Dr. Renuka Jayatissa gives:

Some food for thought on nutrition

NUTRITION: The President Nutrition Society of Sri Lanka, and Medical Nutritionist of the MRI Dr. Renuka Jayatissa in her presidential address at the recently held 18th Biennial Sessions of the Nutrition Society giving some food for thought to policy makers on nutrition said.

"Tonight let me take you through the issues of Nutrition and look at our own achievements and strengths, weaknesses, opportunities in the field and the threats that are there for achieving some of our goals.

Justifiably be proud

We in Sri Lanka can justifiably be proud of maintaining relatively good health at low cost. As you are aware our literacy rates and female education has always been high.

Successive governments have been trying to compete with each other promising and implementing some of the key nutrition programmes with direct support to the poor.

The present government manifesto had many promises relating to nutrition; such as providing money to families with children to purchase milk food. Provision of food basket for pregnant women.

Mid day meal for schoolchildren and provision of fertilizer subsidy. President Mahinda Rajapakse has drawn his personal attention to the issues of nutrition, which is a need of the hour.

Our international partners such as UNICEF, WFP, WHO, World Vision, World Bank have been assisting us technically as well as financially to alleviate nutritional problems that we historically face.

I see the vibrant medical and other academic societies as a great strength to deal with the nutrition issues.

National nutrition policy finalised

We were able to assist the Ministry of Health to finalise a national nutrition policy for Sri Lanka at the request of the Minister of Health, Nimal Siripala de Silva.

I must specially thank the chief guest Dr. Athula Kahandaliyanage for placing trust on our society to perform this national task. There are many members who worked tirelessly to make this a reality.

Defining policy

If we were to define, what policy is, it is all about how the future should be different from today, and what changes are necessary, and how these changes can be brought about.

In making the nutrition policy UNICEF played an eminent role and assisted us in order to achieve this task. Now the policy will be gazetted and will be presented in Parliament very soon.

Is the picture all that rosy?

Is the picture all that rosy today? It is not so, we have some unacceptable nutrition issues on the table today.

We as a nation have not been able to feed our babies while they are in mothers' wombs; one in six of our newborns are suffering from low birth weight and such nutrition issues contribute in a no small way even during the adult life sometimes even bringing chronic diseases.

We should be thankful since there are no cases of Kwoshiorkor and Marasmus. Even though one in six children under five years are stunted or wasted, one third of children are suffering from Vitamin A deficiency.

Anaemia is prevalent among one fifth of children creating lethargy, less productivity and complicates many pregnancies in our country.

Can we be happy of our food hygiene and food handling? This is an area which has got neglected in a big way.

Nutrition in sports is also a very important area. There are unorthodox practices when it comes to sports nutrition. We should streamline sports nutrition in Sri Lanka.

How many in our population will know about their own nutritional status? At least the correct weight for height or Body Mass Index.

Junk foods at Health Ministry meetings

There is a major problem in healthy food choices. Many of our school canteens filled with so called junk foods and amazingly these junk foods appear even in our own health meetings as snacks and refreshments.

Hospital diets outdated

I would also like to draw your attention to our hospital diets which was formulated 3 to 4 decades ago and is continuing without much change. I think that it is time to bring a change to the hospital diet in order to mirror present day requirement.

Opportunities to improve

As you all know there are many opportunities for us to improve nutrition in Sri Lanka. Our society needs to get further involved with the Government to ensure that the nutrition programmes are well targeted and achieve the desired effect.

Know little in reality

We know so much, yet so little in reality, on the practice of optimum nutrition. We have so much food in the world, but the irony of so much hunger. I suppose many people go to bed hungry at night especially in conflict areas. Are we even consuming what we have at our disposal properly?

Over nutrition

The problems of over or wrong nutrition are also severe. Many obese children are present today especially in the urban areas. High incidence of non-communicable diseases such as diabetes, cancers and heart disease.

