19 Jan 2013

NEPAL / NUTRITION

In Nepal, where 41 percent of the population is estimated to be undernourished, children lower down in the – officially abolished – caste system tend to be more stunted than others. Community health workers are going door-to-door to help them. UNICEF

Posted at: January 19, 2013 12:02 am

Duration: 04:30

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STORY: NEPAL / NUTRITION
TRT:  4.30
SOURCE: UNICEF
RESTRICTIONS: NONE
LANGUAGE: English / Nepali

DATELINE: KHATI GAUN AND BIRALTOLI, NEPAL 24 SEPTEMBER-1 OCTOBER, 2012

SHOTLIST

1.	Wide shot mountains
2.	Wide shot, mountains
3.	Wide shot, river
4.	Wide shot valley
5.	Wide shot  farm workers in field
6.	 Close up, pan up farmer working 
7.	Close up,  woman working with grain
8.	Medium shot, women tossing grain
9.	 Wide shot, women carrying grain through fields
10.	 Wide shot, men and women crossing a river with the grain 
11.	 Medium shot children walking on dike with grain carrying  woman
12.	Close up,  vegetables, pan to woman cutting them 
13.	Close up, farm woman
14.	 Close up hands rolling grain
15.	Med shot, woman rolling grain
16.	 SOUNDBITE (Nepali) : Pashupati Saud, Volunteer Community Health Worker, Khati Gaun Village
"We have green vegetables and fruit in our village, but mothers have to go to work in the fields early in the morning and come home only in the late afternoon, there are no other family members to stay at home in that time, so there's no one to feed the children. And there's poor hygiene so the children get sick and become malnourished. The food you see is only enough for three or four months and then after that we have to buy. Every month we council mothers on feeding, but because of these issues, they can't feed their children as often as they should. Children 6 months old need constant feeding with breast milk and supplementary food, but they're not getting that and are becoming malnourished."
17.	Close up, cooking
18.	Med shot cooking
19.	Close up, food plate
20.	Close up child eating
21.	Med shot woman combing child's hair
22.	Med shot , child going to school
23.	Close up, shoes of Pashupati Saud
24.	Med shot,  Pashupati Saud going about the town
25.	 SOUNDBITE (Nepali): Pashupati Saud, Volunteer Community Health Worker, Khati Gaun Village
"The monthly clinic is part of our regular routine work, and during the clinic we screen children for malnutrition. The severely malnourished children, we refer to the hospital, and for the others we council mothers on how to prepare proper nourishing meals and we council them on hygiene as well."  
26 Med shot children being brought to clinic
27. Med shot, nurses working with children
28 Med shot, nurse measuring child's arm 
29. Close up, nurse measuring child's arm
30. Med shot, nurse consulting with mother
31. Close up, nurse consulting with mother
32. Close up notebook
33. Med shot nurse working with kids
34 Close up nurse working with kids
35. Med shot nurse working with kids
36. Med shot, Sita Bad walking towards clinic
37.  Wide shot Sita bad at clinic
38. Med shot Sita Bad and child and doctor 
39. Close up measuring child
40. Close up child eating
41. Wide shot mother and child, eating
42.  SOUNDBITE (Nepali): Sita Badi, Mother: 
"I didn't know that my child was malnourished, so I'm grateful to the health workers for diagnosing and helping her."
43.	Close up nurse's feet, walking
44.	Wide shot nurse visiting Mitthu Bhul, mother 
45.	Close up, measuring child
46.	Med shot  measuring child    
47.	Close up  measuring child
 48. SOUNDBITE (Nepali): Mitthu Bhul, Mother
"My baby was very sick and suffering, but now he's very healthy and active, so I'm very grateful to our volunteer."
48.	Wide shot village
49.	Close up child
50.	 Med  shot, nurse with child and mother 
51.	Med shot, nurse,
SOUNDBITE (Nepali): Laxmi Bhul, Volunteer Community Health Worker, Biraltoli Village
"I do this job because this village is my family and my life.  At first there were lots of children and even mothers suffering from malnutrition in this village but through my work I've been able to help them, I've been able to help the village and I'm very grateful for that."
52.	Med shot,  Nurse and mother preparing food 
53.	Close up, Nurse and mother preparing food
54.	Overhead shot, Nurse and mother preparing food
55.	Close up, Nurse and mother preparing food 
56.	Wide shot, children grinding grain
57.	close up, children grinding grain
58.	Med shot, children grinding grain
59.	Close up, women working with grain
60.	 Med shot, flock of goats
61.	Close up, old woman
62.	Med shot, old women overlooking valley

STORYLINE

Nepal is a country defined by its geography. Running along the backbone of the Himalayas, it rises from just above sea level to almost 9,000 metres in just 100 miles. Terraced fields, carved from steep sided mountains and valleys are the main source of food and, during harvest, are a hive of activity.

