Suman Chepang of Likche in Kailash Rural Municipality, Makwanpur is two years old but he weighs just 2.5 kilograms. His abdomen is unusually large and his skin is sagging. Suman’s parents, however, are unaware that their child is suffering from severe malnutrition.

Suman is the fourth child of Aitaram Chepang and his wife Sita Maya, who is expecting their fifth baby in three months. Their three other children are also malnourished.

The government in 2015 had launched a campaign to distribute Balvita, micronutrient powder, in several districts, including Makawanpur, to control malnutrition among children. However, the campaign has failed to reach many families in the district.

“We are not aware of the Balvita distribution programme or the importance of the powder. We have not offered it to any of our children,” Sita Maya said during a health camp organised at Katunje of Kailash Rural Municipality last week. She visited the health camp suspecting that something was wrong in Suman’s health.

Sita Maya said she has never been to a health post for prenatal or postnatal checkups. She gave birth to her four children at home and plans to do the same with her fifth child. The 23-year-old does not even know that she will get an allowance if she undergoes regular prenatal checkups and gives birth at a health institution.

The 13-month-old daughter of Mangali Maya Chepang of the same village is also malnourished. The 22-year-old mother says she does not know anything about the micronutrient distribution programme nor is she aware of the provision of allowances for regular pregnancy-related checkups.

Not only the children of Sita Maya and Mangali Maya but almost all the children of Likche village suffer from malnutrition. The village does not have a health post so its residents have to walk about three hours to reach the nearest one in Kalikatar.

A lack of health awareness and the absence of health institutions in the village are the main reasons why the people of Likche and other remote settlements in Makawanpur have been left out of government-launched health programmes.

According to Shyam Mahato, the health unit coordinator of Kailash Rural Municipality, many children in several remote settlements of the local unit are suffering from malnutrition but they are not brought to the health institution to receive the micronutrients.

“The government authorities and people’s representatives are also to blame as they have failed to raise awareness about the importance of micronutrients for children,” said Mahato.

According to him, mostly the children of the Chepang community, an impoverished indigenous community that reside in some hill districts of Bagmati and Gandaki provinces, are the victims of malnutrition in Makawanpur district.

The Chepang people have high illiteracy rates and low access to basic public services like health care, drinking water, electricity and education. They mainly depend on subsistence agriculture but the crops they produce hardly last for six months.

As per the data available at the District Health Post in Makawanpur, as many as 223 children in the district are suffering from malnutrition.

Malnutrition is a serious health problem in several districts of Bagmati Province. According to the Province Health Directorate in Hetauda, there are 154,759 children up to 23 months in Bagmati Province and 2,595 of them are suffering from malnutrition.

“Among the total number of malnourished children, 955 are suffering from severe malnutrition in the province,” said Indramani Bhandari, data officer at the health directorate.