The excruciating impact of Covid-19 has led to several relief plans and packages to help alleviate pandemic pain. Sadly, children somehow seem to be overlooked.
A resurgent novel coronavirus outbreak in Thailand that has infected more than 13,000 people (to be updated) forced schools nationwide to close to limit the risk of transmission among young ones and the larger community. But while keeping kids at home for remote learning lowered virus exposure, the perils of malnutrition, especially for children in rural areas, have risen to unprecedented levels.
"Thailand has been praised by the international community for … containing the spread of Covid-19. But when it comes to how we handle children, other countries are now keeping an eye on what Thailand is going to do," said Asst Prof Kitti Sranacharoenpong, lecturer at Mahidol University's Institute of Nutrition.
In 2020, fear of the spread of Covid-19 forced schools in Thailand to close from March to July. During this new virus surge, schools were closed again until today. Schools in Samut Sakhon province, where the bulk of the new Covid-19 infections are being reported, remain closed, as do some private schools, according to the Ministry of Education.
But after months of multiple school closures, reports emerged that students -- especially those in rural and remote areas -- were suffering from malnutrition resulting from missing out on school food programmes that included a healthy lunch and free milk.
Kitti noted that students, especially those from poorer families, received less healthier diets, "both in terms of quality and quantity".
"The objective of Thailand's school lunch programme is to bring students -- especially the underprivileged -- to schools so that they can eat healthy meals," he said.
Families living on the margins had grown accustomed the school system's free lunch programme and were less focused, and often unable, to provide healthy meals at home, he added.
Kitti, who helped design the lunch programme while working with the Office of the Basic Education Commission, completed a recent study that compared nutritional conditions among a cross-section of students nationwide -- ranging from kindergarten to grade 6 -- before and after the Covid-19 pandemic arrived in Thailand. Statistics collected from about 6,400 students in 2018-2019 and 2,000 students in 2019-2020, revealed that about 4.3% of surveyed students were underweight before Covid-19. After the pandemic's arrival, the number rose to 6%. Also, before Covid-19, about 7% of surveyed students were found to be slightly underweight. After Covid-19, the number surged to 10%.
"All this was the weight-related consequences of only four months of unhealthy eating during school closures," Kitti said.
Additionally, the survey revealed that stunted growth numbers surged from 4.6% pre-pandemic to 9.4% after Covid closures, while slightly stunted numbers rose from 6% to 10%.
Kitti said this was a result of children missing out on the school milk project, which provides 200ml of milk per day to all Thai students. And there's no way of recouping that critical lost growth stage due to the complicated nature of calcium absorption, he explained. Providing extra milk or calcium supplements after the fact won't help, he added.
"Students are being encouraged to study from home -- an approach that is not that easy even for older children. As for small kids, it's even more challenging especially when they are starving. Some of them are too young to tell their parents they are hungry," he said.
Without sufficient food to provide energy, children lose focus and are unable to study properly, he noted.
Families in urban areas however, have been far less affected by school closures during the pandemic.
"For students in urban areas and middle-class families, school closures can be relatively positive," Kitti said. "Many parents can work from home, which allows them to spend more time with their little ones. This could be an opportunity for them to pay more attention to what their kids eat."
This is not just a hypothesis but a reality that can be seen through Kitti's survey. Before Covid-19, about 4.8% of surveyed students were found to be slightly overweight. With the arrival of Covid-19, the number dropped to 4%.
Also 6% of surveyed students were reported to be overweight prior to the pandemic. After Covid-19 hit Thailand's shores, the number lowered to only 4%. "We also see a slight decrease in the number of obese children before and after the outbreak -- from 6.4% before Covid-19 down to 5.9%."
Although the vaccines against the novel coronavirus look promising with the first shot expected to be rolled out this month, Kitti said there is no guarantee that the disease will be wiped out and not return. So while the focus shifts to a vaccine rollout and other protective measures, priority also should be given to children's nutrition to ensure that they will develop and grow properly according to their age.
Kitti recommends an implementation of guidelines of short-, mid-and long-term goals to solve the problem. The Ministry of Education should collaborate with academics, nutrition specialists and local leaders in developing a strategy.
"Short-term plans might include the direct distribution of food to students," he said. "Long-term plans should incorporate the philosophy of self-sufficiency, which means families should plant their own fruit and vegetables or develop a pooled vegetable garden where everyone in the community can pick up produce. This way people will have no need to worry about falling short of quality and safe food during any pandemic.
"Covid-19 is an unprecedented catastrophe in which Thailand is recognised as doing very well in crisis management. The country has numerous significant lessons to learn from the past so this is a chance also to do well in all dimensions of the outbreak, not just doing well in treating infected people."
