In the United States of America (USA), the holiday season was classically celebrated with pomp and pageantry reflecting several weeks of ample shopping and decorating estimated at millions of dollars. In the garden state of New Jersey, where I went round with Gill and Sharon, who I prefer to call my Trinidad and Tobago sisters, several homes especially in rich neighbourhoods notably South Orange sparkled with starry lightings, dazzling ribbons and shimmering garlands, a sharp contrast to Christ’s manger. However  the Newark neighbourhood, comparable to Nigeria’s Ajegunle slum, was more like that Biblical manger.

The luscious areas not only brimmed with beautiful decorations, but they also exuded exotic aroma from the  choice dishes and assorted wines set for the twin events.  From all indications, many broke their well-set dietary rules with the beckoning flavours of delicious soups and sweets. For some individuals Christmas should be celebrated every day. There was so much to eat and discard.

But in the midst of this opulence, there were people who were cut off from the merriment because there was no food to eat. And indeed there has not been much good food in the home in a long while. The kitchen remained as dry as ever. The real tragedy is that most poor people either in this country or elsewhere often cannot afford a decent meal either before or after the fortnight show. For these  unfortunate lot, the cry for ‘daily bread’ cannot be too loud at times like these.

Confined to various stages of deprivation, these wretched of the earth would do anything to escape the prison of poverty before the deadly scourge of malnutrition drives them to an early grave. Sometimes it does seem as if the numbers of the poor are exaggerated and their stories phoney. But the reality is that the number of the world’s poor so often computed by the United Nations (UN) and its sister agencies may not adequately capture  the pain and agony of this circumscribed lot.

Despite the vexatious impressions that Africa is the homeland of poverty, there is ample evidence of spreading poverty globally. Virtually every city has its fair share of the world’s hungry tribe.

From New York to Hong Kong, and from Paris to Rio de Janeiro, pictures of malnourished adults and children remain indelible. Homeless and hungry these people provide veritable grounds for disease and death according to the emerging studies.   This explains why the UN singled out poverty and hunger eradication as the topmost  priority in the Millennium Development Goals (MDGs).

As indicated in its numerous publications, the UN noted that ‘today in the developing world an estimated 1.2 billion people survive on less than $1 dollar a day,  800 million are under nourished and 153 million children under age are malnourished. It is reported that in sub-Saharan Africa, half the population lives in poverty, while two-thirds of those who live on less than $I dollar a day live in Asia. In these two regions, it is also believed  that the proportion of people living in extreme poverty has actually increased since 1990, while in Latin America and the Caribbean, it is unchanged.’

 With the spreading poverty, the World Health Organization (WHO) has stated that ‘malnutrition in its many forms persists in virtually all countries of the world in spite of a general improvement in food supplies and health conditions, and the increased availability of educational and social services.’

According to the world apex health organization malnutrition in all its forms increases the risk of disease and early death. Protein-energy malnutrition, for example, plays a major role in half of all under-five deaths each year in developing countries .

Severe forms of malnutrition include:

·        Marasmus as in chronic wasting of fat, muscle and other tissues,

·        Cretinism

·         Irreversible brain damage due to iodine deficiency

·        Blindness and

·        Increased risk of infection and death from vitamin A deficiency.

 Studies have shown that people are malnourished if they are unable to utilize fully the food they eat, for example due to diarrhoea or other illnesses  often referred to as secondary malnutrition, or  consumption of  too many calories  called over-nutrition, or  consumption of diets lacking  adequate calories and protein for growth and maintenance otherwise categorized as under-nutrition or protein-energy malnutrition. Individual nutritional status depends on the interaction between food that is eaten, the overall state of health and the physical environment, it also stated in its review.

 ‘Malnutrition is both a medical and a social disorder, often rooted in poverty,’ the WHO has said identifying poverty as its major precursor.

  ‘Combined with poverty, malnutrition contributes to a downward spiral that is fuelled by an increased burden of disease, stunted development and reduced ability to work. Poor water and sanitation are important determinants in this connection, but sometimes improvements do not benefit the entire population, for example where only the wealthy can afford better drinking-water supplies or where irrigation is used to produce export crops. Civil conflicts and wars, by damaging water infrastructure and contaminating supplies, contribute to increased mal-nutrition.’ Current data by the health body remains daunting:

• An estimated 174 million under-five children in the developing world are malnourished as indicated by low weight for age, and 230 million are stunted.
• Malnutrition results in poor physical and cognitive development as well as lower resistance to illness.
•  6.6 million out of 12.2 million deaths among children under-five - or 54% of young child mortality in developing countries - is associated with malnutrition.
• In addition to the human suffering, the loss in human potential translates into social and economic costs that no country can afford.’

• Over 800 million people still cannot meet basic needs for energy and protein,

• More than two thousand million people lack essential micronutrients, and hundreds of millions suffer from diseases caused by unsafe food or by unbalanced food intake.
• In 1990, only 53 developing countries had reliable national data on the prevalence of underweight in young children but  by 1995, 97 countries had such data, and 95 countries also had data on stunting and wasting.
• It is estimated that more than half of the young children in south Asia suffer from protein- energy malnutrition, which is about five times the prevalence in the Western hemisphere, at least three times the prevalence in the Middle East and more than twice that of east Asia.
• Estimates for sub-Saharan Africa indicate that the prevalence is approximately 30%.
• In some regions, such as sub-Saharan Africa and south Asia, stagnation of nutritional improvement combined with a rapid rise in population has resulted in an actual increase in the total number of malnourished children.
• Currently, over two-thirds of the world's malnourished children live in Asia especially south Asia followed by Africa and Latin America.

But despite this saddening data, the organisation reported that at the end of January 1996, 98 countries had national plans of action for nutrition and 41 countries had one under preparation, in keeping with their commitment made at the International Conference on Nutrition in Rome in December 1992.

While specific activities may vary, it stated,  most programmes that address childhood malnutrition include some conventional activities such as the protection and promotion of breast-feeding, appropriate complementary feeding, nutrition education for behavioural change, growth monitoring, micronutrient deficiency control, nutritional support of the sick child, maternal nutrition and health referral.

What often distinguishes successful programmes,  is that communities are involved in identifying the problems and mobilizing action and resources for solving them. A good technical package is not sufficient, the WHO posited further pleading for more commitment towards  ensuring  good nutritional status of young women before they become mothers as well as  improving  nutrition during pregnancy and lactation. Programmes will require innovative approaches to reach adolescent girls, particularly in countries where their secondary school enrolment is low, it also identified.

In addition, ‘a focus on complementary feeding, combined with continued attention to protection, promotion and support of breast-feeding, will address an important cause of malnutrition. Programmes must put special emphasis on the crucial period from birth to 18 months. Overall malnutrition must no longer be considered without reference to micronutrient status as the two are inextricably linked. Attempting to improve protein-energy status without addressing micronutrient deficiencies, will not result in optimal growth and function.’

Perhaps if  relevant government officials in endemic countries  such as Nigeria and others in similar conditions will come down from their lofty seats and heed the wizened counsel of  WHO, one can easily predict that soon malnutrition and its deadly harbinger will be a thing of the past. But until then, the poor can only remain poor spectators at   annual Christmas and New Year celebrations.