Only 15 cases of malnutrition had been reported in 2019 and 2020 in Darchula district. But in the last two months, 800 cases of malnutrition have been reported in the district.

“The problem of malnutrition is in every ward and village of our district,” Jaya Raj Bhatta, chief of the district health office, told the Post, over the phone.

Of the 800 children suffering from malnutrition, 138 have been suffering from severe acute malnutrition and the rest have moderately acute malnutrition.

Doctors say severely acute malnourished children need hospital care.

Amidst the ongoing coronavirus pandemic, problems of malnutrition have been emerging as a major health issue, health workers say. And what is concerning is that the parents of the malnourished children are unaware of the problems while the health authorities have shifted their entire focus to the coronavirus.

In Benighat Rorang Rural Municipality of Dhading district, 400 cases of malnutrition had been reported in Ashadh (mid June-mid July); 130 of them were severely acute malnutrition cases.

“Malnutrition has emerged as a major health issue in our rural municipality,” Shankar Duwadi, the municipal health coordinator, told the Post over the phone. “We have been working to find such cases and provide treatment.”

Nutritionists, as well as officials under the Ministry of Health and Population, say that the ongoing Covid-19 pandemic has multiplied the malnutrition problems.

“People stopped seeking care as services were halted in most of the places for a long time. Around half of the total patients are still not seeking care,” said Kedar Prasad Parajuli, chief of the nutrition section of the Family Welfare Division under the Department of Health Services.

The increase in new cases of malnutrition does not mean there were no problems earlier. The Multiple Indicator Survey-2019 showed that the problem had worsened long before the start of the pandemic.

The report showed that 12 percent of children under five suffer from wasting. Wasting or low weight for a particular height is an undernutrition condition, which is a strong predictor of mortality among children under five, according to the UN health agency. Wasting in children, if not treated properly, is associated with a higher risk of death, according to the report.

Only 10 percent of children under five were suffering from wasting in 2016, according to the Nepal Demographic Health Survey-2016.

“We had serious problems of malnutrition and the ongoing pandemic has made it worse,” said Parajuli.

The nutrition section has started screening in half a dozen districts for malnutrition in children.

“We have started the screening in a few districts which shows the problem is alarming,” Parajuli said. “We don’t know the actual conditions of other districts, but we can say problems have escalated of late.”

Malnutrition is considered to be a silent crisis in Nepal.

Duwadi, health coordinator for Benighat Rorang Rural Municipality, said that a lot of people have lost their jobs to the pandemic, which lessened their purchasing power.

“Food crops produced from our own land are not sufficient to feed most families for a year,” said Duwadi. “People do not have time to think about the malnutrition problems, as they have been struggling to eat a full meal.”

The ongoing pandemic has changed the food habits of many families. A lot of people lost their jobs due to prolonged restrictions enforced by the authorities to check the spread of infections.

The UN report published in May stated that the number of people who did not have enough food to eat rose steeply during the Covid-19 pandemic.

Nutritionists say that nutrition has a direct link with overall national development.

“Nutrition is a development and social issue, which affects overall development of the country in the long run,” said Dr Aruna Uprety, a public health expert, who writes columns on nutrition issues.

“Only providing treatment for malnourished children cannot address the ongoing crisis. We have to address the root cause to tackle the problems.”

Doctors say children are highly vulnerable to Covid-19 infection, as they have not been vaccinated yet and schools have started in-person classes. If malnourished children are infected with Covid-19, their chances of getting serious illness and dying increases, according to them.

According to the Health Ministry, Covid-19 has infected 62,979 children under 18 years and killed 86 until Wednesday.

Malnutrition is not only a problem of not getting enough to eat but also of the lack of nutritious food, of lack of knowledge to use locally available food, and growing junk food consumption among children, according to experts.

“Unless the authorities promote locally available nutritious food instead of focusing on distributing micronutrient powders, problems of malnutrition will not lessen,” said Uprety.