The Interaction Between Undernutrition and Health Text adapted from The World Food Problem Leathers & Foster, 2009

The Interaction Between Undernutrition and Health Text adapted from The World Food Problem Leathers & Foster, 2009 http://www.amazon.com/World-Food-Problem- Toward-Undernutrition/dp/1588266389

Health and Nutrition Poor nutrition leads to poor health AND Poor health leads to poor nutrition Vicious cycle Girl with Marasmus in Darfur, Sudan http://www.drfletcherinafrica.co.uk/marasmus4.jpg

http://www.usaid.gov/our_work/global_health/nut/images/malnutrition_chart.gif

Infections also cause Malnutrition Loss of appetite –Intolerance of food Cultural factors –Substitution of less nutritious diet when sick Body loss of protein –Used to fight infection http://www.sikhspectrum.com/112006/images/u2.gif

Disease and dietary deficiencies Keratomalacia: Blindness –Vitamin A deficiency Scurvy: Soft gums –Vitamin C deficiency Beri-beri: Nerve inflamation –Vitamin B1 deficiency Pellagra: Skin disorder –Niacin deficiency Anemia: Blood disorder –Iron, B12 deficiency Pellagra http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/18103.jpg

Diarrhea and Nutrition Diarrhea most common infection causing undernutrion – Kwashiorkor induced by diarrhea Worst in children under 5 Diarrhea reduces –Water –Salts Fatal if dehydration > 15% –60-70% diarrhea deaths caused by dehydration http://www.ghi.com/WebMD/topics/diarrhea.jpg

Causes of Diarrhea Rotavirus Cholera Shigella Samonella Parasites Etc. http://203.190.254.12/picture/HSB41_Ban_03.jpg

Rotavirus Diarrhea http://www.brown.edu/Courses/Bio_160/Projects2004/rotavirus/Images/globaldistribution.jpg

Oral Rehydration Therapy Diarrheal salt loss cannot be corrected by drinking salt water –More fluid pulled from body into intestine If add sugar to salt, –sugar crosses intestinal lining –pulls salt into body Signs of dehydration http://www.wikieducator.org/images/6/61/Signsdehydration.jpg

Oral Rehydration Therapy “The cheapest and most effective health intervention that can be implemented in the home to decrease childhood mortality” –UNICEF Diluted salt water with sugar http://ec.europa.eu/research/headlines/images2/cholera_rehydrate.jpg

Malnutrition Exacerbates Infection Philippine children with respiratory infection were 13x more likely to die – if malnourished Malnutrition aggravates –Intestinal diseases –Worms –Parasites Philippine Children http://www.bbc.co.uk/birmingham/content/images/2007/05/15/main_riverside_children203_203x152.jpg

Malnutition Exacerbates Infection Malnutrition most common cause of immune system deficiencies –Decreases in white cell response Interferon skin integrity Mucous membranes Tissue replacement, repair Children with PEM –Atrophied thymus –poor T cell production White blood cell surrounded by red blood cells http://www.sciencemuseum.org.uk/antenna/cancerkillers/images/cells.jpg

Malnutrition reduces Stamina Reduced capacity to cope with life Reduced job performance Reduced income for –Healthcare –Transportation to clinics –Medicines Uganda Health Clinic http://www.doctorsforafrica.org/images/mulanda_health_centre.jpg

Director General of World Health Organization, 1989 “ If we could increase the health spending in the developing countries by only $2 per head, we could immunize all their children, eradicate polio, and provide the drugs to cure all their causes of diarrheal disease, acute respiratory infection, tuberculosis, malaria, schistosomiasis and sexually transmitted diseases.” http://www.who.sk/obr/nakajima.jpg Hiroshi Nakajima

Policies promoting low cost health for the poor Good health promotes good nutrition Good nutrition promotes good health Cheaper to maintain good health –Than to try to cure sick people Low cost health for poor –Barefoot doctors in China –Nutrition huts in Philppines –Health huts in Haiti Barefoot Doctors, China http://www.chinatoday.com.cn/English/20021/1960nian.htm

U.S. Public Health Policies 1840s: modern sewage systems 1900s: Drinking water 1923: Salt fortified –Iodine 1940: Flour fortified –Iron –Thiamin –Riboflavin –Niacin http://www.ames.lib.ia.us/farwell/publication/Pub6940.htm Marston Water Tower, 1897

Subsidizing Maternal and Child Health Services 1974: less than 5% children in developing world immunized against –Measles –Tetanus –Diphtheria –Pertussis –Tuberculosis –Polio Today: 80% immunized due to government policies –Ex: World Health Organization 36 million infants/yr not immunized http://maconareaonline.com/news.asp?id=14271

Maternal and Child Health Centers Immunization –Including hepatitis B, yellow fever Vitamin distribution –Vitamin A pills cost 5 cents to make Monitor Child Development Oral Rehydration Therapy Promote Breast Feeding Nutrition Education Family Planning http://www.new-agri.co.uk/image/043/dev01b.jpg Maternal Health Center, Malawi

Problems with Baby Formula Water supply contaminated with human excrement Household hygiene poor –Flies –Feces No refrigerator Wood stove, little fuel No equipment to clean bottle Uneducated mother –No knowledge of germs http://www.emag.uni-bremen.de/emag/2004/projects/wterprob/my%20home.html

Public Water Case Study Port-au-Prince, Haiti, 1976 50% of municipal water supply leaked out –Few shut off valves –Little incentive to conserve Direct service to 150,000 relatively wealthy 400,000 poor supposed to use 27 public stand pipes http://www.paho.org/English/DPI/100/100feature25_photos.htm Public Water Pump, Port-au-Prince

Public Water Case Study Extreme water scarcity solutions: –40,000 people relied on leaks in pipes –95,000 more wealthy people shared with neighbors –300,000 bought water through private vendors Port-au-Prince http://www.ehponline.org/docs/1994/102-12/focus1.html

Public Water Case Study Private Water Market –Tanker trucks Filled up free at hydrants –2,000 connected households sold water to neighbors –14,000 people were mobile vendors Bought water from connected households Delivered to customers –2 cents a bucket http://www.wehaitians.com/haitian%20suffering.html Port-au-Prince

Public Water Case Study Private Water Market –Customers paid out $3.8 million/year –Municipal Water Authority earned $650,000/yr Family of 5 would pay $4/month for 11 litres/day –40% of families earned $20/month or less –Poorest purchased water only for drinking Bathed in surface runoff http://www.sciencemuseum.org.uk/exhibitions/geographical/fossez.asp Port-au-Prince