Monday, August 5, 2013

Svay Rieng and the challenge to eliminate malnutrition

The little Saroeurn Kunthea looking at the leaflet,
which shows the villagers how to prepare nutritional food for their children.
© UNICEF Cambodia 2013/Pericles Carvalho

SVAY RIENG, Cambodia, 2 August 2013 - One of the most interesting things about being a journalist is being able to tell the world stories about places and people many would never otherwise know. For me, there’s a fascination in discovering new territories and finding people who are “off the global radar”. Located in the southeast of Cambodia, right on the border with Vietnam, Svay Rieng province is one of those places: one of the less developed regions of the country, dissected by a main road - National Highway No 1 - which connects Phnom Penh to Ho Chi Minh City.

It was my first mission to the field and I was prepared with a bunch of documents I found online: I had data about everything in the province, especially about acute malnutrition which, according to the 2010 Cambodian Demographic Health Survey, affects 11% of the children under 5 years of age. Svay Rieng has one of the highest rates of malnutrition in the country and our mission was to report on the treatment provided by the Provincial hospital and find out if families understand the issue and are bringing the children back to the hospital for the designated three follow-up visits and feeding them take-home rations of therapeutic food.
 
UNICEF supports the treatment by providing families with US$7 in financial assistance for transport to return for the follow-up visits and funding the therapeutic food provided for free in the hospital and health centres of the region.

On the ground

After two hours and a half on the road, there I was – visiting the Provincial hospital and also some children in the nearby villages. In fact, the experience I had while visiting each family gave me more information than I could get from the printed data. Once there I could understand how they perceive malnutrition as well as how people live and struggle in places where the GPS of my iPhone doesn’t work.
I could learn, for example, that the rainy season directly affects their lives and also the children’s treatment in the hospital. When it rains they spend time working in the land, planting rice. They’re busy, so some of them don’t have time to take their children to the hospital.

Another difficulty is related to the local economy. There aren’t many job opportunities around Svay Rieng but many women find work in the garment factories. The working schedule means that mothers have to leave their young children with grandparents every day. This can make practicing exclusive breastfeeding, for example, a challenge for working mothers.

Most of the parents work in the garment factories on the border with Vietnam, and their children
stay with grandparents at home. Here are some of them saying goodbye to the UNICEF team.
© UNICEF Cambodia 2013/Pericles Carvalho
As a Brazilian living in Europe for a while, taking children to the hospital to complete prescribed follow-up treatment seems to be a simple journey, but a very complicated process here. When families are very poor going to the city and paying for food while the child is being treated is anything but simple. The second major issue is that families are not making the connection between children getting sick and the food that they are – or are not – eating.

Many families don’t know that malnutrition also makes children more vulnerable to diarrhea, fever and infections. And they don’t seek help or go to the hospital at the first sign of illness! Such was the case for Ms. Puth Sopheap, 46, and her granddaughter 18-month-old Saroeurn Kunthea from Trok village. According to Ms Sopheap, she didn’t know why Saroeurn was sick. It was only at the hospital with the help of the nurses and doctors that she got to understand the seriousness of the problem and how she should feed the child in order to avoid malnutrition and the infections that followed.

At the hospital caregivers also learn to improve the children’s diet and how they can - even with little money - implement changes in their meals. For most, rice is the main and only dish, and it isn’t easy to buy vegetables and meat. But once they are aware of how important it is for the child, they start providing at least one kind of vegetable or meat in the meals.

Even though the challenges still exist, the smiles of mothers and grandmothers while describing how their children became more active and happy after the treatment as well as the sense of community developed in those distant areas will be forever on my mind.

As I said, they are “off of the radar” but I was happy to find out that UNICEF is working to strengthen the health system and make families aware of the risks of malnutrition. It also provides them assistance during the treatment.

UNICEF is helping to build a better life for children. If there isn’t awareness about malnutrition, they are helping to empower mothers and caregivers; if there’s no money to take the children to the hospital for follow-up visits, it’s providing financial assistance and if the families don’t know how to prevent malnutrition in children, they are given food demonstrations to show them how to prepare nutritious meals.

I came back to Phnom Penh with the feeling that although there’s much more to be done, UNICEF working together with the government, partners and local communities is already changing for the better, the destiny of many children in Svay Rieng.

Maybe you’ve never been to the remote areas of Cambodia and won’t have the chance to meet these people and walk around their villages but I took photos so you can see the rice fields, the roads, their houses and the incredible people. Take a look!
  
In the rainy season, the access to the distant villages becomes more difficult.


The green and beautiful landscape in Svay Rieng.
 
Fishing: It’s very common to see kids catching small fish and shrimps with their parents in the rice fields.

Rice fields are everywhere in the countryside. Rice is the main food for most villagers.
 It is planted and harvested twice a year.

The houses: rooms are upstairs and under the house is the kitchen with a common area and hammocks.
In the rainy season, the stilts help to ensure that the family stays dry.


Nurse Som Chanthy carrying the 18-month-old Saroeurn Kunthea in Trok village. Baby Kunthea recovered from severe malnutrition after hospitalization and three follow-up visits when she received therapeutic food.

Chhum Dara, aged 9 from Chipou village playing football in the streets during his holidays.
 
By Pericles Carvalho

Pericles Carvalho, 24, is a journalist currently undertaking the Erasmus Mundus Master’s degree in Journalism, Media and Globalisation in Denmark and Wales. He is interning with the UNICEF Cambodia External Communication team.

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