In numerous cases, our inherent human nature impels us to provide immediate assistance to a dying individual. Nevertheless, when we come across someone gradually perishing, uncertainty may arise concerning the most effective way of extending aid. It can prove to be a challenging task for many of us to comprehend the optimal approach towards aiding an individual in such dire circumstances.
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Child malnutrition is an insidious yet destructive crisis that claims the lives of hundreds of thousands of children annually in Pakistan. As per 2018 National Nutrition Survey 40.2% of the child population is stunted, 17.7% wasted and 33% underweight, with resultant deaths and adverse impact on the economy. 12 million children under five are affected. The long-standing issue of malnourishment and stunting in Pakistan has garnered recognition from both the government and international agencies, who are now dedicating increased attention to address it. Malnutrition is a condition that arises from either insufficient or excessive intake of nutrients, an imbalanced consumption of essential nutrients, or impaired utilization of nutrients. Stunting negatively affects brain function, leading to an inability for children to properly absorb learning or function effectively once their brain development ceases – a problem that can persist into adulthood with physical impairments.

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Children of any age can be malnourished, but most children who suffer from both severe and acute malnutrition are between 6 months to 5 years of age. Malnourishment is diagnosed by measuring the middle upper arm circumference (MUAC). The tape is colored red for severe malnutrition, yellow for moderate malnutrition and green for normal.

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Malnutrition harms physical growth and cognitive development, with lifelong consequences. Nonetheless, there is reason for hope through an innovative and cost-effective therapy known as Ready to Use Therapeutic Food (RUTF). The Trust for Malnutrition and Stunted Growth (TMSG) provides treatment for severely and moderately malnourished children with stunted growth. At present, TMSG is administering successful treatment for thousands of Pakistani SAM (Severe Acute Malnutrition) and MAM (Moderate Acute Malnutrition) children under five years old for six to twelve weeks at length so as to set them onto an auspicious course towards good health while avoiding any lingering consequences thereof. In collaboration with non-profit dispensary partners like AKU, HELP, Memon Hospital, Allah Walay Trust, Al Burooj Clinic, and ZMT, we screen children suffering from malnutrition and provide them with requisite RUTF/RUSF therapy. RUTF is peanut based and RUSF chick pea based-each 92 grams sachet provides 500 calories, one which can be fed daily to a malnourished child, for 6-8 weeks as outpatient. Local production has now started and a sachet cost is approximately Pak Rupees 50 ( US $ 0.35) or Rupees 3000 (US$ 20) treatment cost approximately per child.

OUR SOLUTION

Solution

A trust called “Trust for Malnutrition and Stunted Growth” (TMSG) was registered in Karachi in November 2018. The key sponsor is the Rotary Club of St. Catharines South in Canada, which is providing financial support along with other Rotary Clubs in North America, and the Rotary Club of Karachi as the host club in Pakistan.

The Trust for Malnutrition and Stunted Growth provides treatment for severely and moderately malnourished children with stunted growth by offering therapeutic food (RUTF) and supplementary food (RUSF). The Trust was formed to address the serious issue of malnutrition and stunting in Pakistan, which affects 40.2% of the child population as per the 2018 National Nutrition Survey, with 17.7% wasted and 33% underweight, resulting in deaths and adverse impacts on the economy. Around 12 million children under five are affected by this problem, and the government and international agencies are providing added focus to tackle it. Stunting affects the brain’s ability to function correctly, and a child cannot absorb learning or function adequately once brain development stops, which can continue into adulthood with physical impairment.

solution

TMSG aims to provide Ready to use Therapeutic/Supplementary Food (RUTF & RUSF) to treat the menace of malnutrition, expand outreach, and reduce treatment costs by substituting imports. TMSG can reach out for training in malnutrition where needed. RUTF is peanut-based, and RUSF is chickpea-based, and each 92-gram sachet provides 500 calories, which can be fed daily to a malnourished child for 6-8 weeks as an outpatient. Local production has now started, and the sachet costs approximately Pak Rupees 50 (US $0.35) or Rupees 3000 (US$20) per child’s treatment cost. TMSG has an excellent relationship with a local, highly professional key supplier to the World Food Program (WFP) and UN Agencies for RUTF & RUSF.

To assess a child’s health, measurements of height, weight, head circumference, and mid-upper arm circumference (MUAC) are taken. A healthy MUAC measures around 13 cm and falls within the “green”category, indicating no need for treatment with Ready to Use Therapeutic Food (RUTF). Patients with MUAC measurements less than 11.5 cm fall into the “red”category and require intensive treatment with two sachets of RUTF per day for 4 to 6 weeks. If their MUAC improves above 11.5 cm during treatment, they move to the Moderate Acute Malnutrition (MAM) category and receive one sachet of RUTF per day for six weeks along with guidance on home-cooked meals. An appetite test is also conducted to determine if treatment is needed, with less than 1/4 pack eaten requiring immediate hospital attention and F75 formula dispensed. Accurate assessments ensure appropriate care for children’s nutritional needs.
Solution
Malnutrition harms physical growth and cognitive development, with lifelong consequences. Access to nutritious food, especially in poverty-stricken areas, and promoting breastfeeding can reduce malnutrition rates. Improving sanitation facilities is also crucial, including education on hygiene practices and access to clean water. A comprehensive approach is needed to prevent stunting among children in Pakistan and ensure a brighter future for generations to come. Ensuring proper nutrition is of utmost importance in preventing malnutrition among mothers and children. One of the key factors in promoting a child’s long-term physical and cognitive development is combating stunting. This can be achieved through various means, including access to nutritious food, promotion of breastfeeding, and improvement of sanitation facilities. By implementing these measures, lives can be saved and health outcomes improved. In conclusion, addressing issues related to malnutrition requires a multi-faceted approach that involves promoting access to nutritious food, encouraging breastfeeding practices, improving sanitation facilities, and educating communities on proper hygiene practices. By taking these steps towards preventing stunting among children in Pakistan, we can ensure a brighter future for generations to come.