Children in remote settlements of Makawanpur district are suffering from severe malnutrition.

Kailash and Raksirang, the remote rural municipalities with a majority Chepang community, are the hardest hit. Poverty and illiteracy are making the situation worse, leaving many children, pregnant women and nursing mothers in desperate need of help.

Four children under five years of age died of malnutrition in Kailash Rural Municipality in the current fiscal year of 2023-24. According to Krishna Yadav, the health unit chief of the rural municipality, the victims—two boys and two girls—were from wards 3, 4 and 7.

“All the deaths occurred before mid-February. No malnutrition related deaths have been reported since the rural municipality launched a programme to control malnutrition in mid-February,” said Yadav. According to him, Kailash Rural Municipality has launched a ‘Search and cure malnourished children’ campaign.

A total of 82 malnourished people—48 children and 34 pregnant women and nursing mothers—were identified and treated in Kailash Rural Municipality during the campaign. According to Yadav, 26 of them suffered from severe acute malnutrition, while 56 had moderately acute malnutrition.

The children of the Chepang community, an impoverished indigenous community residing in some hill districts of Bagmati and Gandaki provinces, are the primary victims of malnutrition in Makawanpur district. The Chepang people have high illiteracy 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.

Health workers from the rural municipality’s health unit, health posts and female community health volunteers were mobilised to identify malnourished children and women in all 10 wards of Kailash Rural Municipality.

The rural municipality allocated Rs5 million budget under the heading: Nutrition programme for poor and Chepang family. The local unit has been distributing nutritious foods like eggs, legumes, ghee, Horlicks (a popular nutritional drink brand) and dry fruits to pregnant women and nursing mothers, while the malnourished children are fed with rice pudding, khichadi and haluwa.

Khichadi is a soft creamy dish made by cooking rice and lentil together with spices in water. Haluwa is a sweet dessert made from flour, ghee and sugar among other things.

Moreover, Kailash Rural Municipality also set up treatment centres for malnourished children and women. Such treatment centres are located at Katunje Health Post in ward 3, Niko Health Centre in ward 7 and Bharta Health Centre in ward 8. “Victims of severe acute malnutrition are admitted to these centres and provided with treatment and nutritious foods,” said Yadav, adding that most of the malnourished people are from wards 3, 4, 7 and 8.

“The number of people suffering from malnutrition is alarming in the local unit, mainly due to poverty, lack of awareness, and child marriage,” said Lok Moktan, chairman of Kailash Rural Municipality.

“Impoverished families struggle getting nutritious food and they are often unaware of malnutrition and its consequences. Another leading cause of the rampant malnutrition is child marriage, which had affected underage mothers and their newborns.”

According to Moktan, Kailash Rural Municipality has launched an income generating programme to combat malnutrition. “Seeds of eight different vegetable species were distributed to families with malnourished individuals. We identified 21 poor families and provided each with a Boer goat [an improved goat breed],” he added.

Raksirang, another rural municipality adjoining Kailash, also has a similar health crisis of malnutrition. In the current fiscal year, as many as 98 children have suffered from malnutrition in the local unit. However, there have been no reports of malnutrition-related deaths in Raksirang over the past year.

As per the data from the Health Directorate in Hetauda, 147 infants up to 11 months of age were found suffering from malnutrition in Makawanpur district during the last fiscal year 2022-23. Additionally, 76 children aged one year to 23 months were found to be malnourished in the district during the same year.

The local units of Makawanpur have been distributing Balvita, a micronutrient powder, to infants aged six months to two years free of charge. Three different nutrient powders are distributed by the government—the first for children aged 6-11 months; the second for children between 12-17 months; and the third for children between 18-23 months.

However, the Balvita campaign has failed to reach many families in Makawanpur. “Many guardians do not feed Balvita to their children, resulting in malnutrition among them,” said Raj Kumar Malla, the chairman of Raksirang Rural Municipality.