Similar, but different: the stories of Rita and Sita

By Andres Vera & Alina Shrestha, World Vision Nepal Communicator

At an age when children should be eating healthy and nutritious food, Rita did not eat much - apart from rice and milk. Her parents were not able to provide her with a balanced diet, due to a lack of knowledge about nutrition.

As a result, she hardly put on any weight and remained emaciated until she was identified as a ‘severely malnourished child’ by World Vision staff in Kailai- a district in West Nepal.

“When I was pregnant with Rita, I visited the health post once, and ate food that was available at home. It wasn’t nutritious,” says Khatto Rana, Rita’s mother.
Rita was not only small when she was born, but she also suffered from frequent diarrhoea and marasmus -a gradual wasting away of the body caused by severe malnutrition.

After the World Vision staff attended to Rita and identified her health condition, her parents were counseled regarding the need to send their child for nutrition rehabilitation treatment. At the urging of World Vision and other health staff, her parents decided to admit Rita to the Nutrition Rehabilitation Centre in the district hospital, where treatment is provided free of cost to severely malnourished children.

When Rita was admitted to the centre, she weighed 5.5 kilograms. The centre gave her three glasses of milk, a banana, an egg, porridge and superflour - a nutritious mix of beans and pulses, every day. Her weight was regularly monitored.

After 33 days of treatment at the centre, Rita’s health had significantly improved and she weighed 7.1 kilograms. Since her return from the treatment, Rita’s health condition has improved and she has been able to live the life of a normal child.

She now eats nutritious meals, loves to play with her siblings, and is full of energy. She is well cared for by her parents - who have benefited from a livelihood project with World Vision and now understand the importance of feeding their child nutritious food due to advocacy efforts and increased education around child health and nutrition.

This has been a result of the efforts of her community, local health institutions, and World Vision’s Child Health Now campaign which aims to ‘help all children survive 5’.

This has been a result of the efforts of her community, local health institutions, and World Vision’s Child Health Now campaign which aims to ‘help all children survive 5’.

However, not everyone has been fortunate like Rita. Sita, a two-year-old girl who lives in a remote village of Rupandehi, another district in Western Nepal, is severely malnourished.

Sita cannot stand and crawls on her weak limbs. She does not interact or play with children her age. She sits by herself or on her mother’s lap with expressionless eyes, staring in one direction.

“My daughter does not need any kind of treatment. She is just different,” says Bindrawati Pasi, a mother of three. She is not aware that her daughter is severely malnourished and continues to feed her with a meal lacking in nutrition. Sita’s meals currently consist of rice and lentils.

Like Sita, children in this area are waiting to receive treatment and education about child health and nutrition.

Malnutrition is a common underlying cause of child mortality. An estimated 29% of under-five children in Nepal are underweight. In rural Nepal, the “Nepal Family Health Programme” (NFHP) reported a reduction in the proportion of children underweight from 43% to 40% in the last three years (NFHP 2010). However, it also noted a significant rise in the proportion of children having inadequate nutrition, with the proportion of wasted children rising by 17%.

According to the 2010 Nepal MDG Goals Progress Report, this data indicates that achieving the MDG target of a 50% reduction in the prevalence of underweight under-fives by 2015 is unlikely, if prevailing trends persist.