Flattening a green floor for her daughter’s future

KANDAHAR, AFGHANISTAN – The nutrition department at Mirza Mohammad Khan Comprehensive Healthcare Centre was crowded, the corridor full of mothers waiting to test their children for malnutrition. I could hear babies crying, parents waiting anxiously outside the examination room, counting the moments until their children could be saved.

I was here in April last year, and I could see that the number of malnutrition cases was significantly greater since then. When I saw the records of the nutrition counsellor on board, it showed 30 cases in April of last year, and 50 of January 2022.

In my cyan blue t-shirt, I felt proud to work for UNICEF. We support all healthcare services in this clinic, including screening children under five for malnutrition and treating them when their lives are in danger.

I saw mothers in blue burqas sitting on the floor, heard the nutrition counsellor calling registration numbers of individual children. My eyes were drawn to little Safa.

Safa was only seven months old, but she was clearly suffering. She winced in pain when the nutrition counsellor touched her. She cried, and her skin was droopy.

Now on her third visit to screen for malnutrition, she weighed just 5.3 kilogrammes when she should have weighed seven. But this was a small improvement from her last visit, when she weighed 5 kilos… and everyone was happy about this tiny improvement.

Her mother, Nooria, was nearby, and I asked her why Safa was in such bad shape.

After a big sigh, she replied, “There are many reasons. But mainly, I do not have enough breastmilk or nutritious food. After 40 days my children can no longer breastfeed.”

Nooria and Safa’s story is not unfamiliar. I have heard the same from many mothers. As she speaks, I catch sight of her hands, small like a young girl’s, with thin wrists.

“How old are you?” I asked Nooria.

“I am 21 years old,” she said. “I have four children.”

Four children? At this age?

“I was only 10 when I got engaged,” she said. “At 12 I was married. My husband is a good man, but he is disabled and not able to work.”

I thought to myself, maybe this is why Safa suffers from malnutrition. According to the nutrition counsellor, early marriage often leads to malnutrition, as it is a cycle from mother to child. Plus, if Nooria’s husband could not work and the family was impoverished, Nooria could not afford healthy food to produce enough breastmilk.

I sat with Nooria as the nutrition counsellor guided her on Safa’s ongoing treatment. The counsellor prescribes Safa a strict regimen of ready-to-use therapeutic food, a nutritious peanut-based paste filled with vitamins. The therapeutic food must be taken twice daily for one week until Safa can return to the clinic for another check-up. On average, a child suffering from severe acute malnutrition like Safa must continue taking the therapeutic food for almost two months.

This therapeutic food saves tens of thousands of lives each month, and UNICEF is the only provider in Afghanistan.

I walked with Nooria to her home, where I met her husband and three other children. A brief discussion revealed that her husband earned just 80 cents a day shelfing boxes in a small shop. This could not be nearly enough to feed their family of six...

But despite Safa’s precarious health, Nooria was optimistic.

“I am happy with the results I have seen so far; this therapeutic food is working. I am hopeful that my children will still have a bright future.

I want to be a strong mother for them. I will face all life’s challenges and obstacles to flatten a green floor for my children’s future.”