Nutrition and Care: Giving a good start by Ruth Ayisi Changara, Tete province - Dressed in the best bright- coloured crisply pressed African cloths, about two hundred women gather under the shade of the trees with their babies and children under five years of age, listening attentively to different talks and participating in discussions on health, nutrition and hygiene. Every now and again, they burst into song and clap their hands. It is hard to believe that this is an area with a lot of problems. But most of the women and children living in the locality of Mufa-Caconde, in Changara district in the northern province of Tete, have lived with three consecutives years of drought and hunger. The communities in Changara district have suffered epidemics of cholera and other severe diarrhoeal diseases. Children under five years old have been especially vulnerable, some have lost their lives and others have suffered severe malnutrition, which made them vulnerable to many illnesses. Amongst the congregation is Laurinda Lastin, a mother of eight children, who has come with her one year and six month old toddler. She says these sessions under the trees have been valuable for her and she has learnt a lot about child care. She remembers how her first-born son, Givamore, at the age of five months, fell sick with chronic diarrhoea. He was hospitalized for one month. “But as the medicine was not working, I decided to take him out of the hospital and consult a curandeiro (traditional healer),” says Lastin. “I did not have enough money to pay the curandeiro so I sold my chickens. In return he gave me some medicine and some roots to give to Givamore.” Lastin pauses. But then she says quietly, “he died.” Lastin’s story is typical of Mozambican mothers, many of whom lose their children due to preventable illnesses. Some 124 babies out of every 1,000 born do not live to see their first birthday, and a total of 178 children out of 1,000 live births do not make it to their fifth birthday. Diarrhoea is a main cause of death in children under five, most often due to poor hygiene and health practices and ignorance about how to treat it. The other main killers are malaria – the top of the list –, acute respiratory infections and measles, with malnutrition an underlying cause of half of all deaths in children. Lastin has compensated for her lack of education by attending every one of these educative participatory discussions about early childcare and development, which is part of an integrated supplementary feeding programme supported by UNICEF and the World Food Programme (WFP) set up in response to the drought in 2003. This programme has been implemented in 19 districts facing the dual threat of food insecurity due to drought and high prevalence of HIV/AIDS. Women who are breastfeeding or pregnant and children under the age of five receive a food ration of corn, soya and beans. The children under five also receive Vitamin A drops and de-worming tablets. The NGO World Vision has given a two-week training course to activists selected by the community. They learn how to measure and distribute the high protein food, how to monitor child growth and how to measure the upper arm circumference of the children to assess if the child is malnourished or not. Malnourished children are referred to health centres which provide therapeutic feeding. They also learn the basics in health, nutrition and hygiene education. The activists, who must know how to read and write, also have bicycles so that they can cover long distances, making home visits, checking on the construction and maintenance of latrines, growth and vaccinations of children under five years of age, and the general sanitation in the area. Lastin says that she has learnt how to treat diarrhoea with sugar and salt diluted in water. She has also built a latrine and knows the importance of good hygienic practices, including the importance of boiling drinking water. This year, so far there has not been any diarrhoea epidemic in Changara district, whereas Tete province in the past has usually been among the worst hit provinces. Martine Le Fur, the UNICEF officer supervising the programme, says, “people in the district have much more respect for hygiene, especially in their own homes and are building latrines, too.” Lastin’s toddler does not need to be measured. He is chubby and healthy. “He had one bout of mild diarrhoea recently. I gave him water, sugar and salt solution. It passed. He is generally very healthy,” says Lastin.
|