However, as a nation with admirable advances in socio-economic indicators such as high rates of literacy, low rates of child and maternal mortality, high life expectancy on the one hand and high Government commitment on the other, these nutritional statistics are not acceptable.

What is it that we need to do as a nation? As nutritional practitioners what is our role? It is important that we define both of these. Not forgetting of course that we have to work in concert with other key sectors.

Not domain of Governments alone

Nations such as China, Indonesia and Thailand present evidence that malnutrition due to poverty can be sharply reduced by careful surveillance of consumption and nutrition data and annual budget allocations targeted at those too poor to afford food.

Experiences in overcoming malnutrition show that national plans of action are no longer the domain of Governments alone, but also involved community and non-governmental organisations.

Food for thought

Sri Lanka seems to have the whole cocktail of these approaches. But we do not seem to have the same, here is some food for thought. We may think that the causes of malnutrition in Sri Lanka are well-known.

But do we really know all the household dynamics, do we assess the competencies of the service providers consistently and comprehensively, do we actually do behaviour change communication through our IEC material.

Do we really dispel myths on nutrition among the community and do we guide cultural practices in a positive way? Are we sensitive for various advertising of food?

Where do we start?

As a nation we need to have a comprehensive and holistic policy on a recipe best suited to us with maybe some of these elements. The policy must be evidence based.

Monitoring and evaluating the implementation and impact of this Policy must be anchored in the correct place, which has a sphere of influence overall sectors.

As I stated before, the society in the recent past has done much to finalise the nutrition policy. Stakehodlers have attempted to ensure that it is multi-sectoral and encompasses all different stages of the life cycle.

Target groups such as adolescents, out of school youth and adults who are not usually targeted for nutrition, education and assessment too must be looked after as carefully as in the case of maternal and child nutrition monitoring.

This is after all the segment of the productive population that literally brings home the food and earns money for the country.

If they are too weak to be productive we can forget about the other more vulnerable, dependant segments such as mothers, children and the elderly.

Air pollution deaths now exceed road fatalities

POLLUTION: The WHO reports that three million people now die each year from the effects of air pollution. This is three times the one million who die each year in automobile accidents, says a report published by the Earth Policy Institute.

"Governments work hard to reduce road fatalities but they pay much less attention to deaths people cause by simply driving the cars, while deaths from heart disease and respiratory illnesses from breathing polluted air may lack the drama of deaths from an automobile crash with flashing lights and sirens, they are no less real," says the report.

Air pollution include carbon monoxide, ozone, sulphur dioxide, nitrogen oxides and particulate, all of which stem from the combustion of fossil fuels, such as coal and gasoline.

(Courtesy: Awake)

SAARC Medical Association formed

PHYSICIANS of seven countries in the SAARC region had met in Dhaka, Bangladesh on January 2 and formed a SAARC Medical Association with the objective of ensuring better health services through enhanced co-operation for the 1.40 billion SAARC population.

Dr. Maxie Fernandopulle of the SLMA who represented Sri Lanka at this meeting has been appointed as one of its Vice Presidents.

Bangladesh Prime Minister Kahaleda Zia who is the Chairperson of South Asian Association for Regional Co-operation had inaugurated the SMA.

(Courtesy: SLMA News)

SLCP annual academic sessions on Feb. 24

PROF. COLVIN Goonaratne will be the chief guest at the inauguration of Sri Lanka College of Psychiatrists (SLCP) annual academic sessions for this year at Hotel Taj Samudra in Colombo on February 24 at 6.00 p.m.

For the first time in the history of the college, this year's annual sessions are being held in association with three medical bodies in UK.

The Sri Lankan Psychiatrists Association UK, South Asian Forum International UK and the South Asian Division of the Royal College of Psychiatrists UK.

Dr. Bobby Somasunderam, President Sri Lankan Psychiatrists Association UK was in Colombo recently to finalise details of the three-day conference with Dr. Jayan Mendis, President Sri Lanka College of Psychiatrists.