Germany may be a rich country, but increasing numbers of the poor are suffering from malnutrition. Expatica looks at this worrying trend.

Poverty is causing malnutrition in Germany

While many children in German society are obese, their fat counts are rising and Germans everywhere are fighting excess weight, many others are glad to find enough to eat.

Experts agree that there are definite hunger pangs amidst Germany's luxury.

Lack of food or malnutrition is predominant among the poor, the old and the sick, but is also hitting children with disabilities, according to a study by the German Association for Nutritional Medicine (DGEM).

The main reasons include cutbacks at health facilities and a general state of financial emergency at health care facilities. Most assisted living facilities lack nutritional experts or even the personnel to ensure the elderly and handicapped receive enough to eat.

Throughout the country, the number of people making do with the bare minimum is growing. Charitable organizations and other aid groups are acutely aware of this.

Queuing for hand-outs

They come carrying bags and wait patiently in lines - dozens of people, old and young, students and unskilled labourers. They wait for groceries that other people do not buy and which would be thrown away otherwise. The group Munich Table feeds about 13,000 people every week, but about ten times as many could use support, says organiser Reiner Raab.

"We're always being asked, but we can't support everyone."

It is the same story at the Catholic Relief group in the Laim district of the city. Requests for groceries have gone up for a variety of reasons, such as delays in unemployment payments under the new German Hartz IV system, according to social scientist Brigitte Sobetzko.

"I would not use the term hunger, that really belongs to the Third World. But there is poverty."

Ashamed to be there

Nutrition expert Berthold Koletzko is concerned about rising malnutrition levels

Soup kitchens are also registering increased demand.

"The clientele has got larger recently," says Franz Herzog, a social worker at the soup kitchen 'Come' which is run by the Protestant Relief Organization of Munich. That new clientele includes groomed, well-dressed people who look ashamed to be there. "You see people who put away a lot of food very quickly and then leave very quickly."

A wheelchair user rummages in dustbins in downtown Munich near the Marienplatz. He then rolls around beside the dustbins with a paper cup and a bag, eating the contents. A young couple heads to a supermarket's dustbins at the end of the day and leaves with plastic bags and furtive glances.

"In the city, we're starting to see more and more people looking for food in garbage cans," says Herzog.

Poor diet

Social workers and nutrition experts agree that no one should have to go hungry in Germany. But malnutrition is a problem. People with low incomes buy cheap groceries.

Fresh vegetables and fruit, fish and meat do not make it to the dinner table. Going without these items leads to a host of problems - everything from weight loss to vitamin deficits all the way up to basic mineral deficiencies.

Possible consequences include immunity problems, exhaustion, increased susceptibility to infection, slow healing and lack of stamina.

The elderly and the ill are hit hardest. According to a study by the DGEM, 20 to 30 per cent of all hospital patients in Germany are malnourished.

Among patients over 70, that figure rises to every second patient. Illness, lack of appetite and bad teeth are major contributors to this, as are depression and loneliness. Often the patients come from assisted living facilities.

"Often they cannot eat enough themselves and there isn't enough staff to feed them," adds DGEM President Professor Berthold Koletzko.

Children particularly affected

A "frighteningly high" rate of malnutrition has been identified among sick children. In a children's hospital known as the 'Haunerschen Kinderspital' in Munich, every fourth child admitted is underweight. Many of the young patients are chronically ill or handicapped.

"It is often difficult to provide these children with enough nourishment," says Koletzko. Some are actually malnourished. The malnourishment often manifests itself as restlessness, but is usually not properly diagnosed. Often it is enough to provide nutritional supplements, in emergency cases through a feeding tube.

A July 19 decision by the Federal Commission of Doctors and Health Insurers that ruled out reimbursements for emergency feedings of patients has been termed a scandal by some making it almost impossible to provide nutritional therapy for many seriously and chronic ill patients.

About 100,000 people in Germany rely on special nutrition.

September 2005

[Copyright DPA with Expatica 2005]

Subject: German poverty