But the golden fields paint a false picture, nearby snow capped peaks are a constant reminder that winter is coming, that this harvest is all there is.

And it's not enough, three and a half million Nepalese don't have enough to eat and 41 per cent of the population is estimated to be undernourished. It's one of the poorest countries in South Asia, and geography is partly to blame. The mountains isolate much of the poorest, they struggle to feed themselves and ensure that they have clean water, adequate sanitation and healthcare.

Almost half the children are stunted and one in 10 are wasted.

But throughout the country, a dedicated team of volunteer community health workers backed by UNICEF and the European Union is making a difference. Pashupati Saud is one of them.

SOUNDBITE (Nepali): Pashupati Saud, Volunteer Community Health Worker, Khati Gaun Village

"We have green vegetables and fruit in our village, but mothers have to go to work in the fields early in the morning and come home only in the late afternoon, there's no other family members to stay at home in that time, so there's no one to feed the children. And there's poor hygiene so the children get sick and become malnourished. The food you see is only enough for three or four months and then after that we have to buy. Every month we council mothers on feeding, but because of these issues, they can't feed their children as often as they should. Children 6 months old need constant feeding with breast milk and supplementary food, but they're not getting that and are becoming malnourished."

Pashupati has been trained to identify and in some cases treat, malnutrition. She's knows its causes and solutions. She knows families don't eat enough nutritious foods and, thanks to the programme she's changed the way she feeds her own family. Breakfast is now a balanced meal of vitamin and proteins.

After she sends her eight year old son to school, she herself sets off to prepare the community's monthly malnutrition check up.

SOUNDBITE (Nepali): Pashupati Saud, Volunteer Community Health Worker, Khati Gaun Village

"The monthly clinic is part of our regular routine work, and during the clinic we screen children for malnutrition. The severely malnourished children, we refer to the hospital, and for the others we council mothers on how to prepare proper nourishing meals and we council them on hygiene as well."

The check up targets pregnant women and children under five. Together with another volunteer, Pashuputi spends the morning screening and counselling.

One of those suffering from severe acute malnutrition is two year old Asmita Badi, she's referred to the local health centre, several hours walk away.

Here she's re examined and her diagnosis is confirmed. Her mother, Sita is given two weeks' worth of ready to use therapeutic food after which she'll need to return for a follow up appointment.

SOUNDBITE (Nepali): Sita Badi, Mother

"I didn't even know that my child was malnourished, so I'm grateful to the health workers for diagnosing and helping her."

Some communities have more to deal with than just isolation. Nepal's caste system, although officially abolished, remains deeply entrenched, especially in rural areas, and means lower castes such as Dalit's are mostly landless and significantly poorer than other Nepalese. T their children tend to be more stunted than other castes.

In Biraltoli, a village in the rural West of the country, Laxmi Bhul, a community health volunteer goes to door to door doing follow up screenings of previously malnourished children. Through her efforts, they're now plumper, healthier and more energetic. Three year old Rosan is one of them.

SOUNDBITE (Nepali): Mitthu Bhul, Mother

"My baby was very sick and suffering, but now he's very healthy and active, so I'm very grateful to the volunteer."

This decentralised community management of acute malnutrition is one part of the broader partnership between UNICEF, the European Union and the government of Nepal aimed at ending chronic malnutrition.

For the volunteers, it's the partnership is ensuring that their children and the children in their communities remain healthy and well nourished.

SOUNDBITE (Nepali): Laxmi Bhul, Volunteer Community Health Worker, Biraltoli Village

"I do this job because this village is my family and my life.  At first there were lots of children and even mothers suffering from malnutrition in this village but through the training I've been able to help them, I've been able to help the village and I'm very grateful for that."

It's about ensuring that malnourished children are diagnosed and treated, it's about ensuring families know how best to feed young children and it's about ensuring that Nepal, is able to eradicate chronic malnutrition.

Filed under NEPAL.