School children lead fight to end malnutrition in north

Sunday January 2 2011

Some girl guides after being trained to detect malnutrition

GRADUATES: Some girl guides after being trained to detect malnutrition and (LEFT) one of the girls diagnoses a baby in Kitgum. PHOTOS BY FLAVIA NALUBEGA 

By Flavia Nalubega

If you thought it is only adults that can fight the increasing malnutrition, you are wrong. This is because children in Kitgum District have gone a step a head after being trained to identify the sick babies who are then taken to hospital for free medication, writes Flavia Nalubega:-

Ms Pauline Acop, 35, from Namokora Village in Kitgum District is a widow who has struggled through thick and thin to raise her three daughters. Her husband died when the children were still tender.

In the backyard on her only small piece of land, she grows millet to sustain the family. This is indeed evidence that the family has a mono meal- millet for breakfast (Porridge), lunch and supper, no other food.

Her daughters, although now looking a little healthier, appear malnourished. The youngest, Peace, seven months, is the most affected.
“She is actually improving. She has always been a weak baby since birth, falling sick all the time but now she is better,” Ms Acop says.

Nationwide problem
This is the state of some children (less than three years) in Kitgum and the entire northern region. For every 10 babies in the region, one is malnourished. This too applies to the entire country whose acute malnutrition state is at 6 per cent.

Dr Robert Mwadime, a nutrition specialist and senior adviser in Food and Nutrition Technical Assistance (FANTA-2), says malnutrition comes as a result of lack of nutrients for proper development and health. “While some can be malnourished for a short period, others suffer from continual malnutrition (acute), getting sick and even dying,” he says.

The causes are...
Malnutrition is caused by poor feeding habits like mono-diet, not having enough food, poor care for the infants due to early and un-spaced pregnancies and intense diarrhea. In the north, it is mainly caused by early and frequent pregnancies, poverty, culture of denying children some foods and feeding children on one dish.

Ms Acop says the life of her little girl changed four months ago when she started accessing free drugs and free baby food at the nearby health centre. This was on the advice of nutrition stars - primary school-going children - one of them her eldest daughter Millie who have been trained in health issues.

“One day my daughter returned from school and told me she wanted to diagnose Peace and find out if she was malnourished. She said she had been taught how to do it at school and using a paper (map tape), she measured her hand, after which she told me the baby was malnourished and would die if I did not treat her,” Ms Acop narrates.

Milly referred her mother to a teacher at school. She was given a ticket to enable her access health experts at no cost. At Namokora Health Centre, Ms Acop’s baby was treated, given free drugs and free plumpynut- baby paste which is a combination of peanut butter, vegetable fats, sugar, milk powder and proteins. Since then, the baby has been improving steadily, is a little can even play. The mother is a jolly woman now.

Food and Nutrition Technical Assistance – a USAID project - has embarked on fighting malnutrition among infants three years and below. This is being done through the Nutrition Star Programme, a new drive in Kitgum District. The stars are girl guides and scouts in 40 primary schools of who were given an intense training in health issues particularly in how to detect malnutrition among children.

They use a map tape which they turn around the hand of a baby. On it there are markings of red, yellow and green. Red stands for acute malnutrition which, if not treated could lead to death, yellow for moderate malnourishment while green is for a healthy baby.

The children go out to the communities and test babies. Where they find malnourished babies, the girls offer tickets to the mothers to enable them access free medication at health centres and hospitals.

The food-plumpy nut is a joint effort of the government and World Food Programme. In Kitgum it can be accessed at St. Joseph’s Hospital where feeding centres have been designed for mothers to feed their babies.

“We make sure that mothers who bring their babies for treatment access free food and feed the babies from here in the feeding centres. We set such rules because some mothers would eat the food instead of feeding the children and some would feed them in excess without following the prescriptions,” Dr Terence Acaye, the nutritional coordinator in the infant section of St. Joseph’s Hospital, says. He says the mothers who turn up for this kind of food have since increased.

Why school children then?
Dr Mwadime says they chose to train children so that they supplement the VHTs. “VHTs often ask for big incentives to do the work yet there is no demarcated salary for them. They also need bicycles to ease their movement,” he adds.

He says with the school children, all this is not needed. “We train 40 children in each school and these go out and test the children willingly. They do not need any pay but just a few incentives in form of pens, mathematical sets, books which are affordable and sustainable,” Dr Mwadime says.

Stars overlooked
However, the stars in their struggle to eliminate malnutrition from the communities have faced a number of challenges. Claudia Lamunu (P.6) of Kakong Primary School in Namokora Village says some mothers chase her away saying she is young.

“They say that I’m not a doctor and I’m young, I do not know what I’m doing. They chase me away. Some babies cry when they see the map tape because they think it is an injection syringe,” she says.

The programme is a pilot scheme and there is hope that it will spread out to all the districts in the north to wipe malnutrition out of the region if more funds are provided. It is spearheaded by FANTA-2, Uganda Girl Guides Associations, Uganda Scouts Association, and Mercy Corps.