Malnourished in bountiful Lombok

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By Lucy Williamson BBC News, Lombok The land is fertile but world prices are having an impact on livelihoods

It is never fun going to the doctor - even when it is just an open-air clinic under a bamboo shelter. And the babies gathered here are making some noise about it.

Their mothers sit with them, under the shadow of Lombok's towering volcano, waiting for their turn - a multi-coloured flock settled on the dusty village ground.

Lingsana has brought her 18-month-old daughter to be weighed.

One by one, the children are called up.

They are placed carefully in an old sack, slung under brass weights, and the results called out to be neatly recorded by the health workers in a large exercise book.

Lingsana's baby weighs just 7.3kg (16.1lb) - far too small for her age.

The World Food Programme says child malnutrition on this Indonesian island has reached 40% in some places.

You can see it in villages and school playgrounds - stunted children with the tell-tale reddish hair.

Vitamin imperative

And part of the problem here, says the WFP's country director Angela van Rynbach, is not how much they eat, but what they eat.

She says meals here often consist of a disproportionate amount of rice and very few vegetables.

It's better for my children to eat more rice, rather than more vegetables RauhonMother

"Of course you need the carbohydrate," she told me, "but you also need the vitamins."

The WFP has been trying to teach local women to add vegetables and beans to the rice to improve child malnutrition.

At first glance, this should not be a problem.

Down at the market, there are plenty of stalls selling fruit and vegetables.

And many of the communities living on the lower slopes of the volcano are living on fertile land.

The little village of Senaru is one example. You can grow pretty much anything here - the village is surrounded by fields of cassava, beans and aubergines. Spinach grows between the houses.

But of the 33 children who live here, 10 are underweight.

Rice as status

One of them is Arsad. He is 12 years old, but looks a little over half that.

His younger sister Hurnawati is two and a half, but spends most of her day in her mother's arms.

But they are surrounded by the right kinds of food, so why are these children not getting enough of it?

Selling vegetables is depriving children of vital vitamins

Their mother, Rauhon, shows me round the patch of vegetables she grows for the family.

It provides them with a tiny portion every three days.

She also farms a much larger plot full of aubergines and beans, but she says she needs to sell all of that to buy rice for the family.

"It's more important to buy rice," she explained.

"It's better for my children to eat more rice, rather than more vegetables. Even if we only have rice, without any vegetables - as long as we have salt - it's OK."

But according to nutritionists, it is not OK. Eating rice and little else, they say, puts Arsad and his siblings at risk of stunted growth, lower IQ and weaker immune systems.

But rice has an almost mythical status here in rural Asia - as food, as livelihood, as a symbol of life itself.

Many people live, and farm - and eat - much as their grandparents did.

But their connection to the global economy is closer now, and as the price of rice goes up, so does the pressure of Arsad's family to turn more of their vegetables into money rather than food.