Malnutrition surges as harvests fall

“We didn't expect any patients to be admitted at this time, as it's the harvesting period. Yet, this week we have a full ward," said Peter Wonderford from Madalitso Nutrition Rehabilitation Unit at Monkey Bay in Mangochi District. As the clinician leaves for lunch, a woman arrives with a frail six-month-old baby boy.

April marks almost an end of the hunger and malnutrition season in Malawi, but there is no time to rest for caregivers in the six-bed nutrition treatment centre.

The clinic, situated along the southern shoreline of Lake Malawi receives malnourished children from Monkey Bay Community Hospital and its surrounding villages.

“A Health Surveillance Assistant (HSA) referred me here. My sickly son is coughing persistently, weak and losing weight,” says Beatrice Charles, from Chirombo Village.

Wonderford measures baby Lauren’s weight, height and middle upper arm circumference (MUAC)."The MUAC readings falls on red, meaning the baby is having severe malnutrition,” he tells the mother.

She is not surprised.

"I cannot produce enough milk for the baby since I eat once a day.  So, my baby cries all day.  So I introduced thin porridge to my baby, even though I know that health workers promote exclusive breast feeding in the first six months of baby’s life," Beatrice states.

Due to the devastating floods and high fertiliser prices, her two-acre maize field produced just five bags in 2023. Her food basket ran dry two months before Lauren's birth, leaving the family of eight surviving hand-to-mouth on meagre earnings from a bicycle taxi.

The clinician did a thorough clinical and nutrition assessment on Lauren and immediately admitted him in an outpatient therapeutic programme – starting with a one-week ration of ready-to-use therapeutic food (RUTF) to take home.

He warned: "RUTF is medicine, so ensure the baby takes it without fail. Malnutrition doesn't just threaten a child's health, learning and chances in life, it kills.”

Mangochi District Medical Officer Dr Victor Kunfunda says: "We have seen a 40 per cent increase in malnutrition cases since 2023 and relapses have also risen. Patients who were treated and recovered are relapsing.”

He further said that the country requires more than just food aid.

“This isn't just a health issue; we need a multidisciplinary approach. We need support for health workers to intensify malnutrition prevention, surveillance and treatment. The Ministry of Agriculture needs to promote crop diversification and irrigation.

“Our social welfare colleagues should provide social protection to save the poorest from starving. The Ministry of Water and Sanitation should prevent diarrhoea and other sanitation-related infections that fuel malnutrition," said Kunfunda.

Madalitso Nutrition Rehabilitation Centre has also noted an increase in the number of deaths, it recorded four deaths between January and March 2024 which is very unusual. In 2023, they only recorded 4 deaths for the whole year.

UNICEF supports the Government of Malawi to combat malnutrition through capacity building of health workers, toolkits for nutrition screening, RUTF and therapeutic milk, as well as promoting positive child feeding practices and behaviours.

The country's southern region faces prolonged food shortage due to drought caused by El Nino weather patterns which have affected the entire southern Africa.

Lengthy dry spells have almost halved maize production a year after Tropical Cyclone Freddy affected over 2.2 million people and washed away about 55,000 hectares of cropped farmlands in 13 districts. The loss represents about 27 per cent of the crops Malawians planted in the 2022-23 rainy season, the Department of Disaster Management Affairs reports.

On 24 March 2024, President Lazarus Chakwera has declared a State of Disaster in 23 of the country's 28 districts and appealed for K357.6 billion (about $13.67 billion) for about two million households affected by the harsh weather.

“From cyclones to drought and flooding caused by rains we haven't seen, there's no break for us. We need urgent help as children are wasting and stunting," says Group Village Head Mtondeza of Chikwawa District in the Lower Shire.