Yaounde, Cameroon — The ratio is a stunning one in three. An estimated one third of Cameroon's children are smaller than they should be and some of them will not have long to live.
UNICEF and other humanitarian relief organizations say as many as 1.2 million children are affected by the health condition resultung malnutrition across the nation.
It's a little know fact, say activists, that these children suffer from malnutrition that retards the growth and mental development of a child. Stunting appears in the first few months after birth but its impacts can last a lifetime.
A small sun-burned locality of about 800 inhabitants in northern Cameroon called Pitoa is full of examples of how the problem is affecting the lives of families. In mid-2013, a group of mothers and their babies were gathered under a tree outside a two-room health post for the weekly nutrition consultation.
Most of the children were diagnosed as malnourished, stunted and requiring therapeutic meals.
Forty percent of stunted children die before their fifth birthday
In almost every part of the country, similar diagnoses are being made. Cameroon has more than 40 percent of all malnourished children in the Central Africa. The north is the worst hit, with the prevalence of malnutrition ranging from 35 to 45 percent. But the problem is in the south, as well. Stunting affects around 33 percent of children nationwide.
Children afflicted by stunting are not likely to develop their full potential and are likely to die early. It is estimated that almost 40 percent of stunted children won't make it to the age of five.
Stunting is a severe problem that has been overlooked in Cameroon, says Ines Lezama, a nutritionist at the UNICEF office in Yaounde.
Real crisis is not just in the north
"Most people know that in the northern part of Cameroon there are children who are suffering from acute malnutrition because they can see pictures of the problem or food shortage crisis," says Lezama. "But no one is aware of the real crisis, that the number of stunted children is one million and two thousand."
The high prevalence of the disease is believed to be the result of a complex interaction of poor eating habits, food shortages and inadequate policies to properly address the issue. One study quoted by local UN officials shows that the numbers increased between 2006 and 2011.
International relief organizations, NGOs and community movements have been trying to remedy the situation for many years. UNICEF currently runs a program that uses community volunteers to diagnose malnourished children.
When they find them they send them to health posts like the one in Pitoa where they are treated with free therapeutic food. Specialized units to manage malnutrition have been opened in the few big hospitals in the north of the country.
In spite of the work being carried out, intervention does not appear robust enough to deal with the problem. Campaigners say the current effort is underfunded, aid-dependent and lacks strong political commitment.
Lezama says even though Cameroonian authorities have both sufficient information on the problem and the capacity to deal with it, they have not yet made malnutrition a top priority.
Schools need to embrace the problem, too
"Nutrition is a health-sector priority," says Lezama, but other sectors do not focus enough attention on nutrition. "We need to work together with all the sectors: with education, with social protection, with social affairs, with women's' ministries, with water and sanitation to fight malnutrition in Cameroon."
To attract stronger government support and enlighten them on the broader impact of the problem, malnutrition is now being discussed as a development problem and not simply a public health concern.
Fighting malnutrition has benefits beyond giving children a healthy future. It is an economic investment with big long-term returns. Lezama says such an investment makes sense in a country that wants to develop itself.
"We know that investing one dollar in nutrition can produce 30 dollars in returns because we could have more productive people and a healthy generation that can raise the potential [of the country] intellectually and also produce as much as they can.
"When you have a child that is born in a situation with no water, no sanitation, no health, no food," says Lezama, "probably the child has no chance to life ... " Such a child cannot go to school and perform ... "because he may have anemia. "
Current efforts to address the problem of Cameroon's large stunted population of children may not resolve the problem unless there is greater recognition of the enormity of the problem and greater cooperation and financial support to remedy it.