BAGHDAD, 5 March (IRIN) - Apart from dodging bombs and bullets in their schools and neighbourhoods, children in Iraq are suffering from worryingly high levels of malnourishment, according to specialists.

Poverty and insecurity are said to be the main causes of the children's deteriorating diets. Despite efforts by NGOs and the Iraqi government, violence and the displacement of hundreds of thousands of people are making it very difficult for monthly food rations to reach those families that need them most.

"We are displaced and have to change our place [because of spreading sectarian violence] every month, making it difficult for us to get our food rations. As a result, our children are constantly ill and are malnourished because we don't have enough money to afford good food," said Samira Abdel-Kareem, a mother-of-three who was forced to flee her Yarmouk neighbourhood of Baghdad to the outskirts of the city.

"I lost a child three months ago because of malnutrition. He was only two years old. I don't want to lose my other three children and hope someone can help us overcome this problem," she added.

According to the United Nations Children's Agency (UNICEF), about one in 10 children under five in Iraq are underweight and one in five are short for their age. This means that some 4.5 million children in the country are under-nourished.

But this is only the tip of the iceberg, according to Claire Hajaj, Communication Officer at UNICEF Iraq Support Centre in Amman (ISCA).

"Many Iraqi children may also be suffering from 'hidden hunger' - deficiencies in critical vitamins and minerals that are the building blocks for children's physical and intellectual development," Hajaj said. "These deficiencies are hard to measure, but they make children much more vulnerable to illness and less likely to thrive at school."

Hajaj emphasised the importance of children being properly fed in the first two years of their lives, particularly the first six months when breastfeeding is vital.

"Iraq's exclusive breastfeeding rates are very low compared to other countries in the region. Only 12 percent, as of the last survey, which took place several years ago," Hajaj said.

Diarrhoea and pneumonia

"Infant formula use is still widespread, increasing the risk of illnesses like diarrhoea and pneumonia, which also contribute to undernutrition. Diarrhoea is a major risk in the absence of safe water and basic sanitation, a problem now affecting many Iraqi communities," Hajaj said, adding that the first step in preventing undernutrition in children is to ensure proper care for pregnant mothers.

But with insecurity forcing the closure of many heath outreach centres, and hospitals and clinics lacking medicines and specialists, Iraq's population is increasingly being cut off from access to proper health care, say officials at UNICEF and the UN Refugee Agency (UNHCR).

Children in the most restive parts of the country – such as Baghdad, Anbar, Diyala, Missan and Basra provinces - are less likely to receive critical preventative health care.

Dr Mayssun Abdel-Rahman, a paediatrician at Baghdad's Children Teaching Hospital, said that the country's health system is crumbling and that it was only UNICEF and the World Health Organization that were keeping it afloat. But much more needs to be done, she said, as hundreds of children are dying from easily cured ailments, such as diarrhoea and undernutrition.

Nutrition indicators have traditionally been the lowest – three times the national average - in the poorer southern provinces of Iraq and generally in rural areas, according to UNICEF. Now, because of violence, these areas suffer greater poverty than ever before.

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