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EASTERN AND SOUTHERN AFRICA feature story for Ethiopia

© UNICEF Ethiopia/2009/Getachew

Three-year-old Tamuye Dawit, who is severely malnourished, eats a ready-to-use therapeutic food at a UNICEF-assisted health post in Wondo Genet District. After three weeks of care, his health is improving.

IT TAKES A VILLAGE: HOW HEALTH WORKERS ARE WINNING THE WAR AGAINST ACUTE MALNUTRITION

WOSHA SOYAMA VILLAGE, southern Ethiopia, 27 August 2009 - Alemitu Geneta usually supports her seven children by collecting and selling firewood from the surrounding forests, which requires long daily absences from home.  But her work to put food on the table as a newly single parent has not always been enough to nourish her baby son. 

Just one month after his first birthday, Dawit Samuel developed full blown oedema, or swelling of the body, a symptom of severe acute malnutrition that can be deadly for a child if untreated.

Luckily, a new health service opened in August 2009 in Alemitu’s village that immediately helped her son.  For the first time, the clinic offered outreach health workers who are trained in the management of severe acute malnutrition. It also now has supplies of readymade therapeutic food, or mixtures of essential micronutrients used to treat malnutrition.  

Wosha Soyama village is located in Wondo Genet District, an area where malnutrition is significant and one of several places where UNICEF is supporting emergency nutrition interventions in coordination with national, regional and village-level health officials and NGOs. 

“When I first brought Dawit Samuel [to the health post] he was very sick,” recalls Alemitu. “His body was all swollen and his skin was full of sores. Since we started coming here the swelling has gone down, the dry scaly skin has fallen off, and he no longer has sores – it is like he has a new body. He had no appetite, but now [after three weeks] he eats and drinks well and I am happy.”

It was Senait Shelimo, a 24-year-old health extension worker assigned to the Wosha Soyama health post, who discovered Dawit Samuel’s serious case of malnutrition. She found Dawit Samuel during an afternoon of home visits to families.

“I had gone for another purpose – to check if villagers had built a latrine, if they were using their mosquito net,” explains Senait. “When I first saw Dawit’s body it was all swollen and I was afraid.  I felt sorry for his mother. I saw that she was in trouble, and there are many such children in that area.  I told her to bring her child in the next day. I also told the others during door-to-door rounds.  That’s how our outpatient therapeutic feeding programme started.”

Senait is one of 30,000 health extension workers who have received training from the Ministry of Health, with the support of UNICEF and its partners.  Since 2008, UNICEF has been intensifying its training programme on the management and treatment of severe acute malnutrition with the Ministry of Health and regional health bureaus. This extra collaboration came about in direct response to a lethal combination of drought, inflation, global recession and constraints on food aid that had led to thousands of people suffering or dying from malnutrition and related diseases in the southern part of the country, and with after-effects into 2009.

By the end of 2009, the outreach training and treatment programme will operate in 211 districts. In addition, UNICEF also provides ready-to-use therapeutic food products, medicine and other required supplies.  Using pre-prepared foods means that children with malnutrition who do not have other medical complications can receive the life-saving treatment close to home.

The outreach health worker programme also means reaching more children.  “This work needs to be done at the health post level,” confirms Senait. “We are close to the people.  If the children who are on this treatment stop coming for whatever reason, we are the ones who are best placed to track them.  We know their homes, their neighborhoods, where to find them.”