1. STI disease spreading- rape, young early mother, pregnant teens.  

2. Malnutrition among children increasing. the children does not get enough proper      food to help them with growing and developing. Resulting in retardation, stunting, wasting

3. Food insecurity - not getting enough food, does not eat for days

4. Increase mortality or more death - increasing no of innocent people, getting shot

5. Economic collapse - hard for them to get food, clean environment, lower hygiene as they dos not have clean water source resulting in spreading of disease and die.

 

Nutritionist role:

1. Give them food that fortified with nutrient.

2. Establish more feeding center- they give free food to children

3. Develop a food that are fortified with nutrient.

4. Make a packaging that have macronutrients and macronutrient and distribute to them 

5. Make them more aware about the importance of exclusive breastfeeding

Second, conflicts also can cause a decrease in food availability and eventually hunger. This will lead to an increased in the number of children affected by acute malnutrition. Malnutrition can stunt children’s growth, deficiency in essential vitamins and minerals, making them more susceptible to infectious and chronic diseases. As a nutritionist, we can conduct a targeted supplementary feeding program in which the children were given cooked food and rations to supplement their daily food intake

As a nutritionist, we should raise awareness about the health consequences of conflict such as transmission disease which might be long-lasting diseases. Besides, we should provide and make it easy for people who are suffering from a certain type of disease to access health care facilities. We should provide professional psychologists to provide the right support for women who are sexually abused.  It is important to highlight that women are most affected during conflicts, as they are unable to receive nutritious food to breastfeed their own babies, and also during the delivery they might not have safe delivery or haemorrhage  that will result in more serious health issues. 

-       Firstly, war could lead to the impaired food availability for the family This is because farmers or the first chain of the foodservice couldn’t produce the food product from the farm because of the insecurity or it could also be because the farm ( source of food) is destroyed by the war. This lack of food resources especially the rice, vegetables, livestcok and fruits that provides us the essential nutrients could lead some high risk children to malnutrition. 

-       RON- Nutrionist could help with findings other resources to support their food from the outside and maybe give some Medical nutrition therapy where it included lifecycle nutrition, weight management, and nutrition intervention for various disease states, critical care,and recognition of physical signs of malnutrition. So that they are aware of their own children and the mothers health itself.

-       Next, sexual of genders based violence especially for the women as this includes rapes,sexual slavery, sexual abuse that used to punished, torture the woman and subsequently leads to trauma, abandoned of their family members (considered dirty) and also HIV infections.

-       RON, Nutritionist can play a role as a comforter towards the victim and give some mental support to them. Most victims had trauma and don’t have an urge to live anymore because of the experience thus, nutritionist could give them motivation and some advices to go on with their life as they have to also took a good care of their food intake. We can also give some protection to the survivors from further sexual violence and msybe can propose some laws about the prohibition of the sexual violence for the military involved. 

-       Lastly, economic collapse is one of the consequences to the child and mother as well as they will having difficulties on having the money to fullfiled the basic needs to live such as shelter, food and access to health services. This will impaired their overall health as status because lack of this will lead to various diseases and even mortalility

-       RON, Giving them awareness about their own heatlh status and also acknowledge them about the what kind of prevention that they can do by themselves. Help them to create a new ideas about the things that they can do to earn some income that could lead to their better life for example, creating some crafts or using any of their talent to earn money. 

Role as a nutritionist

As a nutritionist, I can do nutrition intervention that focuses on tackling undernutrition and micronutrient deficiencies. One of the strategies that can be done is by distributing complete food to the camp's base to make sure the people get enough nutrients. 

The availability of food will decrease and the economic will collapse which will lead to the poverty of the family. Also, it leads to decline in habitat. The risk of malnutrition of mother and children will increase and they getting higher risk of exposure to disease. Then, for the consequence, diversion of public spending, loss of qualified personnel and destruction of infrastructure result in no preventive and curative health service available which will lead to death and disability of women and children.

First as a nutritionist, I can work together with dietitian to provide nutrition intervention to them. Mobile clinics and community-based care can be increased to help mother and their children. Establishment of feeding centers like therapeutic feeding centers and supplementary feeding centers for malnutrition in children. Then, as a nutritionist, I will provide micronutrient distribution programs to tackle micronutrient deficiencies in children and mother. Then, I will provide food assistance programs to distribute the foods to children to decrease the stunting, wasting and malnutrition rate. Also, as a nutritionist, I will provide nutrient-dense fortified spread to the mother and children; so, they can obtain the needed nutrients daily. Nutrition therapy via outpatient day care center can also provide to them. Several nutrition interventions targeting malnutrition and micronutrient deficiencies can be effective in the stable and development phases of emergencies such as refugee camps on malnutrition, vitamin deficiencies, and standard anthropometric measurements.

Armed conflict has lead to economic collapse because the government are diverting resources to military purposes. When the economic collapse, families lose the ability to buy food and this may lead to malnutrition because they are unable to get essential nutrients from food. Furthermore, malnutrition will  increase exposure to disease which may then lead to the death and disability of women and children. As a nutritionist, we should participate and volunteer in food distribution program so that everyone will have access to nutritious food to prevent the risk developing diseases. 

Besides that, armed conflicts also causes destruction of infrastructure. So when service infrastructure is destroyed and health workers migrated, fled or killed, women and children do not have access to health care services which will eventually lead to the death and disability of women and children. As a nutritionist, although it is not my decision to plan on rebuilding infrastructure, but as nutritionist, we can provide them some basic health care services and advices. 

1)    Impaired food availability 

-          The combatant was bad enough to loot civilian fields and food stores for their survival during the conflicts.

-          During the conflicts, there is inadequate food in the market because traders flee, markets close during the conflicts.

