Mazira: Refugee mother who feeds triplets on one breast

The  drive through the dusty but smooth murram roads south of Adjumani Town leads to Oligi refugee settlement in Oligi Village, Alere Parish, Pachara Sub-county.

 Oligi is one of the cluster refugee settlements under the greater Alere Refugee Settlement in Adjumani District.

 At the entry of Block B of the settlement, a brown, slender lady dashes out of a hut on her bare feet to welcome her guests.

 With a smile, she then rushes back inside the small hut with a worn-out thatching to return with a broken but well mended blue plastic chair in one arm, which she offers her guests while holding a toddler, seemingly in her seventh month, in the other arm.

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 Behind her, two women quickly emerge from the same hut, each carrying toddlers (babies) who appear be to the same age as the one she is carrying.

 The young woman introduces herself as Florence Mazira, a South Sudan national who fled to Uganda three years ago following the civil war in their country.

 Whereas the attention of her guests seems to have been drawn to the three babies, they quickly interject with a smile to admit that all the three are Ms Mazira’s biological children born five months ago.

Once she arrived in Uganda, Ms Mazira was hopeful of resuming her studies to become a medical doctor.

 However, she recounts that this dream was cut short at the beginning of 2021 by the need to sustain her family that was struggling to raise a single meal per day during the Covid-19 lockdown.

 “I had a lot of pressure from my family to marry off so that they could generate the resources to keep them alive and that is how I got entangled in an affair with a fellow refugee who promised to marry me later in the year,” she says.

 Upon conceiving for the man, Ms Mazira ensured she did not miss any of her scheduled antenatal visits.

 The couple were, however, shocked when they discovered four months into the pregnancy that they were expecting triplets.

 “I underwent a lot of counselling but the man abandoned me, on one end I heard he was hiding in another settlement while another version was that he fled back to South Sudan for fear of responsibility,” she says.

 Due to the nature of her pregnancy, at the time of delivery, her case could not be handled at Alere Health Centre II and was then referred to Adjumani Hospital where she had to undergo a caesarean section in January 2022.

 “I delivered my triplets safely and they were all female. They sent me back to Alere Health Centre II for postnatal care services a week later,” she says.

Complication

All seemed well for the new teenage mother of three until she started developing a condition on her left side of the breast that was discovered during one of her frequent visits to the health centre.

 A diagnosis conducted from Alere Health Centre II indicated that because she had suffered a breast engorgement, an infection had resulted.

 Breast engorgement is breast swelling that results in painful, tender breasts. It’s caused by an increase in blood flow and milk supply in one’s breasts and it occurs in the first days after childbirth.

 If one decides not to breastfeed, they may still experience breast engorgement. It can happen in the first few days after delivery. One’s body will produce milk, but if you don’t express it or nurse, the milk production will eventually stop. Medical documents this newspaper saw indicate that on April 13, 2022, Ms Mazira visited the facility and found that the engorgement condition had resulted in a lump in her left breast that needed to be operated on.

 Ms Mary Muya, a senior nursing officer at the health centre, told this newspaper that Ms Mazira started developing the breast engorgement a month after delivery, but was quick to report to the facility.

 “While we worked round to transfer her back to Adjumani hospital to get the lump removed, we advised her to continue exclusively breastfeeding and keep the triplets suckling only the right breast,” Ms Muya said.

 “I received her and treated her for the condition and told her not to feed the babies on the left breast since the condition needed to be removed. We advised her to continue breastfeeding on the one side of the breast that was fine until it was removed,” she added.

Challenges

Whereas the lump was removed and treated, the procedure has caused a malfunction in Ms Mazira’s left breast, rendering her to breastfeed the triplets on the right breast alone.

 “It is difficult, it is a hard task for me because most times the right side itself hurts so severely because it cannot rest from the pressure of the three babies,” she says.

 Ms Mazira says it is her hope that she can get a correction done on the left breast to save her from the challenge.

 Besides facing hurdling in breastfeeding the triplets, Mazira’s condition has limited her from seeking means of survival.

 “Whereas in the past I would vend vegetables at the market here and provide food and other needs of the family, I can no longer do that because I have to spend full time everyday attending to the babies,” she says.

 Ms Mazira, also the family’s breadwinner, is afraid that the babies could soon suffer nutritional challenges (deficiencies) due to difficulty in raising enough food to supplement the little breast they feed on.

 “I am struggling to feed these babies and myself on my own including their medical treatment requirements due to lack of resources, remember I need to fend off for the rest of my other three siblings,” she adds.

Intervention

Her condition has, however, attracted the intervention of Action against Hunger, a local NGO, operating in Adjumani district.

She says the organisation a fortnight ago enrolled her for support under its programme that manages mothers and children under six months at risk of nutrition deficiencies.

Mr Matias Owori, a nutrition officer working with the organisation, says they screened the babies and discovered that they weighed below the normal weight and decided to bring her on board.

“During our engagement in the community we met Mazira and the triplets, so what we did was to screen them, take their weight; they were 1.5kg, 2kg and the other 1 kg respectively,” he explains.

Ms Mazira is one of the many women that visit Alere Health Centre II seeking medical attention for breast engorgement related cases every year.

Ms Muya says four out of 100 women report to Alere Health Centre II every year with breast engorgement disorder.

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