100 children fall ill from micronutrients

At least 100 children in the eastern Pakistani province of Punjab fell ill after consuming a dosage of micronutrient tablets in the wrong way. The tablets were distributed by project workers for the government of Pakistan. "There is nothing wrong with the programme, the only problem is that these students should not have chewed the tablets, but swallowed them whole instead," Nasir Jalil, the national project director for the Tawana Pakistan Project, told IRIN in the capital, Islamabad, on Monday. Last week, the 100 children in Punjab suffered adverse reactions such as nausea, vomiting and diarrhoea after taking the supplement. Of a total of 1,800 who received the supplement in Pakpattan District, six percent were adversely affected. The micronutrients, in the form of a tablet, were supplied by the United Nations Children's Fund (UNICEF) to the Tawana Pakistan project, a government initiative which aims to increase the enrolment of girls in schools and to provide them with better health and nutrition. The project, which began in 2002, is targeting half a million girls aged between five and 12 years at 5,300 schools in 29 districts throughout Pakistan. Such micronutrients are internationally approved and no adverse effects are reported. Jalil added that a team of health-care experts had visited the area and was drafting a preliminary report. After the incident, the project had halted the distribution of medicines, while other components of the project, such as providing the students with fresh meals and vermicides, are continuing. He maintained that the adversely affected children had not taken the micronutrient correctly: it should only be taken after meals with lots of water. "In two schools, children took the medicine even before eating food. But you cannot really blame the children. This was the first dose and probably they became more nauseated," he said, adding that Tawana was trying to put together all such pieces of information with a view to issuing a new set of instructions. "I think what has happened is unfortunate. But the situation is now under control, and the children suffered from an upset stomach, and that is bad as it can get," the country representative for UNICEF, Ibrahim Jabr, told IRIN. "We feel we have a moral responsibility. We are an agency for children, and so we advised the government to stop the process for a while and make sure there are instructions on how to administer the tablets," he added. Jabr maintained that although the advice was there, it needed to be more systematic. "We are now taking another look at the system to make sure there are no cracks," he said. While recognising the government's efforts to tackle malnutrition, Jabr said UNICEF was part of a process of establishing a working group to find out where the gaps were in the information flow, and hoped to resolve the issue within the next two weeks.