More than 1,500 children in the flood-hit districts of Rasuwa, Nuwakot and Dhading have been found suffering from moderate acute malnutrition following the August 26 Bhotekoshi catastrophe, according to a study by the Ministry of Health and Food Safety.

The study also found 13 children suffering from severe acute malnutrition, the most extreme and visible form of malnutrition that requires urgent medical attention.

Health experts say children with severe acute malnutrition are 10 times more likely to die than healthy children.

“We have been preparing to distribute fortified flour to 7,000 vulnerable children, pregnant women, and new mothers in those affected districts,” said Lila Bikram Thapa, chief of the Nutrition Section at the Family Welfare Division under the Department of Health Services.

“We have been planning to launch intervention measures immediately.”

Malnutrition is considered a silent crisis in Nepal.

Moderate acute malnutrition, also known as wasting, indicates significant recent weight loss or a lack of weight gain, often caused by insufficient food intake or illness, according to the World Health Organisation.

UNICEF said that over 84,000 people, including more than 32,000 children, across 17 municipalities in six districts were affected by the August 26 disaster, which caused widespread devastation along the Bhotekoshi-Trishuli corridor. Families lost their livelihoods in an instant. Seven health facilities, 23 schools, 10,000 toilets and 64 water systems were damaged or destroyed. 

The UN agency says supplementary feeding is necessary to prevent children with moderate acute malnutrition from progressing to severe acute malnutrition.

Health officials said they were preparing to provide pregnant women and new mothers with 6 kg of micronutrient-blended fortified flour every month for three months.

Similarly, children will receive 3 kg of fortified flour every month for six months through UNICEF.

Nutrition experts warn that more children in the flood-hit areas are vulnerable to severe malnutrition because relief supplies often include junk food, such as instant noodles, which children have been consuming frequently instead of nutritious meals.

“No one is concerned about nutrition issues, and even those providing relief materials to the affected population have ignored these things,” said Dr Atul Upadhyaya, a nutrition expert. “Huge investments will be required in the coming days for treatment and other intervention measures if we keep ignoring nutrition issues. Children must be provided protein-rich, nutritious foods.”

Experts say immediate intervention is needed to address moderate acute malnutrition and prevent more children from developing severe acute malnutrition.

The national nutrition assessment campaign conducted in April and May found that 88,205 of the 1,035,201 children screened had acute malnutrition, including 18,309 with severe acute malnutrition.

Along with children, adults and the elderly are also affected by poor access to nutritious food. Experts add that a growing trend of consuming junk food—including processed and packaged foods and sugary beverages—has worsened overall nutrition among children.

“As parents are under stress and they may have other things as a priority, children may not get nutritious foods on time,” said Dr Aruna Uprety, a public health expert. “We should not forget that the impact of malnutrition is lifelong and will affect the cognitive development of children.”

Uprety, who has worked for decades to promote locally available nutritious foods through writing and advocacy, urged the authorities concerned to launch intervention programmes immediately to prevent the situation from worsening. She said supplementary feeding was essential to prevent children with moderate acute malnutrition from progressing to severe acute malnutrition (SAM).

Nepal has made visible progress in reducing stunting among children under five, with the prevalence falling from 57 percent in 2001 to 25 percent, according to the Nepal Demographic and Health Survey 2022.

Wasting, a debilitating condition in which children under five lose muscle and fat tissue, declined from 11 percent in 2001 to 8 percent.

Nepal also has international obligations to improve children's nutritional status. To meet its Sustainable Development Goals targets by 2030, the country must reduce stunting to 15 percent from the existing 25 percent, wasting to 4 percent from the current 8 percent, underweight prevalence to 10 percent from 19 percent, and anaemia to 10 percent from more than 43 percent at present.