|© UNICEF video|
|A child with her mother at a local health centre in north-eastern DR Congo. The centre is part of an effort by the government, UNICEF and local partners to treat malnutrition at the community level.|
UNICEF Executive Director Ann M. Veneman is in the Democratic Republic of the Congo for a five-day visit to assess the situation of women and children amidst what is widely seen as Africa's worst humanitarian crisis. Here is the first in a series of related reports.
By Shantha Bloemen
ORIENTALE PROVINCE, Democratic Republic of the Congo, 26 August 2009 – Local health centres here have opened their doors for the weighing and measuring of young children. It’s a simple check on child health status, but it is having a dramatic impact.
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Instead of waiting for children to become so sick that they have to spend weeks in a hospital, the health centres work to keep children healthy.
“We try to reinforce [local capacity] to treat and prevent malnutrition,” explained Abel Nimpojeje, a nutritionist with the non-governmental organization Action Contre la Faim, which is rolling out services in 27 health clinics in the province. “The children are not hospitalized and they are able to stay in their community,” he added.
Monitoring and treatment
Three-year-old Mandula’s mother learned about the programme through a community volunteer. “Usually she would eat a lot, play with her friends. But she has lost her appetite…. She doesn’t sleep or play anymore,” said the mother.
Mandula was sick for almost six weeks before being brought to the health centre. Since then, her condition has been monitored each week, with treatment adjusted as needed. After a test showed that she could digest food on her own, she was prescribed three daily sachets of Plumpy’nut, a ready-to-eat mix of peanut butter, milk and oil.
The health centres provide pre-packaged Plumpy’nut as a nutritional supplement. In Mandula’s case, clinic staff expected it would take a month for her to fully recover and go back to playing with her friends.
|© UNICEF DRC/2009/Marinovich|
|Nineteen-month-old Gisha, suffering from acute malnutrition, is treated at a health centre in DR Congo.|
Nineteen-month-old Gisha wasn’t lucky enough to make it to a health centre before his acute malnutrition set in. After almost three weeks of treatment, he was still suffering from diarrhoea, vomiting and fever, making it even harder for him to respond to the medicines.
“He doesn’t eat sufficiently. The mother told me he only eats once a day,” said health worker Popaul Kafu. “This is a serious problem. But we cannot condemn the mother. She may not have the money to give enough food to her children.”
The community approach to treating malnutrition began in 2008, when the Government of DR Congo adopted a national protocol and training modules for health and community workers. UNICEF, along with a network of 43 partner organizations, is helping expand those services to more health zones around the country.
Community volunteers visit homes and invite mothers of malnourished children to weekly nutrition sessions at the clinics, which aim to educate them on how to prepare healthy food cheaply.
“We find the principal cause of malnutrition is feeding habits,” said Mr. Nimpojeje of Action Contre la Faim. “There are also many cases of malaria, and if a child is sick, he or she will have problem with digestion and become malnourished.”
A nutritional surveillance system has been set up in 67 health zones (representing 13 per cent of such zones in the country). Results of the surveys have been used to guide decisions about establishing feeding centres; in addition, the data have strengthened the vulnerability assessment system supported by the UN Food and Agriculture Organization here.
DR Congo has a long way to go before all its children are guaranteed their right to survival. Many combined factors – weak health systems, poor vaccination coverage, lack of access to safe water, inadequate sanitation, widespread malnutrition and diseases such as malaria – still threaten millions of young lives.
Yet it is remarkable how a few simple but effective interventions by frontline health workers can bring children like Mandula back to life.
“With the previous approach to treating malnutrition, we observed lots of cases of children being left on their own for long periods in the community because their parents were away taking care of the hospitalized children,” noted Mr. Nimpojeje. “Now we work directly in the community, and parents have more time with all their children.”