‘Myanmar is still the third-most malnourished country in Southeast Asia’

27 January 2016
‘Myanmar is still the third-most malnourished country in Southeast Asia’
WFP staff briefing the flood-affected communities of Magway Division in Central Myanmar on the ration size of the food commodities they are about to receive. Photo: Aung Khaing Win/WFP

The United Nations’ World Food Programme (WFP) in Myanmar is facing a funding shortfall of $51 million to meet all the needs till the end of 2016. The organisation, which has a 250-strong staff in the country, says it provided food and cash assistance to 1.2 million people in 2015. This includes emergency food assistance to half a million victims of disasters and conflict.  
Myanmar Now chief correspondent Thin Lei Win spoke to Dom Scalpelli, WFP country director in Myanmar, about what the shortfall means, why Myanmar is still food insecure, and what eradicating hunger and malnutrition would mean to the country. 
Question: How concerned are you about the funding shortfall? Or is this part of a long-standing problem? 
Answer: The funding shortfalls are a common part of our business, unfortunately. It’s like running a fire department without having the money for the trucks or the petrol in the trucks. Imagine, each time there’s a fire, you need to quickly run around the city and ask for money. 
This is a bit like what happens when a flood happens in Myanmar or conflicts displaced people in Shan State. If it’s a new emergency we typically have to run after new money. It’s a constant challenge but that’s the way the system is at the moment. 
Q: What would the shortfall mean in terms of humanitarian assistance?
A: We have enough food for the internally displaced people (IDP) to support them fully until April. (After that) we start to run into some problems. We’re continuously in discussion with traditional and newly emerged donors, so we’re very hopeful that new contributions would materialise before April. 
When there is a funding shortfall, we have to prioritise life-saving activities. This means nutritional support to malnourished babies and children under 5 years old, and pregnant and nursing mothers, assistance to the internally displaced people, especially those that are confined to camps in Kachin, Rakhine and Shan states, and the floods- and landslides-affected people. 
Things like the daily school meals programme - nutritious snacks to about 230,000 children in primary and pre-schools in very food insecure areas - to encourage parents to keep sending their children to school have to be put as a second priority. Same for other development programmes like rehabilitating community infrastructure like dams, fish ponds, roads and bridges, although it helps to prevent or mitigate future shocks and builds resilience.  
Q: Myanmar is a food surplus country, and yet a lot of communities, especially in ethnic areas, are food insecure, leading to malnourished people and children. Why is that?
A: Every country in the world, to some degree or another, has malnourished individuals. There’s a huge issue of education. Even when people have access to food, they won’t necessarily always be consuming it the right way. They might not even consume it, they might sell it and eat cheaper foods. 
It’s true that Myanmar is a rice surplus country and rice is often equated with food. But rice is not in and of itself nutritious in the way it is eaten here. Not many people eat brown rice. It has to be as white as white, and that means all the nourishment are gone. 
Also, when you’re talking about a place like Chin State, just to get from one town to another could be three hours in a good vehicle. The food may be available but it’s expensive. We saw this in the floods when a bag of rice costs $100 when it normally should have been $30, which was already quite high. So access is another issue. 
Food insecurity is common among disadvantaged populations, like the landless, smallholders and minority ethnic groups, due to limited or inequitable access to land and resources, poor agriculture conditions and low resilience. Most farmers only have access to very small areas of land. This limits their ability to cultivate sufficient amount of staple food or vegetables for their household needs during the whole year. Agriculture conditions are not optimal. In the dry zone, soils are sandy and rainfalls are low. In mountainous areas, arable land are limited and cultivating cycles too short to allow the soil to regenerate. 
In ethnic areas, the issues related to access to land and livelihood sources are more important due to movement restrictions and/or insecurity.  
Q: What are some of the most food-insecure places in Myanmar and why? 
A: Essentially, border areas and the central dry zone are the most food insecure areas in Myanmar. In Chin, its remoteness and isolation, and lack of job opportunities and arable land. In Rakhine it is movement restriction and lack of access to job opportunities and land, for all communities in Rakhine. For the central dry zone, it’s poor soil and agriculture techniques.
Q: How bad is malnutrition in Myanmar?
A: Myanmar is still the third-most malnourished country in Southeast Asia after Timor-Leste and Cambodia. There’s no reason for it. It’s a country that’s rich in resources. It’s just access to these resources, education and behavioural issues, and sometimes cultural practices that need to change to promote better nutrition. 
The worst malnutrition in Myanmar is in the border with Bangladesh in the northern part of Rakhine State. The average stunting rate for under-5 children in Myanmar is about 34 percent, meaning one in every three children under five years is too short for his age. On the border with Bangladesh that is over 50 percent. (Editor’s note: Northern Rakhine State’s Maungdaw and Buthidaung townships are home to the roughly 1 million-strong stateless Rohingya Muslim minority.)
There were many short people in Japan after the war but now if you go to Tokyo there are lots of tall people. It really only takes a generation to break this cycle. It’s doable. Nutrition is not just about food. It’s about health and sanitation. In South Asia for example, bad sanitation ultimately leads to bad nutrition. Things like encouraging exclusive breastfeeding in the first 1,000 days of a child’s life accompanied by nutritious food after 6 months may not be encouraged everywhere according to various cultures. 
Q: Malnutrition can have permanent impacts too, right?
A: Yes. If a malnourished girl - someone in a food-insecure area here in Myanmar - typically gives birth at too early an age, chances are the child will be malnourished with some sort of deficiency, physical or mental. 
If the baby doesn’t have enough nutrition for the first 1,000 days then the brain will not develop properly. Think about multiplying that across the whole population. There are studies in countries where the economic loss can be, on average, 11 percent of the GDP just because its babies are malnourished. That cycle can be broken. If, while she’s pregnant, she starts to consume adequate, nutritious food and good, clean water etc, and continues to breastfeed exclusively after birth and gives nutritious food afterwards, the child can grow up healthily especially up to the age of two. 
But it doesn’t stop there. The child has to go to school so they understand the importance of nutrition. And the longer a girl stays in school the more likely she’ll give birth at a later age, meaning healthier babies, and the more likely she’ll space her babies.
Q: What can be done to address the problem? What should the new government do? 
A: We’ve just started with the government of Myanmar and a few other organisations to produce fortified foods. We want to try and put (that) on to the market and for us to be able to purchase it for our nutrition programmes. I understand Myanmar is the largest per capita rice consumer in the world, with more than 200 kilograms per person per year. If people are consuming that much of a certain food and it’s fortified, that would go a long way to helping (malnutrition) even though it’s not the perfect solution.
In areas where fortified rice might not reach for now, we have to make sure the populations have access to nutritious food and there’s diversification in agriculture and access to markets. For a country like Myanmar to address this is to make it a priority. You need champions at different levels of society whether politicians, educators, celebrities and sportspeople. Myanmar doesn’t produce qualified nutritionists yet. The willpower and the commitment is important. 
Myanmar government launched the Zero Hunger Challenge in late 2014. It’s a first step. It’s a global initiative and there’s a draft action plan on nutrition and food security, with clear responsibilities so that by 2025 there won’t be any stunted children in Myanmar.