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Examining the Refugee Situation from the Syrian Conflict; Observing Stunting in Children Resulting from Malnutrition

Aired October 16, 2012 - 15:00:00   ET


CHRISTIANE AMANPOUR, CNN HOST: Good evening, everyone, and welcome to the program. I'm Christiane Amanpour.

And tonight, we devote our entire program to the world's most vulnerable: it's children, whether in war zones or in dire poverty, they suffer the physical and psychological effects of both. And we're discussing all of this with our exclusive guest, Anthony Lake, the executive director of UNICEF, United Nations Children's Fund.

He's just seen first-hand the refugee crisis pouring out of Syria. More than half of those who are fleeing for their lives are children. Some are alone. Some are war orphans without parents, and all of them are traumatized.

The numbers are exploding, and in just the past 24 hours, Turkey says that it has reached its limit, 100,000 refugees has flooded into that country and the government says it can't build camps fast enough to house the vast numbers.

Human rights groups say right now at least 15,000 Syrian refugees are stranded at the border. Turkey won't let them in, and they are sitting ducks for Bashar al-Assad's artillery and his air force.

But it's not just Turkey. Tens of thousands of other refugees are flowing into Iraq, Lebanon and Jordan, countries who have even fewer resources to deal with them.

Anthony Lake will join me in a moment to talk about this and some of the other critical issues affecting children.

First, let's look at what's coming up later.


AMANPOUR (voice-over): Malnourished as a child makes a lifetime of difference. We'll talk to the man who's making a difference now.

And they're called the cleaners of Cairo. The Zabbaleen have been collecting the garbage for 50 years, but now will their business turn out to be rubbish?


AMANPOUR: We'll get to that in a bit. But first to someone who's seen first-hand the trauma inflicted on Syria's children by this civil war. As head of UNICEF, Anthony Lake is just back from visiting a Syrian refugee camp in Jordan, where he toured the makeshift schools and met with the children who were sent there alone.

Mr. Lake is no stranger to international crises. He was a foreign policy adviser for Barack Obama's 2008 campaign and he served as U.S. national security adviser under President Bill Clinton.

Welcome, thanks for coming in to the studio.


ANTHONY LAKE, UNICEF: Thanks very much, Christiane.

AMANPOUR: First and foremost, the most dangerous thing that's happening right now, Turkey is not allowing any more in and human rights groups are saying they are endangered and they need to have some refuge.

Is Turkey going to be able to keep them out? What do you think?

LAKE: Well, they can certainly try, and there will certainly be some refugees still going across the border. But the main issue is what happens to those human beings? And unfortunately, the pressures are growing in both Jordan and Lebanon also against accepting more refugees. And if that happens, it could be a human tragedy even bigger than we face (inaudible).


AMANPOUR: Now your sister agency, the UNHCR said that there's some 300,000 Syrian refugees around those bordering countries. And that could more than double by the end of this year to some 700,000.

LAKE: (Inaudible) think that 300,000 is low, because those are the refugees who are either registered or said they want to be, but in Jordan, for example, you have over 100,000 already who are registered or applying for registration but probably maybe that many again who have not registered.

AMANPOUR: So just sort of what, waiting?

LAKE: Well, no, the -- it's not just the camps. You have the camps in Turkey, camp in Jordan that I visited, but in Jordan probably two-thirds of the refugees are actually in communities, taking advantage of traditional Arab hospitality; in Lebanon, just about all of them are in -- living in communities, which is putting territory pressure on the schools, on the health systems in those communities and more and more you're seeing the population then in Jordan and Lebanon saying, wait a minute; this is inflationary; competition for jobs. Maybe we shouldn't be taking so many more.

AMANPOUR: So you've just come back from Jordan and we've talked about how such a large proportion of these refugees are children, all of them under 18 years old.

What is the crisis in Jordan? You've come from schools; you've talked to them. What are the children saying to you there?

LAKE: Well, oddly enough, I came away both appalled because the children and their parents are -- usually just a mother -- are in really dire straits because they came out during the warmer months and we're on the edge of winter now.

