Displaced but not forgotten

Under normal circumstances, the Multi-sectoral Nutrition Programme, including the Early Childhood Development project, as implemented in the area of Traditional Authority Machinjiri in Blantyre, carries out several activities to improve the nutritional health of pregnant women, lactating mothers, and under-five children. 

The project, implemented in the area by the Farmers Union of Malawi (FUM) with support from KFW through UNICEF Malawi, builds the capacity of women, especially caregivers, in nutrition through the care group model. This model allows information about nutrition, hygiene, sanitation, and early child development to cascade from frontline workers down through promoters to cluster leaders who lead care groups. 

"We train them in sanitation and hygiene, as well as the best feeding practices for under-five children, and pregnant and lactating women," explains Florence Kambala, the FUM Nutrition Field Officer for the area. 

She says the project encourages beneficiaries to construct good toilets and maintain proper handwashing facilities complete with soap. The project also encourages beneficiaries to practice integrated homestead farming, where they grow vegetables around their homes and rear small livestock from which they can obtain meat and eggs for good nutrition. 

"We also ask them to use micronutrient powder to supplement the children's nutrition and encourage them to access vitamin A and Albendazole for deworming," Kambala adds. 

The project also encourages pregnant women to attend antenatal clinics for advice from health surveillance assistants (HSAs) and to access iron folic acid. 

However, Cyclone Freddy has upended all that. Some women and children who were beneficiaries of the project are now confined to camps for internally displaced persons (IDP), where they cannot establish backyard gardens nor access the best food for their children, lactating mothers, or pregnant women. 

That, however, has not kept the Multi-sectoral Nutrition Programme, including the Early Childhood Development promoters, from following up with the children and women at the camps. Under challenging circumstances, it is doing all it can to ensure their nutritional health, sanitation, and hygiene are maintained. 

"Most of the Cyclone Freddy survivors also come from the areas where we work. They are our beneficiaries. Since the cyclone, everything was disrupted, especially the care group sessions, because the people were traumatized. After they moved into the camps, we started going there to conduct care group sessions. We conduct community complementary feeding sessions where we cook diversified food, including porridge, for children, lactating mothers, and pregnant women," Kambala says. 

One such camp for IDPs is at Mayera in Chileka, Blantyre, which currently has about 400 people, of whom 14 are pregnant women, and 52 are under-two years old. The camp also holds IDPs previously at Chirimba and Namatete camps, both since discontinued. 

Kambala explains that the project has not relented in its advocacy for better health services in camps, such as antenatal and under-five clinics, nutrition screening, and supplementing of vitamin A and Albendazole. 

"We are working hand in hand with HSAs. On some days we hold under-five and antenatal clinics, and we also conduct nutrition screening and cook porridge for children," she says. 

Crucially, the project has also trained mothers, some of whom are new to the project, on hygiene and sanitation, especially body hygiene and surrounding areas, building their capacity on good feeding practices, diversification of food, as well as the importance of access to the six food groups, Kambala adds. 

Lucy Evans is one IDP who moved into the camp with her three children — 11 and seven years old, and another seven months old — after her house collapsed due to the effects of the cyclone. Before her infant son was born, she had been employed grading pepper at a firm within the area, but she had to leave her post following the birth of her child. The cyclone left her in a difficult situation. 

Although she was not a care group member before the cyclone, Evans says she fed her children properly. Since joining a care group under the Multi-sectoral Nutrition Programme, including the Early Childhood Development project, she has learned more than she could have imagined. 

"What I have gathered from the sessions we have had here is about preparing potatoes as porridge with groundnut flour, eggs, and vegetables added to it. It's very nutritious food for a child, and my children can grow healthy with this," Evans says. 

Andrew Maduka, the HSA for the Chileka Health Centre, says the Multi-sectoral Nutrition Programme, including the Early Childhood Development project, encourages using locally available resources to improve the nutrition of babies, pregnant women, and lactating mothers. 

"FUM has been helpful. The project has focused on how we can prepare nutritious food with locally available resources. So when this camp started, FUM realized that some of its beneficiaries were there. We come here periodically to measure their nutritional status using the MUAC [mid-upper arm circumference] tape. We would refer any children to the Chileka Health Centre for further treatment if they were found to be in danger, but we haven't had a case of malnutrition since the camp was opened," he says. 

Despite the trauma she has experienced, Lucy is determined not to waste the knowledge she has picked up during her time at the Mayera camp, such as rearing livestock and starting a backyard garden. 

"When I return home, I want to start a backyard garden and feed my children meals based on the recipes I have learned here. My biggest desire is to rebuild my house to return my life to normal," Evans says.