-          The child may face malnutrition due to poor nutrient intake. If this condition happens over a long period, child stunted and wasted may happen during conflicts.

2)    Economic collapse 

-          lose the ability to buy food 

-          this causes malnutrition to happen.

-          Some of them cannot afford medical care 

-          this decreases their quality of life.

-          their health status may impair during conflict period. 

3)    Destruction of infrastructure 

-          Loss of health care service 

4)    Displacement 

-          the child and mother to separate in the conflicts.

-          The children do not under care by their mother 

-          they may face physical exhaustion and malnutrition injury after a long period of conflicts. 

5)    Sexual abuse and sexual violence

-          Rapes (method of war / punishment) 

-          Cause trauma, injury 

-          A woman will become the community’s shame, and be pointed as dirty / stained 

6)    Increase in the sexual transmission disease such as HIV. 

-          Impaired their health status 

Role of Nutritionist 

1)    organise a food assistance programme

-          distribute the foods to them

-          prepare nutrient-dense food

-          reduce anaemia and correct linear growth in stunted children

-          significant reduction in the risk of stunting, wasting and underweight can be observed

-          distribute the packages typically containing nutrient rich food products containing powdered milk, biscuits, baby food, dried mashed potato and others.

-          Food was provided in the form of weekly rations and packages. 

2)    organise micronutrient powder distribution programs

-          reduce the risk of stunting

-          A combination of multiple vitamins and minerals designed to be mixed in the children’s home-based foods just before consumption.

-          The micronutrients powdered were associated with significant decreases in the prevalence of stunting among refugee children.

3)    Educate them / give them knowledge 

-          Teach them how to avoid malnutrition

-          Teach them how to protect transmission of disease. 

-          How to protect them and how to maintain hygiene 

-          How to take enough nutrients / balanced diet  

4)    Give them mental support 

-          Moral value 

-          Let them no feel they are alone 

5)    The use of contraceptive method 

-          Condom 

-          Protect against sexual transmission disease

6)    Enforcement of the law 

-          Protect them from sexual abuse 

7)    Be part of the volunteer 

-          Distribute the food 

-          Teach them the proper meal plan 

-          Support them 

The most common conditions and consequences that conflicts cause are: 

·       Depression, anxiety and psychosomatic disorders. 

·       Mortality in women and children during conflicts.

·       violence: infectious disease, malnutrition and complications of pregnancy 

·       impaired food availability

·       Sexual gender violence and cause reproductive problems.

·        Economic collapse

In my opinion, nutritionists can increase the awareness of those people about family planning and how they can avoid HIV and all the infectious diseases which are very dangerous especially because of the lack of basics needs of life

·        Apart from that, provide social support for the mother 

It can be said that women and children bear substantial morbidity and mortality as a result of armed conflicts. Besides, indirect violence causes impaired food availability, economic collapse and loss of health services. All of these consequences can lead to the problem of malnutrition, exposure to diseases and eventually death among women and children indirectly. Insecurity stops the farmers from going to the field to tend the crops.  Food aids are no longer easily accessible by everyone. Governments spend less to build their economies, diverting resources to military purposes. Health services also decline in conflict areas. Families lose the ability to buy food, live in precarious and disease-prone environments, and cannot afford medical care. It can thus impaired maternal and child health status.

Generally, intervention that can be done by nutritionists is providing nutrition therapy to them. Apparently, wasting, stunting, and underweight are the common existing problems faced by childrens involved in armed conflicts. Hence, assessment can be done to identify nutrition deficiency and underlying diseases. Children with malnutrition were sent home with vitamins and medications for associated infectious diseases.  Nutrition therapy that includes enriched milk and locally prepared porridge and biscuits can be provided to them. Children also received play therapy for emotional needs. This is because emotional feelings can be considered as a bigger issue especially in the conditions with armed conflicts. Besides, mothers also need to receive daily lessons on hygiene, safe water, and infectious disease prevention with the use of graphic tools. As mothers gain the knowledge of basic nutrition, they can change their habits and thus the risk of her and her children getting malnutrition or nutrition deficiency  can be reduced. 

We can develop prevention programs that are suitable for the people in conflict areas. Improve better health assessments to know their specific concerns and conditions nutritionally. Wasting and stunting may be very common in this situation, so nutritionist may develop a suitable education and program for them in terms of diet that can help to prevent further decrease in overall health status. For example create an idea of meals that they can still afford to have and still has the nutritional values that can complement their needs especially for mothers and children.

These areas may also lack in hygienic knowledge. If ignored, it may further lead to increase in communicable diseases in the population. Try to teach them simple education about hygiene that they can still receive in that conflict condition. Many infectious diseases can occur in areas that are suffering from poverty, which is an indirect effect of conflict areas.  

Work together with other health professionals and providers to help supplementing victims of conflicts, especially to mothers and children who are the majority of affected groups. Nutritionist can work in many ways and not limited to assessing their health. We can provide help and support in any ways that we can to help them overcome their problems.

Nutritionist and other health workers may not be able to help them directly in conflict conditions, but indirectly we can provide them education that they need to know. We are also aid workers, aiding victims like mother and children in their needs of support.

As the role of nutritionist, nutrition intervention should be given to this target group. Nutritionists should cooperate with the government and relief agencies to carry out such nutritional interventions. General food distributions, blanket supplementary feeding programmes for vulnerable groups, micronutrient distribution, and infant and young child feeding programmes were among the interventions used to treat micronutrient deficiencies and malnutrition. In addition, as a nutritionist should provide mothers with education on breastfeeding and timely introduction of healthy and nutritious complementary food. This is crucial for supporting the health of children aged 0-24 months. As a nutritionist, we should educate the women who have been sexual violence about the sexual education. Besides, women who have experienced sexual violence are likely to have psychological problems. Hence, the mental health of these women should also take into consideration.