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Malawi, 12 April 2017: Fighting malnutrition in Mwanza

© UNICEF Malawi/2017/Phwitiko
Ellena, a Health Surveillance Assistant, speaks to Agnes during a home visit.

The family of Agnes and Julius Goza is not your typical rural Malawian household. Although far from living comfortably, this young enterprising couple is not struggling as much as some of their neighbors. With a goat pen in the homestead, a couple of chickens, and a vegetable garden, it is hard to believe that their son, Madalitso would become malnourished. But that is exactly what happened.

“It is a miracle that he is alive today, and healthy too,” says his mother Agnes Julius. The first few months of his life were pretty tough for him and his parents; he had constant diarrhea and was losing so much weight.

Madalitso Julius was born with a split upper lip. What seemed like a minor problem in the beginning nearly cost the little boy his life. When he was 7 months old, Ellena Kalikokha, a community volunteer, dropped by on a routine visit to monitor the baby’s growth.

On this visit, Ellena was accompanied by the Health Surveillance Assistant (HSA) for the area. This partnership was facilitated by a nutrition programme that UNICEF and the Government of Malawi are implementing with funding from the Government of Japan. The partnership not only supplies therapeutic foods to under five children but also provides training to HSAs, clinicians, nurses and community volunteers.

Ellena and the HSA quickly assessed Madalitso’s situation and recommended that he be taken to the hospital. He was admitted into the Nutrition Rehabilitation Unit (NRU) at Mwanza District Hospital where it was determined that the cleft lip was making it difficult for Madalitso to nurse. He was not getting the nutritious breastmilk he needed to grow.

© UNICEF Malawi/2017/Phwitiko
A healthy and cheerful Madalitso at home.

For a week in the NRU he was given therapeutic milk and quickly started regaining his strength. His cleft lip was operated on. At the time he was discharged, the homecraft workers in the NRU gave his parents strict instructions about his feeding to avoid a relapse. He was placed in an Out Patient Therapeutic Programme (OTP) where he received a weekly supply of Ready to Use Therapeutic Food (RUTF). RUTF is a high energy, therapeutic food given to malnourished children to save their lives.

Ellena continued her follow up visits with the family, while Madalitso was in hospital and later when he was discharged. On these home visits, Ellena made sure that the child was being fed consistently. At times she even asked to see the RUTF wrapper as evidence of feeding. Ellena also assessed Madalitso’s growth, measuring his Middle Upper Arm Circumference (MUAC) which improved and was a positive sign that Madalitso was recovering.

There are currently five other children in the same village in the OTP programme, and six receiving supplementary feeding packs every fortnight. Ellena and nine other volunteers continue to work with the HSA to screen for malnutrition every month and follow up with newborns, pregnant and lactating women and children under five. Within the Government of Japan-funded programme, she has also been trained to teach mothers like Agnes how to prepare nutritious meals, from locally available products. Ellena advises them to combine certain ingredients like soya, maize and groundnuts to achieve a higher nutritional value.

Agnes now adds a little more to the porridge she makes for her son, some soya, groundnuts or an egg, depending on what is available that day. She tells her friends to heed the advice of the volunteers and health workers. “It is because of them that my son is alive today. Looking at him now you can’t believe how bad it was,” she said with a smile.



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