By December, the temperatures could get down to around zero and all they've got are the wrong clothes for winter. We are working very hard to bring in prefabricated buildings, et cetera. But at the same time, if you look at the children's faces that you see, just look at them. (Inaudible) on the screen here -- those kids are playing.

Those kids are in makeshift school, wanting to learn. And what I always -- I always come away inspired by how tough, resilient these kids are and if they're that tough and strong and courageous, then we should be in our support for them.

AMANPOUR: And they certainly are. So how does one support these children who, by all accounts, are traumatized? What have they seen? What do they say? How do they adapt, even, to school?

LAKE: Well, school serves a double function here. One is that they desperately need normality in their lives. And all of them -- I talked to the kids; they have dreams of what they want to be. They said they wanted to be teachers, doctors, all kinds of things. So they need the education and they want the education.

But even more, they need the normalcy of just a safe space, of being able to play, of being with the other kids, because they have gone through terrible traumas. And one of the things we have to worry about is that that trauma can lead to a psychology of revenge and we can simply replicate in the next generation the same conflict we have now.

AMANPOUR: And we're actually hearing from the young children, whether in Jordan or elsewhere that they are already sort of in their mind is cemented these ethnic divides. And they're sort of saying hateful things, probably that they've heard from the adults about, let's say the Alawites, Assad's tribe.

LAKE: Yes. No, it's very disturbing when you hear that, but you can fix it by bringing them back to something more close to a normal life and teaching them something about the need to reconcile with others, et cetera.

If I could tell you just one brief story -- because I was so impressed by it -- there was a little girl I saw in one of our schools. And when we asked, so what do you want to do with your life, she said, "I'm studying hard here because I want to be a teacher someday."

I saw her an hour later in a play area, and she waved at me and I said, "So which would you rather do? Would you rather be in school studying math? Or would you rather be here playing?" I know what answer I would have given.

She said, "I want to study, because I want to be a teacher someday."

AMANPOUR: Yes, I mean, they know. They know that part of their future.

But what about things like this: one of the 15-year-old refugees told Save the Children about when he had been taken with hundreds of others to a school in Syria, and he said, quote, "They hung me up from the ceiling by my wrists. Then I was beaten. I passed out from the severe pain. And then they took turns stubbing out their cigarettes on me." He's talking about the Assad forces in Syria.

Now UNICEF has just had an agreement with the Syrian regime to try to provide more help.

What do you say to the regime? Because you've heard these stories as well.

LAKE: Oh, and I heard them again in the camp from kids who had been tortured, 16-, 17-year olds, whose families had told them, "Escape. Just get out of here." So --

AMANPOUR: Escape so that what? So that you don't get tortured?

LAKE: So you don't get drafted into the army --

AMANPOUR: Oh, drafted.

LAKE: -- or tortured, jailed, whatever.

What we say is, on the one hand, stop it. And we have issued statements a number of times, calling on the regime and other parties to observe the rights of children, not to be abused in this way.

At the same time, what very few people know is that throughout the crisis, we have been able to go on working within Syria as well as in neighboring countries, reaching a quarter of a million kids with various measures, a quarter of a million with vaccinations.

And the other thing that is quite surprising is that even as the conflict gets worse, we've been developing a great network of local civil society organizations through whom we can, for example, we plan to carry out an immunization program for over a million kids.

So on the one hand, we have to take a stand for these children; and on the other hand, continue to work on their behalf within Syria. And we're doing it.

AMANPOUR: Well, they certainly need all the help they can get, particularly with the U.N. not intervening to stop the war. So certainly all the help that you --

LAKE: The U.N. is doing its best to stop --

AMANPOUR: Well, trying, but it's not, unfortunately.

LAKE: (Inaudible).

AMANPOUR: Paralysis again. You've seen it before. We're seeing it again.

But anyway, Anthony Lake, please stay around, because we're going to talk about another major issue affecting children in our next segment, and that is stunting. It's happening to bones, bodies and brains that are undernourished and underdeveloped. The global crisis that you may not have heard about when we return.




