UNICEF and partners work together to end child wasting
From Wasting to Thriving: UNICEF's efforts to save Makara and other Cambodian children from malnutrition
"I never thought my child was malnourished because he was always so active and seemed happy," says Dol Sna, a young mother from Siem Reap province.
"I didn't realize that his small size and lack of weight gain were signs of a serious problem. It wasn't until a health worker pointed out the issue that I realized how much danger he was in." Her 4-year-son, Makara Lyhour, was identified as severely wasted during a mass screening organized by provincial health workers and supported by UNICEF 2022. "As a mother, it's my job to protect my child, but sometimes we need help to see what we can't on our own," she says.
In December 2022, a team of health workers from Siem Reap province visited Dol Sna's village to conduct a child wasting screening programme, which involves weighing and measuring children to identify those at risk of malnutrition. Dol Sna and her husband agreed to have their son screened, but they didn't think anything would come of it.
To their surprise, the health workers found that Makara was severely malnourished and needed immediate medical attention. They referred the family to a nearby health center, where Makara received treatment for malnutrition and other related illnesses. His parents were shocked to learn that their son had been suffering from acute malnutrition all along and were grateful for the screening programme that had identified the problem. Only after speaking with a health worker from Reul Health Center, which is located eight kilometers from her home, and learning more about the dangers of malnutrition, she did realize how serious the situation was.
"Regular screenings can help us catch cases early so we can provide life-saving interventions like Ready to Use Therapeutic Food and medical treatment. However, access to screening services remains a challenge in many parts of Cambodia, particularly in rural and remote areas where resources are limited," says Set Iche, chief of Reul Health Center in Puok District, Siem Reap.
The health workers provided Dol Sna with therapeutic food with vital nutrients and practical advice on how to improve Makara's diet. With the help of the medical staff and a UNICEF-supported nutrition programme, Makara began to recover. His parents received education and training in providing nutritious meals for their family, even on a limited budget. They also learned the importance of hygiene and sanitation and other care practices to prevent illness.
Today, Dol Sna visits Reul Health Center on a regular basis to see a health center staff and get updates on her son's nutritional status. After receiving the treatment, Makara is now a healthy and active boy who loves playing with friends and running across the health center, entertaining medical workers.
"We are happy to see Makara healthy. I have seen firsthand the transformative power of nutrition on children suffering from wasting. With the right treatment and care, these children can recover and thrive," says Heng Chamnan, a nurse at the Reul Health Center who received the training on management of severe acute malnutrition organized by National Nutrition Program through collaboration with Provincial Health Department.
UNICEF supports the Ministry of Health’s National Nutrition Program to capacitate government health staff on the community level on the management of severe acute malnutrition. It includes severe wasting identification and assessment, treatment, follow up, and final assessment to exit from the treatment.
"As a medical nurse, I have a pivotal role in identifying acute malnourished children and providing them with the necessary treatment and care. With the knowledge gained from this training, I feel more empowered to make a positive impact on the lives of children in my community and ensure that they receive the support they need to grow and thrive,” adds Heng Chamnan.
"Despite a reduction in stunting from 32% in 2014 to 22% in 2021, wasting has remained stagnant and persistent at almost 10%. Acute malnutrition is significant concern for Cambodia and there is a need for more investment to understand the determinants and address the causes. More investment and scale-up of evidence-based interventions, including those that prevent all forms of malnutrition, are needed. Government and partners need to continue working closely together to build a future where every child has access to the nutrition and care they need to survive, thrive and reach their full potential," says Hedy Ip, Chief of Health and Nutrition at UNICEF Cambodia.
Since September 2022, UNICEF, with the support of UK CIFF, has been working to scale up interventions for the prevention and treatment of wasting in six additional provinces in Cambodia, of which Siem Reap is one. The scale up is planned to be conducted in two phases targeted high burden and underserved provinces to increase the capacity of healthcare staff like nurse Heng Chamnan, to prevent, detect malnutrition and treat children with severe wasting. Other key interventions include community empowerment to enable monitor and assess child wasting, to seek health care services, to enhance Infant and Young Child Feeding knowledge and practice and to strengthen the capacity of planning, budgeting and monitoring of local health systems.
"Addressing child wasting in Cambodia is a complex challenge that requires a multisectoral approach. One of the main challenges we face is limited access to nutritious food, particularly in rural areas where poverty and food insecurity are high. We also need to address cultural norms and behaviors around feeding practices, as well as improve access to quality healthcare services for early detection and treatment of malnutrition," says Thoeun Sopheary, Provincial Nutrition Manager in Siem Reap. "However, we are committed to working with our partners and UNICEF to improve access to nutritious food, promote breastfeeding and good feeding practices, and provide essential health services to prevent and treat malnutrition among children."
Thanks to a united approach, children like Makara can recover from malnutrition. And as a result, Dol Sna, as an ordinary Cambodian parent, is overjoyed to see her son healthy and safe. “It was a difficult journey,” she says. “But with the right care and support, we were able to pull through.”