Falling short

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Vietnam's population of stunted children is growing along with the gap between the haves and have-nots

12-year-old Dao ethnic minority girls carrying vegetables in the northern mountainous province of Ha Giang. One in three children under age five in Vietnam is stunted and the number of stunted children in remote and hinterlands almost doubles that of their peers in the plains, a national report says.

Ho Van Xon brings his lunchbox of rice, salt and chili to his kindergarten in Dakrong Village.

By the time he arrives, the chilli has withered and the three-year-old boy returns to his impoverished home hardly nourished from his inadequate lunch.

The monthly income of his parents is around VND250,000 (US$12), which only allows them to feed him a meal with meat once a month. Xon weighs 11 kilograms and stands 85 centimeters tall, far short of Vietnam's average standard of 14.3kg and 96.1 cm for children at his age.

Dozens of Dakrong children in the north-central province of Quang Tri are like Xon, Lao Dong (Labor) newspaper reported last month. They are among 2.5 million Vietnamese children who are stunted due to chronic malnutrition, according to the latest and most comprehensive national report on child nutrition.

The report says that the number of stunted children in remote and hinterlands is almost double that of their peers in the plains, suggesting the yawning gap between better-off and impoverished areas in Vietnam have continued to widen.

One in three children under age five in Vietnam is stunted, or too short for her or his age, and this is an irreversible outcome of chronic nutritional deficiencies during the first 1,000 days of a child's life, says the General Nutrition Survey 2009- 2010. The report, launched Wednesday (April 4) in Hanoi, also says that the damage stunting causes to a child's development is "permanent."

"There are about 7 million children under 5 in Vietnam, therefore, this means that at any given point in time about 2 to 2.5 million children in Vietnam are stunted," said Nemat Hajeebhoy, Vietnam country director for Alive & Thrive, a Washington-based non-profit organization that seeks to improve health and nutrition and reduce stunting.

"Given Vietnam's level of economic development, this rate is high and as a result, Vietnam ranks 13th in the world in terms of number of children stunted," Hajeebhoy told Vietweek.

The stunting rate among children in remote and hard-to reach areas is twice as high as the rate among their peers in the plains, says the report, prepared by Vietnam's National Institute of Nutrition with technical support from Ministry of Health and several United Nations agencies such as UNICEF, the World Health Organization, and the Food and Agriculture Organization.

During the 2001-10 period, "there has been a notable reduction in stunting, however, the prevalence is still high and the General Nutrition Survey has revealed emergent socio-economic disparities," Kumar Sharma, UNICEF Vietnam's deputy representative, said in a press release on the report.


Around 6 per cent of Vietnamese children under-five are overweight and obese, and in Ho Chi Minh City and Hanoi this rises to 12-15 percent, the General Nutrition Survey 2009- 2010 report said Wednesday (April 4).

The national rate is six times higher than it was in 2000, it added.

"We face new challenges with the rise of obesity, especially in urban centers," Nguyen Viet Tien, deputy minister of Health, said.

"This situation requires early and timely interventions so we do not follow the same road as other middle income countries," Tien said.

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Globally, about 450 million children will be physically and mentally stunted over the next 15 years unless the world takes action to tackle malnutrition, a report from Save the Children said in February.

Every hour, 300 children die worldwide due to a lack of nutrients in their diet, while those who survive are permanently damaged in a way that impacts on their lives and the economic prospects of their countries, the NGO said.

The problem has become even more urgent because of volatile food prices, economic uncertainty, climate change and demographic shifts. In Asia, for example, where 100 million children are stunted, the Save the Children report predicts that the effects of climate change on food yields will result in seven million more stunted children by 2050.

Vietnam plans to reduce the stunting rate to 23 percent in 2020 and to achieve this, the country needs to secure commitment and investments from national and provincial levels as well as the international community, experts say.

The government's allocation of around VND100 billion each year for the national nutrition program is "by no means sufficient to adequately implement the seven main projects/programs mentioned in the National Nutrition Strategy and there is a need for leaders to raise both awareness of the severity of the issue and allocate more resources to improving nutrition," Hajeebhoy said.

Stubborn challenges

With ethnic minority children recording the highest rate of stunted growth, up to 41 percent in the Central Highlands, according to latest government figures, experts say disparities observed in nutrition status reflect the rifts in economic and educational status between these and other regions.

An independent UN expert on human rights and extreme poverty wrote in a report last year that ethnic minorities have clearly not enjoyed the same progress experienced by the country overall.

In her report, Magdalena Sepúlveda Carmona said that geographical isolation alone does not explain the disproportionate vulnerability to poverty among ethnic minorities who have more difficulty in accessing social services for a variety of reasons including linguistic barriers.

"If patterns are not reversed, poverty will remain a phenomenon dominated by ethnic minorities," Carmona wrote.

A VnExpress article in February featured the uplift experienced by 40 students at a secondary school in Lo Pang Village in the Central Highlands province of Gia Lai when the local authorities were able to provide them with VND3,000 each for their lunch and afternoon meals before they walked home in the scorching sun, around 10 kilometers away from school.

A little rice, dried fish and water-dominated soup made up the meals and the students relished them.

"I can only have such dishes at school," the article quoted Thom, a seventh-grader, as saying.

"At home, there is only rice and wheat plant."

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