AMANPOUR: Welcome back to the program. And I want to focus now on an issue that threatens 180 million children below the age of 5, all over the world. It's called stunting, the stunting of growth and of intellectual development that can come with malnutrition.

The vitamins and the nutrients that a child receives in the first two years of life will literally impact that child's entire future. And that damage can be irreversible. I first discovered this phenomenon while traveling on assignment for ABC News to countries where children are stunted. And we started in Niger during the hunger season.


AMANPOUR (voice-over): Each year between May and the October harvest runs out, and families go hungry. At this aid site run by the group Doctors without Borders, an emergency: 16-month-old baby Rabia (ph) is brought in near death.

DR. SUSAN SHEPHERD: We need to take care of her now.

AMANPOUR (voice-over): Dr. Susan Shepherd orders her rushed to the hospital.

SHEPHERD: We're not going to spend time talking about her.

AMANPOUR (voice-over): As Rabia (ph) struggles for every breath, nearby a mother cries out in grief. Her baby, being carefully wrapped in a blanket, has just died, one of hundreds who will succumb this year.

Decades into a global effort to stop malnutrition, scenes like this remain sadly familiar. But the real tragedy is not just lack of aid, but lack of the right kind, especially for children under 2.

The united states sends roughly $2 billion in food aid around the world every year, but the U.S. Farm Bill requires the bulk of it to be commodities that are U.S. grown, packaged and shipped, products like CSB, a corn soy blend, which lacks the vital nutrients that babies really need.

SHEPHERD: When food supplements were first developed, they were basically an infant cereal with milk powder in it.

About 20 years ago for economic reasons, the milk powder fraction was simply removed, and we basically need to put the milk back in.

AMANPOUR (voice-over): Dr. Susan Shepherd of Doctors without Borders says that food aid to babies should really look more like this, a ready-to- use product distributed primarily by U.N.-funded , programs called Plumpy'Doz.

The sugary peanut paste is fortified with vitamins, minerals and milk powder, everything these children need to be healthy.

SHEPHERD: It's a tablespoon three times a day and the mothers manage it.

AMANPOUR (voice-over): But products like this aren't getting to enough children in enough places, like here in Guatemala.

AMANPOUR: Guatemala has one of the highest malnutrition rates in the world. In indigenous Mayan villages like this one, malnutrition can reach 80 percent of the population or more.

It's not that children are dying of hunger, but they are starving for what they need to grow and to thrive.

AMANPOUR (voice-over): You see evidence of it everywhere, stunted growth.

AMANPOUR: So I'm going to measure you, OK?

AMANPOUR (voice-over): Victoria (ph), a grandmother, is a good example.

AMANPOUR: It's 53 1/2. A normal 10-year-old is 54 1/2. Wow.

AMANPOUR (voice-over): It's not just genetics.

We drew this line to mark the average height for 9-year-olds worldwide. But these 9-year-olds living in rural Guatemala are about half a foot shorter than the average.

We did the same thing in Florida with 9-year-olds of Guatemalan descent, born and raised in the united states with access to better food. They are all normal height or taller.

Luke Armstrong, who runs Casa Jackson, a center for severely malnourished infants in Antigua, Guatemala, says the problem with stunting is not just height. It is reduced mental ability and a weakened immune system that can put babies at increased risk of dying from common diseases. And the damage can be irreversible.

LUKE ARMSTRONG, CASA JACKSON: She is permanently going to be stunted.

AMANPOUR: And IQ is probably permanently impaired?

ARMSTRONG: Yes. Her IQ will be impaired.

AMANPOUR (voice-over): Luke and his doctors fan out to rural villages on the hunt for babies in distress. On this day they find 2-month-old Gricelda, whose mother, Maria, tearfully agrees to let her daughter be taken away to Casa Jackson for care. Luke said they reached her in the nick of time.

ARMSTRONG: But if you just even touch her legs, it kind of feels like a water balloon. You can just see her veins just popping out of there. It's because she's retaining fluid. She could be weeks away from her organs shutting down.

