Minority children still hungry

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Hill tribes suffer from the loss of land and natural resources that once sustained them, analyst says
  An ethnic Man carries her young son to harvest crops in the northern mountainous province of Ha Giang. Experts have called for more action to reduce undernourishment among ethnic minority children. Photo: AFP

Vi Quoc Duan was a mere 2.5 kilograms (5.5 lb) when he was born.

His mother, 25-year-old Hoang Thi Hue, said rearing her sick son was difficult for several months.

"He was in poor health, and often suffered from respiratory infections and pneumonia. When he turned seven months, he was given extra food together with breastmilk but still weighed just six kilograms (13.2 lb)," said the farmer from Dong Quan Commune in the northern mountainous province of Lang Son.

Simply put, the family did not have enough money or food to eat nutritious meals. They earn a meager monthly household income of VND400,000 (US$19) from rice and cassava farming and Hue's husband's infrequent day labor jobs.

Their second son, Vi Duc Huan, might also have been malnourished if they had not benefited from a charity program.

Under a project by UK-based NGO Save the Children, which aims to reduce undernourishment among children, Hue was trained to raise chickens and grow her own vegetables, giving her the ability to prepare more nutritious meals for her children.

She was also supplied with iron tablets, food and vaccinations before giving birth to a second son last year. Both sons are now healthy and no longer undernourished.

But many other children in Vietnam's remote and poor ethnic minority communities are not so lucky.

According to the Vietnamese government's 2009-2010 National Nutrition Survey and Surveillance, vast disparities exist according to socio-economic status and among provinces and ethnic groups.

"Nearly one third of children under-five in Vietnam (2.1 million) are stunted," the survey said. "The stunting prevalence is over 50 percent in H'Mong, Ba Na and Gia Rai ethnic minority groups, compared to 23 percent in Kinh children and long-term insufficient nutrient intake is among major causes of stunting," it added.

On the fringes

Among children suffering from undernourishment is a group of more than 110 children from Dak Sar Hamlet, an isolated community of mostly H'Mong people in Dak Nue Commune, Lak District, Dak Lak Province.

The hamlet has some 300 households and has no electricity, no tap water and no market and is connected with the commune center by a 30-kilometer road that often becomes muddy in the rainy season and almost inaccessible by motorbike, according to a recent report on Dan Tri online newspaper.

Four teachers from a school in the commune have volunteered to teach children in the hamlet in a shack classroom that is only open to first and second graders.

Teacher Ngo Thi Thuong said all the students are from poor families and many of them are thin, pale and undernourished because they often skip breakfast or have just a little plain rice.

Ma Van Son, a 2nd grade student, said he often comes to class with an empty stomach or having eaten only a cucumber taken from his family's farm.

"It's great if there is [plain] rice for breakfast," he said.

Son's classmate Duong Thi Van said her family has never had breakfast and she is used to it.

"The H'Mong people here struggle just to fill their stomachs and there's no time to think about the issues involved child nutrition," said hamlet head Nong Van Du. "They often eat rice with wild bamboo shoots and vegetables and salt. Some households only eat cassava."

Growth "˜masks' inequality

In a statement on September 21, Save the Children warned that more progress is needed in Southeast Asia's fight against child malnutrition.

"[Many] Southeast Asian countries need to invest more resources to reduce children under-nutrition," said Michel Anglade, Campaigns and Advocacy Director for Save the Children in Asia.

"Unless they act soon, millions of children in the region will become physically and mentally stunted in the years ahead, making it harder for them to break out of the poverty cycle."

The organization launched the Nutrition Barometer at the United Nations General Assembly in New York on September 26. It assesses governments' political, legal and financial commitments to tackling malnutrition in 36 countries with high numbers of undernourished children.

Four of the five Southeast Asian countries in the report, including Vietnam, Indonesia, Myanmar and for the Philippines, are showing progress in fighting child under-nutrition. But Cambodia is not, according to the NGO.

"For Vietnam, the barometer shows that the country is doing extremely well in lowering malnutrition, but is only "˜emerging' in its commitment (political, legal and financial) to tackling malnutrition," Save the Children Asia's media manager Lynette Lim wrote to Vietweek in an email.

She said Vietnam's economy has also been growing quickly in recent years, leading to rising household incomes and improvement of the general population but "national averages often mask huge inequalities."

"These countries still have high burdens that are usually concentrated in the poorest households," she told Vietweek. "Economic growth does not automatically translate into improved nutrition outcomes for poor children."

Save the Children is calling on these Southeast Asian leaders gathering in New York for the UN General Assembly summit to take urgent measures to tackle child under-nutrition.

"Unless promises are translated into swift action, the ambitious commitment made at the World Health Assembly earlier this year to reduce the number of stunted children by 40 percent by 2025 will not be met," the organization said.

"All 36 countries featured in the barometer, including five Southeast Asian ones, accounting for 90 percent of the world's undernourished children, are capable of saving millions of lives and reducing the number of stunted children by some 64 million by 2025. But this requires political will and commitments, followed by decisive action," it said.

According to the UN, while Vietnam has made significant progress in reducing the numbers of underweight children, stunting still affects more than one-third of its children.

Stunting rates are highest in the Central Highlands (41 percent) and other disadvantaged regions where ethnic minority people live (35 percent in the Northeast and 36 percent in the Northwest), according to the UN.

Nemat Hajeebhoy, Vietnam country director for Alive & Thrive, a Washington-based nonprofit that seeks to improve health and nutrition and reduce stunting, said the stunting prevalence in Vietnam is still unacceptably high for a lower middle income country.

"Typically we can see gaps between ethnic and other communities in accessing services, primarily health and education," she wrote in an email to Vietweek.

"In terms of nutrition, I would add that nutrition services and products are not covered by social health insurance and this is a financial barrier for the clients," Hajeebhoy said.

"In addition, since these services are not linked to payment there is little or no incentive for health workers to focus on these cost effective and preventive interventions."

The National Nutrition Strategy for 2011-2020 urged government leaders to recognize the magnitude of the problem and ensure that interventions and services target hard to reach areas, poor households and ethnic minority groups. It also said health sector capacity needed to be raised to address the problem.

Pushed to the brink

But why all the trouble for Vietnam's hill tribes and ethnic minorities?

While some analysts have attributed inequality to racism, an ethnic minority expert at the Institute of Cultural Studies in Hanoi who requested anonymity attributed poverty and undernourishment in ethnic minority groups to a decline in biodiversity and the difficulties they now have accessing the natural resources that they used to subsist on.

"In many mountainous areas, natural forests that can be exploited for forestry products like [wild] animals, bamboo shoots or many highly nutritious vegetables have been zoned as "˜specialized" or "˜protected' forests and have been put under strict management of forest rangers," he said.

"Many areas that used to be shared by the communities have been named "˜empty land, eroded hills' and granted to households. In reality, these areas could supply food for locals."

He said in many ethnic minority cultures, the areas surrounding villages are considered common places and old and poor people are given priority access to vegetables and firewood.

"Disadvantaged families have lost the ability to access these areas that have been granted to rich and influential families. Thus, the chance to access available nutritional sources for them has significantly reduced," he said.

"While there are limits to "˜eliminating hunger and eradicating poverty', maybe the best way is to create favorable [policies] for the [hill tribe] people to exploit their surrounding natural resources."

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