( By A Working Guide (WHO - OMS, 1989) )

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Chapter 4.Nutrition

Nutritional problems arise above all following prolonged drought but may also occur after certain other types of disaster involving damage to crops, to stock and to food distribution systems and thus leading to difficulties in maintaining supplies.

The countries where these problems are the most likely to occur are those in which even in normal times the nutritional status of the population is unsatisfactory. The most vulnerable groups are:

· infants (particularly those not breast-fed),
· children,
· pregnant women,
· nursing mothers, the sick.

Children have very high nutritional requirements compared with adults. A table in Annex 3 provides information on energy and protein requirements.

Nutritional status is monitored on the basis of the clinical signs of malnutrition and measurements of the following values:

· Weight for height. It is considered that children with a weight of under 70 % of the normal weight for their height are suffering from a serious degree of malnutrition and those with a weight between 70 % and 80 % of normal from a moderate degree of malnutrition. Annex 3 summarizes the percentage deviations from normal weight for height.

· Arm circumference (a more rapid but less reliable measurement). The circumference is measured on the left arm half way between the tip of the shoulder (acromion) and the tip of the elbow (olecranon). A child with an arm circumference of under 70 % of the standard value is considered to be in a state of serious malnutrition. Annex 3 summarizes deviations from normal in arm circumference.

Education on nutrition should be based on using foodstuffs available on the spot to prepare balanced meals. In general a balanced meal should contain at least 20 g of protein and fats should contribute between 20 % and 40 % of total calories. It should contain carbohydrates (sugar, cereals, edible tubers), vitamins and mineral salts.

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