Enriching food to curb rising cases of hydrocephalus

A change in policy could play a big role in reducing the cases of spina bifida and hydrocephalus in Uganda. The Uganda National Bureau of Standards is creating more awareness of food fortification and training food inspectors in anticipation of the day the government will make food fortification mandatory, writes Esther Nakkazi

In Africa, and particularly Uganda, there is lack of awareness about use of folic acid or vitamin B9. “It was the first time this happened in my family. I don’t know what caused it, but people told me it was witchcraft, use of family planning commodities, said Nakibuuka now attending to her baby with hydrocephalus and spina bifida who will be discharged soon.

Studies have shown that if taken before conception, folic acid can reduce a baby’s risk of neural birth defects by 50 per cent.

Policy change?

Officials at CURE hospital say a change of policy can play a role in reducing the infection rates of spina bifida and hydrocephalus in Uganda.

Training for both teachers and nurses should incorporate care for disabled children for teachers and nutrition for nurses, says Florence Kalikwani, nurse manager at CURE.

Currently, nursing schools are training nurses to give mothers folic acid when they are pregnant. But that is too late, according to Kalikwani. Folic acid intake is needed before conception. “The Ministry for Health should change the syllabus so that everybody gets to know how to go about it,she says.

A policy to change teachers’ training so that they have disability training for children who are affected should also be implemented by the Ministry of Education, she adds.

Mr William Ssali, also a consultant with the Ministry of Health MOH-Gain food fortification project, says government should target institutions like schools, prisons, the army, and hospitals to be supplied with foods that are fortified. Most of these use maize flour as a staple food. The MOH-GAIN project has partnered with World Food programme, which now has a policy to supply only fortified foods.

The Uganda National Bureau of Standards is creating more awareness and training food inspectors in anticipation of the day the government will make food fortification mandatory. David Eboku, head of foods and agricultural standards for UNBS, says the bureau is drafting regulations that will make fortification of some foods mandatory. The inspectors should be able to know if the food is really fortified.

If these efforts succeed, fewer babies will have to suffer as little Lisha Nakiyingi has. For now, her condition is stable: the spinal protrusion on her back has been closed and the fluid that had enlarged her head has been drained. But her future is uncertain. It is a sad story about a condition that in many cases could be prevented, especially in Uganda, where infections are contracted after birth.