Slamet Susanto The Jakarta Post Yogyakarta
Two thousand children under five in Yogyakarta -- one percent of an estimated population of 200,000 -- suffer from severe malnutrition or marasmus while 20,000 others, or ten percent, are malnourished, a local official has revealed.
Chief of the Yogyakarta provincial health office Bondan Agus Suryanto said severe malnutrition could be caused by infections diseases such as tuberculosis and intestinal worms but that poverty was the main factor.
He acknowledged that compared to a national index of 8.1 percent the number of marasmus sufferers in the province was low, but he said he hoped it would be remedied "as soon as possible."
To overcome the problem, he said his office had provided medical care through the Jamkesos social health insurance program and promoted a foster-care program for toddlers, which handled 59 cases last year.
He predicted numbers of sufferers would rise this year due to people's low buying power and rising costs of food and other basic necessities.
Spokesman for Sardjito Hosptial Heru Trisno Nugroho said he was shocked by the eight cases of severe malnutrition the hosptial had treated so far this year.
"In 2007 there were 37 patients, but already in the first month of this year there have been eight patients."
Another problem was whether or not patients could meet their daily nutrition needs after being released. "It is national policy not to charge people (in cases like these). The question is how patients will get the nutrition they need after they're released, keeping in mind most people are facing a rough time right now," said Heru who believed the malnutrition cases were linked to soaring prices of basic commodities.
Sardjito patients such as one-year-old Ria Ariani, from Nglendah, Kulonprogo, come from poor families. Both her parents work as farm hands.
"Medical treatment is free but patients' relatives have to pay for transportation and food," said Ria's mother, Ponijah.
Ponijah said she that to buy medicine she had to sell one of her cows as well as borrow Rp 700,000 (approximately US$77) from relatives.
According to Mari Astuti, a food technology and nutrition expert from Gadjah Mada University, a diet with more raw bananas and tubers would be a good alternative rice, tempeh and tofu.
"Bananas and tubers are plentiful in the province, they cost less ... and contain nutrients and as many calories as rice and soybeans.
The problem, she said, was whether the government had the will to promote this message so people would change their minds about alternative diets.
Mari said babies should be breast-fed for at least six months after birth to insure maximum immunity levels.
She also recommended porridges made from bananas and tuber flour.
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