You are what you eat, but some do not have the privilege to choose. Nai, who is skinny and short for his age, lacks more than just a proper diet. He has been abandoned by his mother, and his father is serving a jail term. As a result, his uncle has kindly taken him into his own family. But like others, he is living from hand-to-mouth, so providing his nephew with a balanced diet from the five food groups is difficult. Due to a lack of variety in their diet, slum children, though not starving, are suffering from malnutrition.
For them, a daycare centre is an escape from basic meals. With three meals a day and two snacks, they are now growing healthily.
Surrounded by piles of broken electrical equipment, an enclave in Soi Sua Yai Uthit is home to low-income earners, including rural migrants. While townhouses and condominiums are cropping up, a few blocks away, corrugated steel shacks are holding out under redevelopment pressure. Inside, there is everything from food to groceries, but the quality of life is subpar. Some are surviving by sorting electronic waste, while others are in dead-end jobs to pay bills amid the rising cost of living.
"Parents are struggling to make ends meet. In the morning, they rush to work. After the daily grind, they are too tired to cook and therefore buy takeaways in their community," said Srilada Rangsigunpoom, manager of the Foundation for Slum Child Care.
"Chicken, rice, omelette, grilled pork and instant noodles. No fruits and vegetables. After work, parents buy paeng loy food [food served in pits] like clear soup and share with their children."
Founded in 1981, the charity is committed to improving the lives of children from disadvantaged backgrounds. It runs four childcare centres in Bangkok's poor neighbourhoods -- Pracha Uthit, Klong Toey, On Nut and Nong Khaem -- which can accommodate around 250 children from the age of three months to five years old. Low-income parents are charged minimal fees of no more than 30 baht per day, but in some cases, such as that of Nai, there is no charge.
A lack of variety in diet is better than not having enough on the plate.
Srilada said poor living conditions and nutrition are correlated. In Nong Khaem, children eat rice with fish sauce or pick up discarded food from a dumpster. In Klong Toey, children of addict parents are neglected and become very skinny. The economic impact of Covid-19 has exacerbated the situation. Due to low income and savings, slum parents have been unable to cope with unemployment for longer than two months. Handouts from temples and charities were their only recourse.
"In times of need, we provided low-income families with dried food and milk. When the pandemic subsided and daycare centres reopened, children who returned were less lively and thinner," she said.
Controversy over poor meals in a school textbook for fifth-grade students brought the issue of child nutrition to the mainstream. The problematic part of the story in the textbook was that it showed children at an orphanage sharing a meal which includes stir-fried water spinach. Everyone is also given half a boiled egg to enjoy with a plate of rice and sprinkles of fish sauce. Such representation was criticised as romanticising malnutrition and poverty.
Srilada said rice and boiled eggs (but no fish sauce) are wholesome, but dishes for other meals should be rotated for nutritional variety. Dishes at daycare centres are based on a balanced diet from the five food groups. Still, it is difficult for low-income parents to afford a wider choice of healthy foods with a daily wage of just over 300 baht.
"Price hikes are making it worse. A mother told me that she had her three children eat rice with kai palo [pork belly and egg stew], while she and her husband had spicy curry together. It is not enough," she said.
Dr Suwannachai Wattanayingcharoenchai, director-general of the Department of Health, warned parents of the impact of an unhealthy diet on schoolchildren. Food for them should be based on five nutrient groups. The daily intake for six-to-14-year-olds is 1,600 calories. Each meal should include a proper amount of rice or flour, meat, vegetables, fruit and milk. Strong flavours, soft drinks, snacks and processed foods are not recommended.
"It is alarming that around one million children are stunted because of malnutrition," said Vitoon Leanjamroon, director of BioThai, citing the figure based on the report from the Department of Health's Bureau of Nutrition in 2021.
Of these, 420,811 children are under five, even though the current constitution endorses the physical and cognitive development of kids.
It is not the only finding that shows a concerning trend in child malnutrition. In October 2020, Unicef Thailand launched a survey on the plight of children and women in Thailand, covering around 40,000 households across the country. Despite the falling birth rate, the number of stunted, wasted (a child too thin for his or her height), and overweight kids had increased. Because of prolonged malnutrition, 13% of children under five were stunted, 8% wasted, and 9% overweight, up from a previous finding in 2015.
Vitoon said a food welfare system should be implemented for the vulnerable population. A free lunch programme is currently offered to kindergarten and primary school students. In the short term, the government should subsidise local schools to cover three meals. By investing in state-run meals, it will improve education and human resources. But in the long term, the government should increase the average earnings of low-income families.
"Tackling inequality will reduce malnutrition," he said.
Covid-19 has brought food security to the fore. Vitoon said urban dwellers, especially the poor, have limited access to food. Given equal income, rural households fare better. Civil society groups are pushing for community farming in Bangkok. Around 2,000 sites within the capital are expected to be converted into organic vegetable farms. It can be a community, state-owned or private-owned space, depending on each neighbourhood.
"But it is not easy. Besides plots of land, urban farming needs lighting, water and accessibility," he said.
In the last leg of the election campaign, political parties touted policies on agriculture and food security. Decharut Sukkumnoed, director of the Move Forward Party's Think Forward Centre, announced plans to increase the school lunch budget from 22 to 30 baht per head per day, cover high-school students, and use local produce to support farmers. Child nutrition, however, is part of a universal welfare scheme. Under the child subsidy programme, the government is offering 600 baht to children from birth to six years of age, but it leaves behind around 30% of kids that do not qualify for this financial relief.
"Instead, we will give 1,200 baht to every child, which will help raise the average income of households with young kids to keep up with expenses," Decharut said.