AMANPOUR (voice-over): We went to Maria's home in the Mayan village of Cajagualten. Maria, her husband and six children live on less than $1 a day. They raise beans and corn but they don't have enough money to buy proteins like milk and meat.

AMANPOUR: When Luke came here to take the baby to the center, you were crying. Were you afraid? MARIA (through translator): It made me sad that this happened to my daughter, because maybe it was my fault.

AMANPOUR (voice-over): All Maria's children are stunted, and probably not just physically.

Liliana (ph) is 13, but she's had to drop out of school because her mother says she can't remember things.

AMANPOUR: Did you learn to read and write?


AMANPOUR: Why not?

LILIANA (PH) (through translator): I want to learn, but I can't.

AMANPOUR (voice-over): Studies do show a link between stunting, lower IQ and lower earning potential.

ARMSTRONG: Dealing with the problem of early childhood stunting, early childhood chronic malnutrition is really the solution to breaking the cycle of poverty.

AMANPOUR (voice-over): Peter Rohloff, an American doctor who has worked in this region for years , teaches mothers how to use a locally made fortified corn gruel.

It's cheap but needs to be mixed with water, which in communities like these can often be contaminated.

Plumpy products have none of these problems. It's one of a variety of food supplements that aid groups would like to see more widely used.

UNIDENTIFIED FEMALE: We aren't doing a good job for young children if we're giving them substandard food and telling ourselves, well, it's better than nothing.


AMANPOUR: It's a tragedy.

Anthony Lake is back with me. He's the executive director of UNICEF.

And joining us is Angelique Kidjo, a Grammy award-winning singer and songwriter and UNICEF goodwill ambassador. She recently traveled to Kenya, where more than 2 million children suffer from stunting.

Thank you for joining us.

ANGELIQUE KIDJO: Thank you for having me.

AMANPOUR: And let me just ask you to put this into perspective. We talked about irreversible damage. And look, we have this chart here, which shows the appalling high number of stunting in countries from Afghanistan to North Korea, Guatemala, where I reported there.

Is there a sense that one's breaking the back of this problem? Or only just getting to it?

LAKE: Not yet, but we're starting to get there.

And first of all, thank you for bringing attention to this issue. It's probably the least understood, most underappreciated development issue -- human issue, perhaps -- in the world, because those children that we saw will lose probably the equivalent of three years of schooling, 20 percent less earnings over their lifetime. That's a huge drag on development.

How can a country with stunting rates like this possibly develop in the way we want to see it? And more than that, inside countries, children in the poorer areas are twice as likely to be stunted. And they're four times as likely to die from common childhood diseases. That's the bad news.

And if what we saw doesn't make us angry, it should.

But the good news is that there's a huge opportunity here because this is not an expensive problem to address. The Copenhagen Consensus, former Nobel prizewinners in economics, said that the provision of nutrition, micronutrients, the things -- breastfeeding, the things that can fix this at very little cost are the greatest potential contribution to human welfare out there.

AMANPOUR: And we talked a bit about this product, Plumpy'Nut.

Let me ask you, Angelique, because you've come back from Kenya. We've got some great pictures of you with the mothers that you met in the villages there.

What is it -- this is one mother and her child here. What is it about, let's say, I don't know, the culture or the habits of those communities which leave these children not to have enough? What have you learned?

KIDJO: One of the first things that I learned that really shocked me is that when the men come back home, he is the first one to be fed, before the children, before a pregnant woman, before his own mother, before any vulnerable person. And that is where I draw the line. I said, no. He's not been providing food.

You should be the last one to eat, because while you were gone the whole day, nor your wife, nor your children, nor your mother, nor your mother-in-law have any food to eat. And you know your wife is pregnant. The first (inaudible) I met, she was pregnant five months. And she hasn't eaten the whole day.

AMANPOUR: Were they receptive when you said that? Was it like, oh, gee whiz; yes, maybe we should rethink? Or was there -- or was there pushback?

KIDJO: Well, in the eyes of the women, you know that they know it. But because of the tradition, they don't dare do it. So I turned to them, the mother-in-law, I said, you are -- you have on your lap one that's your grandchild that can't walk. Why can't you talk to your son? The solution we can bring food from outside. But within the community, you guys have to help me out here.

