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 But the fourth of five children, all born in a Dhaka slum, Ali shows
one danger sign - at 80 centimeters tall, he is a good 10 cms
shorter than the ideal height for a boy his age.
Poverty and a diet of mostly boiled rice or mashed potato are partly
to blame for his stunting, which is caused by a lack of nutrients,
protein, vitamins and minerals found in meat, fruit and vegetables.
Research shows that insufficient nutrition in the first 1,000 days
of a child's life can lead to irreversible damage to health, growth
and development.
Nutritious food has become even harder to afford since Ali's father
was forced to work in a brick factory to pay off a debt.
It will take him at least six months to pay back what he owes,
depriving the family of the little income he would earn pulling
rickshaws around Dhaka's teeming streets.
"How can I feed the children? How can I pay the rent?" said Ali's
mother, Taslima Begum, who spends her days picking up discarded
plastic bottles in an upmarket neighborhood to sell for recycling in
the hope of making a dollar or two.
The rate of stunting in under-fives in Bangladesh has fallen to 36
percent from 45 percent in 2000, official figures show, partly due
to a growing economy which has helped lift some 20 million people
out of poverty over the last two decades.
But more than 5.5 million Bangladeshi children under the age of five
are still affected by the condition.
Health experts say a major challenge for the government is to reduce
stunting especially in ever-expanding slums, where it is worse than
in other areas.
"There has been a reduction in the level of stunting in Bangladesh
but it remains unacceptably high," Anuradha Narayan, nutrition chief
at the United Nations Children's Fund (UNICEF) in Bangladesh, told
the Thomson Reuters Foundation.
"At present, Bangladesh is still one of 20 countries in the world
with the largest burden of stunting among children."
DISEASE, INFECTIONS
A 2016 survey by UNICEF and the Bangladeshi government shows the
poorest children are disproportionately affected with 40 percent of
children in slums who are stunted, compared with the overall urban
average of 26 percent.
"Children in urban slums tend to be from families that are among the
most vulnerable," Narayan said. "Families in urban slums might be
more food insecure, but also live in environments which increase the
risk of disease and infections."
Of Bangladesh's 160 million people, around 2.2 million live in
14,000 slums, according to a 2014 slum census.
In Balurmath slum where Ali grew up, the putrid smell of sewerage
seeps through the air as children play barefoot in the narrow alleys
lined by corrugated iron houses.
Residents bathe in the open, close to women filleting fish and girls
cooking on mud stoves.
Poor sanitation and diseases linked to dirty water such as diarrhea,
which causes vital nutrients to be lost from the body, are a common
scourge.
UNICEF's Narayan said progress was hampered by the government's
focus on development through infrastructure.
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"Investments in nutrition don't get attention that a bridge or road
or infrastructure project might get," she said.
Ministry of health officials agree more needs to be done to improve
nutrition among slum residents.
"We're trying to address this in a different way," Roxana Quader, a
senior ministry official, told the Thomson Reuters Foundation,
without giving details.
DEVELOPMENT PRIORITY
Last October, the World Bank announced it would increase funding to
tackle stunting in Bangladesh to $1 billion over the next three
years from about $330 million it has invested in two programs.
Part of the money would be spent giving 600,000 families cash to buy
nutritious food for their children in return for regular monitoring
of their development, including height and weight.
"Investing in reducing child stunting should be a priority in
Bangladesh," Qimiao Fan, the World Bank's Bangladesh country
director, told the Thomson Reuters Foundation.
If Bangladesh is to achieve its target of becoming a middle-income
country by 2021, "investing in child nutrition and their cognitive
development is among the most cost-effective development actions,"
Fan said.
Health experts say this is critical because under-nourished girls
tend to grow up and give birth to under-nourished babies - unless
action is taken.
They say more awareness needs to be raised about the link between
early marriage and stunting, and the importance of allowing more
time between pregnancies to give mothers a chance to regain their
health.
By the age of 27, Ali's mother had already given birth to five
children. The oldest, a girl, is 12.
For many struggling to survive in the slums, nutritious food remains
a luxury they cannot afford.
Manik Mia, a father of six, worries about his daughter Jannatul who
turned five this month. Measuring 82 centimeters, she is severely
stunted.
He spends the $38 monthly income that one of his daughters earns as
a maid on paying the rent. Anything else goes on food.
"We know eggs and milk are good for babies but how can we buy them?"
he said with a shrug.
(Editing by Katie Nguyen. Please credit the Thomson Reuters
Foundation, the charitable arm of Thomson Reuters, that covers
humanitarian news, women's rights, trafficking, property rights and
climate change. Visit http://news.trust.org to see more stories)
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