communities and countries.
Without optimum nutrition and care, children are especially vulnerable to life threatening illness, including infectious and water borne diseases. This is further exacerbated when they are deprived of adequate quantities of safe drinking water and sanitation. In other words, nutrition, water and sanitation are integral parts of what is needed to prevent disease, sustain life and further development. A breakdown in one can lead to a downward spiral into poor health and poverty.
Malnutrition is a violation of a child’s right to survival and development. Yet, it is on the rise in this region. Escalating violence and armed conflict, political instability, poor feeding and care practices, lack of access to health care services and inadequate investment in water, sanitation and poverty reduction services continue to haunt the region’s children. This must stop.
The situation is further aggravated by the region being the world’s poorest in terms of water availability – where the share of available water resources per person is about one sixth of the global average. The growing population and economic patterns compounded by climate change, are foreseen to further reduce the per capita share to about 200 cubic meters every year; absolute water scarcity. This will spell further food and water insecurity and additionally strain children’s nutrition status. To avoid it, we must make immediate and concerted efforts to adequately manage the region’s water resources and improve water and sanitation services.
With the desert of Saudi Arabia being hit with snow, flooding in the United Arab Emirates, drought in Morocco and extreme summer temperatures in Kuwait, climate change is real. Global temperatures are expected to rise even faster in this region, causing more frequent and severe droughts and less food and nutrition security. About 25 per cent of the region’s workforce is employed in agriculture and about 67 per cent of the agriculture is rain fed. With climate change, agricultural production will decline and food insecurity will rise.
Combine climate change with conflict and you have the perfect storm for disaster. I have just returned from a trip to Yemen. By some estimates nearly 60 per cent of children there aged 24-59 months are stunted and close to half a million children under the age of five suffer from severe acute malnutrition. Some 17 million people are food insecure and over 920 Yemenis have died due to a recent outbreak of cholera. The country is teetering on the verge of famine. Yemen provides an alarming example of water resources being nearly depleted. The per capita share of available fresh water (mostly rain) has dropped to less than 400 cubic meters per year, imposing heavy constraints on both food and water security.
Meanwhile, in some places in war-torn Syria, a country that has never been food insecure, children are at risk of losing their lives as sieges of some towns and cities deprive them of optimal nutrition, safe water and health care services. The conflict is also taking a heavy toll on water resources and health care infrastructure. With the deliberate water cut-offs, groundwater has evolved as the only viable alternative, resulting in overexploitation. This can be seen in severe declines of water tables, salinization of aquifers and reduction in yield. The impact is a further reduction of the quality and per capita share of drinking water, again negatively affecting the nutrition status of children.
What is especially heart wrenching is that we know what it takes to prevent and treat malnutrition. Cost-effective, integrated strategies that combine nutrition, prevention and treatment of common childhood illnesses such as diarrhoea and pneumonia, water and sanitation, water resource management, food security, education, protection, social policy and health interventions are critical - and timing is key. This includes keeping mothers healthy and well-nourished during their pregnancy so they can care and provide optimal nutrition to their children during the critical 1,000 days of life. Otherwise the physical growth and cognitive development of these children are permanently damaged.
An integrated approach also means providing effective disease control and other community based interventions that deliver combined packages of nutrient and health care. Key to UNICEF’s work is applying the integrated approach in partnership with governments, civil societies, the private sector, communities and other UN agencies to scale up efforts and reach more children while strengthening the system. Despite all the challenges we have seen some recent gains. Coverage of vitamin A supplementation and use of iodized salt to address micronutrient deficiencies have increased, as has the number of children who were treated for severe acute malnutrition with therapeutic food and who have been protected from vaccine preventable diseases through life saving immunizations.
It is time to expand public and private partnerships to scale up these programs and interventions, which yield results for children – and to demand that civilians caught in conflict have unrestricted access to nutritious food, safe drinking water, hygiene and basic health care. Investing in the nutrition and health of children is the best investment in the future - for all of us.
