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Rickets was a disorder of growing children associated with bony deformities resulting from inadequate mineralization of growing bones. It was first reported in the mid-1600s1 from Europe. Glisson described the disease as bony deformity with curving of the legs. Treatment pattern changed over decades as sunlight (UV radiation) and cod liver oil were found effective in treating rickets in 1800s, and vitamin D was identified as the essential ingredient of this oil in the early 1900s .

Vitamin D supplementation made rickets a rare disease in the industrialized countries during the 20th century . However, at the end of the last century two striking things happened: (i) nutritional rickets became a widely seen problem in North America and (ii) its higher prevalence in economically disadvantaged parts of the world where vitamin D insufficiency was uncommon .

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The bone disorder most clearly related to nutrition is rickets. It was first reported from Europe in the mid-1600s . Rickets in the growing child or adolescent develop in a variety of clinical situations and have in common an absence or delay in the mineralization of growth cartilage and in newly formed bone collagen. Glisson and others have described typical findings of bony deformity with curving of the legs in rickets, which continued to be reported during successive centuries. Re-emergence of nutritional rickets as an important and widely seen problem in the North America3,4 and secondly its higher prevalence in economically disadvantaged parts of the world where vitamin D insufficiency was uncommon5 were the two most striking things happened at the end of the last century. In United States and other western countries, rickets was most commonly seen in exclusively breastfed children with relatively darker pigmented skin.

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Disability is to an increasing extent being addressed as an issue to be included into mainstream development rather than as a matter of separate programs and charity. This follows the recognition that people with disabilities are citizens with equal rights, who – given the opportunity – are able to contribute economically and socially to their households and communities. However, people with disabilities are often discriminated against, socially marginalized and do not have access to basic social services. As else where, the number of population, both male and female, with disability is growing in the country. The number of people with disabilities in Bangladesh is high enough to merit special attention. Based on an assessment of the available figures and estimates by WHO and World Bank for developing countries, an overall disability prevalence of about 10% of the population remains a valid working estimate. The prevalence of disabilities in children below 18 years can be estimated to 6% and for the age group above 18 years the prevalence to about 14% or corresponding to 3.4 million children with disabilities and 10.2 million adults with disabilities (Danida, 2004. Disability in Bangladesh: A Situational Analysis).

Although women with disability constitute a large proportion of our population, very little information are available about their characteristics, the constraints they face in their daily lives and the quality of life they enjoy. The government has limited program interventions in addressing issues related with disability and for the disables. In recent years, a number of organizations in the non- government sector have come up with programs and projects for the benefits of the disabled. However, organization run by the disabled dealing exclusively with disability issues is yet to emerge.

In view of the above, a study ought to be conducted to know the real situation especially of women with disability so that appropriate program, project intervention and organizational set up could be designed and launched in the future.

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Purpose
Mukhe bhaat is conducted when the baby is ready to make the transition from a liquid diet to solids. It is performed after the baby has completed six months and before the first birthday. The purpose of mukhe bhaat in ENICAPLW project is to introduce solid food/complementary food in a timely manner that will help the baby achieving a good nutrition status and prevent malnutrition.

Where it will be conducted?
Mukhe bhaat will be conducted at the Mother Baby Area of different camps. The beneficiaries who will be the resident of respective camps will participate in the ceremony.

How it will be conducted?
The mukhe bhaat will be conducted thrice in a month. The date will be 10th, 20th and 30th of the month. If those days are not available due to holiday or other reason, the mukhe bhaat will be organized on the next official working day. The children along with, who will complete their 6 months from 1st to 10th of the month, will be the participants of the Mukhe bhaat ceremony on 10th . Those who will complete their 6 months from 11th to 20th of the month will be the participants of the Mukhe bhaat ceremony on 20th. And those who will complete their 6 months from 21st to 31st of the month will be the participants of the Mukhe bhaat ceremony on 30th . During mukhe bhaat, mothers will bring their babies to the BFSC/MBA on mentioned time. At first, there will be a cooking demonstration which will be facilitated by the counselor. She will demonstrate the process of cooking nutrient rich food such as khichuri in a proper manner for the children. The mothers will learn the process and will follow the techniques to prepare foods in their respective homes for their baby. After preparing the food, the children will be fed the food.

What kind of foods can be offered to the baby?
Food for the baby’s first bite may be rice, pulse, mixed khichuri, kheer, payash (if to offer baby something sweet). Or it is plain mashed rice with a pinch of well-cooked dal although a variety of food will be better to be served in the baby’s bowl.

Some attentive measures should be taken during mukhe bhaat:
 It is best to limit the gathering to just the selected participants to conduct the program properly and to avoid feeling baby overwhelmed.
 Hands and all the utensils should be washed well before feeding the baby.
 Baby’s food must be prepared fresh and maintaining all kind of hygienic measures.
 A small towel/soft tissue should be kept handy to wipe the excess food around baby’s mouth.
 The mother will feed their baby first.

Emergency Nutrition Intervention for Children under 5, Adolescents, Pregnant & Lactating Women   |   Social Assistance & Rehabilitation for the Physically Vulnerable (SARPV)

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A mother to mother support group is a group of women. The women may be either pregnant or lactating or a mother of a child under 2. Mother-to-mother supports for breastfeeding means women helping women breastfeed their babies. Experienced breastfeeding mothers model optimal breastfeeding practices, share information, experiences and offer support to other women in an ambience of trust and respect. In this setting, pregnant women and mothers who are breastfeeding explore options that result in a satisfying breastfeeding experience.  Click For Details

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UNICEF and SARPV Bangladesh jointly published Bangla booklet on Rickets for public awareness. The booklet is available in online as PDF version. [ Downlad2.55 MB, PDF ]

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