“Children with moderate acute malnutrition need urgent food support or they will move into severe acute malnutrition and potentially severe infection and death”, says Dr Audrey Aumua, Officer-in-Charge of the WHO Representative Office in Solomon Islands.
“The immediate priorities are on the provision of nutritious food, food supplements and safe drinking water.”
One third of Solomon Islands children are stunted (low height/length for age) which is a measure of chronic malnutrition.
In addition almost half of children under 5 are anaemic.
The lack of access to nutritious food will disproportionately affect vulnerable groups such as infants, young children, pregnant and lactating women and the elderly.
Currently, there are more than 9,000 people living in the 31 evacuations centres throughout Honiara and Guadalcanal Provinces following the flash flood on 3-5 April 2014 that affected 52,000 people.
As these people return to their homes, there is a high risk of the affected population leaving without basic nutritional and food safety knowledge.
WHO said food requirements of people vary according to their nutritional needs and levels of physical activity.
“The average adult should consume a diet of about 2,100 calories per day and should consist of a variety of foods,” it said.
“Pregnant women should consume additional 300 kcal/day and lactating women additional 500 kcal/day.
For people staying in evacuation centers, in addition to the existing diet provided as part of food rations, WHO recommends the following food that is both affordable and currently available in local markets:
- Vegetables and fruit provided in at least one meal of the day for all individuals.
- Children aged 6 months should be given mashed vegetables such as pumpkin, kumara, yam or cooked banana.
- Pregnant and breastfeeding women should be given an extra meal each day, preferably high in iron.
A standard food basket is recommended, to include: iodized salt, sugar, fruit (dried or fresh), vegetables (dried, canned or fresh), root crops, tinned fish, rice, pulses, nuts, vegetable oil and flour.
WHO said in times of disaster, women should continue breastfeeding infants 6-24 months, with children under 6 months exclusively breastfed.
“It is recommended that children over 6 months continue breastfeeding with safe and nutritious complementary feeding. Safe, sheltered (private) and appropriate areas for breastfeeding should be provided to lactating women.
“Donations of milk powder supplies should be avoided as they contribute to a higher number of infants with diarrhoea and pneumonia and further exacerbate the percentage of exclusively breastfed infants.”
WHO encourages pregnant women to take their iron and folic acid tablets daily as prescribed.
Nutritional needs of children
WHO said infants from 6 months onwards and older children need hygienically-prepared, and easy-to-eat, digestible foods that nutritionally complement breast milk.
“It is critical to support and strengthen micronutrient supplementation especially Vitamin A to boost children’s immunity to infectious diseases and deworming home fortification with multi-micronutrient powders to treat and prevent anaemia in children.
For Infants 6-24 months, appropriate foods complementary to breast milk include:
- Soft, easy to eat porridge and as nutrient dense snacks, for example bananas, avocado or the usual family foods that have been mashed or strained;
- Soft mixtures of typical food aid commodities, for example cereals, green leafy vegetables, fortified blended foods, oil and sugar, together with a variety of vegetables and fruits;
- Fortified complementary foods or vitamin-mineral powders as needed.
In addition to the essential food items, children aged 24-59 months also require the following:
- Blended foods fortified with zinc, iron and other micronutrients;
- Micronutrient powders; Vitamin A supplementation;
- Iron supplementation;
- Zinc supplementation to treat watery diarrhoea, if needed.
“Following natural disasters, such as the recent flood in Solomon Islands, food in affected areas may become contaminated and consequently be at risk for outbreaks of foodborne disease, including diarrhoea, dysentery, cholera, hepatitis A, and typhoid fever,” WHO warned.
“Poor sanitation, including lack of safe water and toilet facilities and lack of suitable conditions to prepare food are major risk factors for mass outbreaks of foodborne disease.”
Outbreaks of foodborne diseases are directly related to risk of malnutrition and food safety is particularly important for infants, pregnant women and the elderly who are most susceptible to foodborne disease.
“During disasters, it is important that food safety authorities maintain existing support for food safety and heighten their vigilance against new foodborne risks introduced by the disaster,” says Peter Hoejskov, Food Safety Specialist of WHO.
“Basic messages, such as those contained in the WHO Five Keys for Safer Food, should be reinforced to all food handlers, especially those involved in mass catering.
“Food that has been in contact with flood water should not be consumed unless the package can be cleaned and sanitized.”
WHO, together with the United Nations Children’s Fund (UNICEF), is working in close collaboration with Ministry of Health and Medical Services (MHMS) and the National Disaster Management Office (NDMO) to improve the nutritional status of people affected by the flood.
Food rations are being provided and church groups have been mobilized and funded to prepare hot meals for distribution in evacuation centers.
While an appropriate quantity of food needs to be supplied, it is equally important that safe water and clean food preparation areas are provided to prepare food – particularly for infants and young children.