These boys were born on the same day, but they look very different. Here's why.

At first glance, one might think how nice it is that the older boy is helping the younger one. The two boys are in fact the same age, five years old. They were born on the same day. However, next to healthy and normally developed Miranto, Sitraka is small, thin and weary.
He suffers from chronic malnutrition.

His mother Mariette explains how her son was born underweight: “The pregnancy went well,” she says, “but I did not have enough to eat and I was working a lot. Even now, I sell what I can, but at times I only make 1,500 ariary (around 65 Australian cents) a day. It is not enough to feed myself and my three other children. My husband works too, but he spends his money on drink.”

“He cannot defecate standing up yet, and that will bother the other kids at school,” his mother confides despondently.

Sitraka plays in the courtyard with other kids, but he cannot speak very well. Unfortunately, at only 5 years old, the consequences of his malnutrition are impossible to reverse, creating a vicious cycle of multiple deprivations.

Chronic malnutrition early in a child’s life can impact far more than their growth and height. It can cause stunting, which reduces a child’s cognitive capacity and traps them in a lifetime cycle of poor nutrition, illness, poverty and inequity. Once a child falls behind, it is hard to catch up.