Growth of Children in Conflict
Growth of children in regions of conflict is likely to be disrupted by lack of food and an excess of psychological stress and physical disease. An example of the severe effects of conflict was seen in the northeast of Sri Lanka which has suffered more than 20 years of economic sanctions and long periods of active warfare in the Tamil struggle for autonomy. An anthropometric survey in 2005 revealed 34.3% of children <5 years old in Kilinochchi, the de facto capital of the northeast, to be under-nourished compared with 13.2% in the capital of Sri Lanka, Colombo. Ultrasound measurement of the lengths of the kidneys of these children revealed a progressive fall from the mean, suggesting a renal contribution to the cardiovascular disease in developing countries. Measurements of Tamil children in the tea estates in the mountainous centre of Sri Lanka revealed even greater stunting and wasting. The mothers of these children were also stunted and many displayed signs of vitamin and mineral deficiency. The low birthweight rate of 45% confirmed an inter-generational effect of under-nutrition according to the theory of the ‘developmental origins of health and disease’. The degree of stunting and wasting of Tamil children in the northeast and the tea estates is much worse than that of the other major ethnic group in Sri Lanka, the majority Sinhalese, in whom progress in nutrition has been recorded in the last 25 years. Indeed, when compared to anthropometric reports from other regions of conflict throughout the world, the under-nutrition of Tamil children in the tea estates and the northeast of Sri Lanka is revealed to be the worst. The under-nutrition in the tea estates is the worst of all reported, confirming the concept that ‘silent’ conflict, distant from the world’s media and the pressures of international rivalry, may have a greater effect on the growth of children. The WHO database, Anthro 2006, is a useful tool in the field with which to record individual and communal anthropometry and make comparisons with an international standard. There are some technical difficulties in its use but the greatest impediment to the accurate measurement of the anthropometry of children in conflict remains neither the database nor even accuracy of measurement. The greatest impediment is access to the children.
KeywordsSevere Acute Malnutrition Acute Malnutrition Underweight Child Renal Size Renal Length
Body mass index
Global acute malnutrition
Liberation Tigers of Tamil Eelam
National Center for Health Statistics
Severe acute malnutrition
World Health Organization
The authors gratefully acknowledge the secretarial assistance of Jennifer Binney.
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