One of the biggest challenges Grade 1 teachers in Australia face is keep up with the energy levels of their young students.

At Nammen Primary School in northern Laos, Grade 1 teacher Pim has the opposite problem.

Her students often come to school lethargic. Their young minds aren’t buzzing with enthusiasm. Instead, they are distracted by stomach pains and headaches.

Laos has some of the highest rates of child malnutrition in Asia. In many remote villages like Pim’s over half of all children are chronically malnourished and over a third are underweight.

Pim, who has been teaching at the government school for 13 years, sees firsthand the effect this has on children.

“My students often come to school hungry and when they are hungry they cannot concentrate, it is very hard to teach them,” she says.

Malnutrition locks children into a cycle of poverty.

When a child doesn’t get the food they need, their growth can become stunted, making them more vulnerable to disease.

Without proper nutrition, a child’s brain may not develop to its full cognitive ability. When children are repeatedly ill, their body can struggle to retain the nutrients of an already meager daily diet.

Repeated illnesses can affect their families, who may have to miss work or school to look after the child and spend more of their limited resources and income on medical care.

The majority of children who are stunted come from families living in poverty and who already under considerable financial stress.

Nutrition-related factors accounted for about 45% of all deaths of children under five in 2016. In Laos, every year more than 6,000 children die due to illnesses related to malnutrition.

For every undernourished child who survives, countless more are permanently affected. When stunted children become adults they can expect to earn 20% less than adults who were not stunted as children.

Thaimoua Yongvang, ChildFund Laos’ provincial area manager for the region that covers Nammen village, says this is one of the region’s biggest problems.