You have to talk to your son and tell your son, this is the gravity of the situation. Your wife that is pregnant five months is stunted; the child that's going to come out is stunted. The one we had delivered here is as stunted. So what are we going to do about it?

AMANPOUR: So you also had a government minister, Kenyan government minister along on this trip with you. Is there something the government needs to be doing?

KIDJO: The first of all, I had to say something. It's the first time I'm going in the field, addressing an issue such as stunting that I have government people need me before, during my trip and after, to ask me what I've seen and what they can do better.

Most of the time the leaders in Africa don't talk to them to come to any village. They want to stay in their palaces and the big cars. They don't care about the people. But the women that I've met at the office (ph) said to me, I know that stunting is one thing that is on the way of developing into middle class in Kenya. And that will take away our work forces.

And they are already working toward it. What they want is not only that we bring the appropriate food, but to come with them with solutions. So I went to them and said, let us educate the community about it.

AMANPOUR: And they were -- I see you nodding. Is it a question of also getting the governments on board? Does it -- or is it for the ground up or from the top down?

LAKE: It's both. And happily, there is something out called the Scaling Up Nutrition, or SUN movement, that began two years ago, which now 30 governments have joined, saying they are going to scale up nutrition, they are going to work harder on making progress on the issue. But in the end, it's the communities.


LAKE: And it is changing behavior in the communities, as Angelique was saying, including not just more food, but the right kinds of food and then doing simple things like washing hands to cut diarrhea, because diarrhea contributes to malnutrition.

AMANPOUR: You were a national security adviser. In terms of national security or global security, does this have an effect?

LAKE: Huge. Of course. If you see the nations that you're pointing out that have a population in -- that is itself at risk, stunting, and then is deepening the cycles of poverty in the poorest areas within those countries, such countries are not, in the long run, stable.

So we have a national security, all of us, not just the United States' interest, but primarily development in human interest in attacking this problem, this opportunity, which is a cost-effective way, probably the most cost-effective way of addressing poverty.

AMANPOUR: And, finally, what drew you to this, Angelique?

KIDJO: What drew me to this is --

LAKE: If I could interrupt, you can see why she is such a force as an ambassador for UNICEF. Terrific, yes.

KIDJO: What drew me to this is we're talking about education, right? We spend a lot of time since I became goodwill -- at UNICEF, goodwill ambassador, in summer education, now I'm very active in secondary education. But what kept the girls from learning and going to university, if they have been stunted, they can't get learning ability if it's already impaired.

And here you are, trying to put and asking people in America and around the world to give you money to give the people good education before we educate any child in the world, that child have the right to three, equal good meals, and we don't have it yet in Africa.

AMANPOUR: Angelique Kidjo, Tony Lake, thank you very much indeed for joining me.

LAKE: Thank you very much.

AMANPOUR: Focusing on the world's children.

LAKE: Thank you.

AMANPOUR: And we'll be right back with another story, right after a break.



AMANPOUR: And finally, tonight we focused on the dangers of childhood. Now imagine a world where a child's survival depends on garbage.

On the outskirts of Cairo rises Garbage City, home to 60,000 Coptic Christians knows as the Zabbaleen, as depicted in the award-winning documentary, "Garbage Dreams." The Zabbaleen are the unofficial garbage collectors, gathering the trash left by Cairo's 18 million people, and separating the refuse from the reusable.

For 50 years with a skill passed from generation to generation, the Zabbaleen have recycled 80 percent of the trash, almost four times the recycling rate of Western countries. But over the last decade, the Mubarak government contracted foreign companies to do the work.

Because of the inefficiency and incompetence, though, of those contractors, they failed. And Cairo's garbage, as I can attest, is mounting ever higher. The new Morsi government has promised to clean house, but with modernization, the livelihood of the Zabbaleen could be destined for the scrap heap. Their methods may be pre-industrial, but the people of Cairo prefer them. And they surely work.

That's it for us. Thanks for watching. Goodbye from New York.