Burma's children still struggling with beri-beri
June 4, Democratic Voice of Burma
Analysis - Burma's children still struggling with beri-beri
HIV/AIDS, bird flu and polio may have grabbed most of the recent health headlines, but there is one disease that perhaps underlines the failings of Burma's healthcare response more than any other-beri-beri.
Caused by a lack of thiamine, or vitamin B1, in the diet-previously a common problem in countries in which polished rice is the staple-beri-beri has largely been eradicated from the developing world as it is non-contagious and straightforward to treat.
But in April, an internal UN update on the humanitarian situation said Burma remained the only nation in which beri-beri was still a reported cause of child mortality.
"Though in part a result of poor nutritional habits, the fact that [beri-beri] is the fifth leading cause of infant deaths in [Burma] is attributable to the inability of families to diversify their food intake," the document said.
More than one in ten Burmese children die before their fifth birthday. A UN report examining child and mother health from 2005-which provides the most up-to-date figures on the disease-says that beri-beri accounted for 5.5 percent of all deaths among children under five years old in Burma, compared to 5.7 percent in the case of malaria, the leading cause of mortality among the whole population.
The Burmese have long favoured a diet of tea, fish paste and betel nut, all of which inhibit thiamine use in the body. They also rely on a staple of polished rice, which is low in thiamine. In addition, the country's stunted socio-economic status and lack of spending on healthcare means efforts to combat the disease have been too little, too late.
The United Nation's Children's Fund (UNICEF) says that the standard treatment for an acute case of infant beri-beri is a 50mg injection of thiamine and a two-to-three week course of thiamine tablets with a total cost of just 500 kyat. However, the Ministry of Health planned to spend only 427.8 kyat per capita during the 2006 financial year, its own data shows. This represents a rise in health expenditure of just 5.2 kyat per person, or 1.23 percent, compared to the previous year.
In real terms this should be considered a decrease in health spending. At the beginning of the 2006 financial year, Burma's currency hit an all-time low of 1,450 kyat to the US dollar, says the London-based Economist Intelligence Unit, which estimated 16-percent inflation in Burma during the same period.
The Ministry of Health Website says that there are still just 348 Maternal and Child Health Centres in Burma, the same number as in 1988. DVB was unable to find any evidence that the Ministry of Health has attributed
money to tackling beri-beri. The Department of Health Planning was unavailable for comment.
"To our knowledge, UNICEF is the only agency working on infantile beriberi [in Burma] at this time," said Susan Aitken, the agency's spokesperson.
In June 2006, the Australian Agency for International Development donated US $832,000 to UNICEF for a two-year nation-wide project "which aims to quickly and dramatically reduce infant deaths from beri-beri." A 2005-2006
survey in 16 townships recorded a beri-beri mortality rate of nearly six percent.
The UNICEF project aims to provide thiamine supplements to pregnant and lactating mothers, increase awareness of infantile beri-beri through increased information with a longer-term strategy aimed at increasing
levels of thiamine in the Burmese diet. Results from the campaign are not yet available.
The challenge will be reaching rural areas in which 87 percent of all under-five deaths are recorded and diversifying the average Burmese diet, a difficult prospect given the deteriorating socio-economic conditions in
the country, as noted by the UN in its internal appraisal of Burma's humanitarian situation in April.
A recent household survey conducted by the Central Statistics Office in collaboration with international humanitarian agencies showed that more than 30 percent of the Burmese population lives "well below" the poverty
line. In ethnic minority areas the situation is worse than the average.
In Chin State, more than 70 percent of the population lives below the poverty line, while in East Shan State it is more than half. In Arakan State, 60 percent of children under five were found to be "moderately underweight," the highest levels in the country, where Muslim Rohingyas living mostly in the north still suffer severe restrictions on food
supplies.
As the UN Food and Agriculture Association has said previously, "Over the years beri-beri has tended to disappear as economic conditions have improved and diet has become more varied."
Given that neither of these two critical factors are moving in the right direction and funding to tackle the disease is still miniscule, Burma appears to have a long way to go before it can join the rest of the world in eradicating beri-beri.
Reporting by Clive Parker-a freelance journalist based in Chiang Mai, Thailand.
