Cambodian malnutrition kills children

Press, Volume CXV, Issue 33779, 27 February 1975, Page 17

Cambodian malnutrition kills children

(By SYDNEY SCHANBERG, of the New York Times News Service, through N.Z.P.A.) PHNOM PENH, February 25. Cambodia’s five years of war, with the resultant shortages and astronomical prices, has finally produced serious malnutrition in this once bountiful country and children are beginning to die in numbers. Scenes like the following are ordinary today:

A three-month-old infant, his body wasted by severe malnutrition, lies in a bamboo basket, an oxygen tube is in his nose and an intravenous feeding tube in his arm, which is shrunken into a twiglike thing. Abandoned in a poor section of Phnom Penh, he was found by a pitying old woman who named him Lach Sao and brought him to the nearest medical facility, the Chinese hospital. But when the hospital learned she could not pay, they stopped all treatment and discharged the infant.

The bewildered woman then carried him to a Centre of World Vision, an international relief agency, but despite the oxygen and the intravenous feeding it is much too late. He dies the same day. In a World Vision clinic. Ah Srey, a two-month-old girl, grossly dehydrated from plain starvation, has just been brought in by her grandmother. Ten days before they were caught in the maelstrom of a battle a few miles from Phnom Penh. In the panic, the family became separated and the grandmother found herself alone with the child. For 10 days they have been surviving on hand-outs and scraps or garbage. Skeletal horror The child had been malnourished before. Now she is a skeletal horror little more than bulging eyes and a protruding rib cage. Every few seconds she produces a wail that racks her body. In three hours she is dead. On the table next to Ah Srey,is an older child of 19 months who is dying right now. His name is Nuth Saroeun. Out of his mouth comes a steady whimper and rattle. His father was killed by a rocket three months ago. His 25-year-old mother, also suffering from malnutrition (she has beriberi and her feet are going numb), stands helplessly at his side,

sobbing. A doctor tries to force a tube down the child’s throat to get out the mucus that is blocking his breathing. Suddenly the child utters a tiny cry that sounds like “mak” (mother) and then his head slumps over and he is gone.

Waves of mothers carrying gravely ill children, swollen children, children with sticklike concentration camp bodies, children with parchment skin hanging in flaccid folds, coughing children, weeping children, silent children too weak to respond to any stimuli any more press forward every day against the doors of the relief agency clinics, desperate to get in. Not enough doctors But there are not enough doctors or nurses or medicine or food for them all. So for every 500 who come, only 200 or so can be treated only the most serious cases. “How do you think I feel?” said a Western doctor. “Having to turn away 300 from our clinic every morning?” Sometimes mothers burst into tears in the clinics simply out of relief that they have been allowed in with their children. j/ But even those who get in must surmount more obstacles. Most of the children should be immediately put in hospital, but the hospitals are full of war wounded and there is no room for undernourished children. The only beds are the ones that become available when other children die in the few special children’s centres. Emergency airlift The Americans have stepped up an emergency airlift of supplies from Thailand, because the insurgents have blockaded Cambodia’s main supply line, the Mekong River, but until now the cargo these planes have brought is all military aid. Mostly ammunition. There has been no food. On Monday, the United States Administration announced that beginning on Thursday the airlift would begin bringing rice to Phnom Penh, but this is only to replenish stocks and maintain the status quo. The astronomical price of rice will not change, and the many Cambodians who are hungry now will continue to be hungry.

There are no accurate survey figures yet, but everyone involved in the Cambodian relief effort believes that at minimum, from the first-hand evidence, tens of thousands of children are now dangerously malnourished and that at least dozens are dying daily, most of them in and around this capital city bursting with refugees. Yet it is not the official refugees, those living in camps or otherwise, being fed by the relief agencies with United States food and funds who are suffering most. It is instead the marginal people everywhere — those who are refugees but not registered as such, those who are trying to scrape by without a humiliating dole, underpaid civil servants, office workers, rickshaw peddlers and even soldiers. In short, it is the general population that has been driven over five years of hav-i

ing to eat less and less because they lack money to a point of critical nutritional weakness. On the brink “They’re on the brink,” says Dr Penelope Key, World Vision’s medical director. “The children have reached the cumulative point where large numbers are being struck by a sudden deterioration. A year ago, we were seeing only a few malnourished children, and these were all under three. Now the numbers are large, and some of the children are 10 and 11.” Agencies like World Vision feed and provide medical care and shelter for 400,000 people in Cambodia these days. But it is nowhere near enough: at least every other person in this country of seven million is a refugee from the war. No sight is more common than an oxcart caravan of villagers raising clouds of yellow dust as they flee the latest fighting. Many people have been uprooted three and four times. Even new refugee settlements erected by the relief agencies are sometimes burned down by the Communist-led insurgents, and the displaced must move on again. Rich in food Cambodia before the war was a country so rich in her food produce that even the very poor were never hungry. Everyone had a piece of land and there were always bananas and other fruit growing wild and a river or stream nearby where fish could be easily caught. Now it is a country of landless nomads with empty stomachs.

In early 1970, before the war began, rice was 6 riels a kilogram on the Phnom Penh market. Now it is 350. Even when people can put together enough to buy rice, they have no money left over for the supplements to balance their diet, fish, beef, vegetables and fruit. In such conditions adults

usually become only weak, but children begin to fail. The children have all the classic forms of malnutrition, marasmus, beriberi, and the vitamin deficiencies that lead to blindness but they are succumbing also in their debilitated state to pneumonia, tuberculosis, dysentery, and a host of other diseases. Virtually no child arrives at a clinic with only malnutrition. “Kids are dying who should not die,” said Robert Beck, a World Vision doctor. “They die in our arms. It’s hard to believe. There’s no excuse for it.” Soldiers’ families Humanitarian relief for Cambodia has always been given a much lower priority by the White House than military aid. Ironically, the families of foot soldiers are among the worst sufferers. They travel with their husbands and fathers, and they are often shifted to a new battlefront suddenly, without food. Their pay is sometimes late. Many of the children showing at malnutrition clinics in Phnom Penh are children of soldiers — a demoralising truth for a Government that is depending on its Army for survival. Although children are starving, the authorities say that despite the latest insurgent offensive and the Mekong blockade, food supplies right now are “adequate” for the next month or more. “Up to now,” said a Western diplomat, “the Cambodians have shown a tremendous ability to survive their physical hardship. But their strength has been sapped. And maybe now they’ve reached their limit and are beginning to topple."