Analysis - Burma's children still struggling with beri-beri
HIV/AIDS, bird flu and polio may have grabbed most of the recent health headlines, but there is one disease that perhaps underlines the failings of Burma's healthcare response more than any other-beri-beri.
Caused by a lack of thiamine, or vitamin B1, in the diet-previously a common problem in countries in which polished rice is the staple-beri-beri has largely been eradicated from the developing world as it is non-contagious and straightforward to treat.
But in April, an internal UN update on the humanitarian situation said Burma remained the only nation in which beri-beri was still a reported cause of child mortality.
"Though in part a result of poor nutritional habits, the fact that [beri-beri] is the fifth leading cause of infant deaths in [Burma] is attributable to the inability of families to diversify their food intake," the document said.
More than one in ten Burmese children die before their fifth birthday. A UN report examining child and mother health from 2005-which provides the most up-to-date figures on the disease-says that beri-beri accounted for 5.5 percent of all deaths among children under five years old in Burma, compared to 5.7 percent in the case of malaria, the leading cause of mortality among the whole population.
The Burmese have long favoured a diet of tea, fish paste and betel nut, all of which inhibit thiamine use in the body. They also rely on a staple of polished rice, which is low in thiamine. In addition, the country's stunted socio-economic status and lack of spending on healthcare means efforts to combat the disease have been too little, too late.
The United Nation's Children's Fund (UNICEF) says that the standard treatment for an acute case of infant beri-beri is a 50mg injection of thiamine and a two-to-three week course of thiamine tablets with a total cost of just 500 kyat. However, the Ministry of Health planned to spend only 427.8 kyat per capita during the 2006 financial year, its own data shows. This represents a rise in health expenditure of just 5.2 kyat per person, or 1.23 percent, compared to the previous year.
In real terms this should be considered a decrease in health spending. At the beginning of the 2006 financial year, Burma's currency hit an all-time low of 1,450 kyat to the US dollar, says the London-based Economist Intelligence Unit, which estimated 16-percent inflation in Burma during the same period.
The Ministry of Health Website says that there are still just 348 Maternal and Child Health Centres in Burma, the same number as in 1988. DVB was unable to find any evidence that the Ministry of Health has attributed
money to tackling beri-beri. The Department of Health Planning was unavailable for comment.
"To our knowledge, UNICEF is the only agency working on infantile beriberi [in Burma] at this time," said Susan Aitken, the agency's spokesperson.
In June 2006, the Australian Agency for International Development donated US $832,000 to UNICEF for a two-year nation-wide project "which aims to quickly and dramatically reduce infant deaths from beri-beri." A 2005-2006
survey in 16 townships recorded a beri-beri mortality rate of nearly six percent.
The UNICEF project aims to provide thiamine supplements to pregnant and lactating mothers, increase awareness of infantile beri-beri through increased information with a longer-term strategy aimed at increasing
levels of thiamine in the Burmese diet. Results from the campaign are not yet available.
The challenge will be reaching rural areas in which 87 percent of all under-five deaths are recorded and diversifying the average Burmese diet, a difficult prospect given the deteriorating socio-economic conditions in
the country, as noted by the UN in its internal appraisal of Burma's humanitarian situation in April.
A recent household survey conducted by the Central Statistics Office in collaboration with international humanitarian agencies showed that more than 30 percent of the Burmese population lives "well below" the poverty
line. In ethnic minority areas the situation is worse than the average.
In Chin State, more than 70 percent of the population lives below the poverty line, while in East Shan State it is more than half. In Arakan State, 60 percent of children under five were found to be "moderately underweight," the highest levels in the country, where Muslim Rohingyas living mostly in the north still suffer severe restrictions on food
supplies.
As the UN Food and Agriculture Association has said previously, "Over the years beri-beri has tended to disappear as economic conditions have improved and diet has become more varied."
Given that neither of these two critical factors are moving in the right direction and funding to tackle the disease is still miniscule, Burma appears to have a long way to go before it can join the rest of the world in eradicating beri-beri.
Reporting by Clive Parker-a freelance journalist based in Chiang Mai, Thailand.
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