“I also learn from the other mothers”
Mariam Berthé is a Community mobiliser who is resident in Mancourani, a suburb of Sikasso. The entire region is reputed to be agriculturally well endowed, but evidence shows that malnutrition among children under five is prevalent in the region of Sikasso
Sikasso District hospital records a weekly average of 6 to 7 referred cases of severe and acute malnutrition (SAM) with complications. These cases of child malnutrition are referred to their Intensive Care Unit for Nutrition Education and Rehabilitation (URENI). While on admission, the children under treatment receive Therapeutic milk and Therapeutic food [RUTF] procured with funding from ECHO, so it possible to treat the malnourished children at no cost.
Mariam Berthe is a community mobiliser and a member of the Support Group on Nutrition for mothers (GSAN). She has been active in her community, Mancourani since 2009. The GSAN groups ten women “On a typical day,” Mariam says “we go out in pairs, and we do our house to house visits in the evenings when people would have come back from work.
“I have come to observe that the problems of malnutrition in children start when it’s time to add solid food to the breast milk for the babies… In January, I attended a practical cooking demonstration to learn how to combine local ingredients as food for growing babies” says Mariam Berthé a mother with four children of her own.
“In our GSAN [Support group for mothers on Nutrition], I also learn from others, we learn from each other, so l shared this experience with other mothers on my visits.”
She recounts her own experience. “My own child refused to take the complementary food that l gave her. I thought to myself, this is not negotiable, she has to eat. It was a struggle at the beginning because l knew that the breastmilk alone was not enough for her after 6 months. Another mother told me how she added one fruit at a time, to her child’s food.
“In UNICEF, we continue to treat severe and acute malnourished children as part of its routine activities” – says Harouna Kondé. In 2020, with ECHO funds used for supplies and training of health workers, we saved the lives of over 17,700 critically-ill children under the age of five here in the Region of Sikasso.”
A nationwide SMART Nutrition is another component of ECHO’s Sahel Nutrition Response. “Sikasso has observed a slight reduction in the malnutrition trend among children under five.” Harouna Konde, UNICEF’s Nutrition Specialist in Sikasso. “In line with the objectives of the Sahel Nutrition Response financed by ECHO, we have made a deliberate choice to cover both prevention and treatment in our nutrition interventions,” he concludes.
Dr. Aboubacrine Maiga who is responsible for Nutrition in the District is convinced that the Nutrition Treatment Protocol last revised in 2017 is in the right direction as it empowers Community Health agents to treat children without complications at home “cases of edema at home, while they accompany parents of malnourished children in the communities.”
Mariam Berthé’s community work around nutrition and other child-related issues started way back in 2009 when she first became a community mobiliser. The support group and other service providers are trained in Sikasso - thanks to ECHO funding.
When 11-month old Rokiatou suffered from severe and acute malnutrition with complications this February, her mother sent her 10 kilometres from their home to the Intensive Care Unit for Nutrition Education and Rehabilitation (URENI) in Sikasso.
She was referred to Mancourani community centre for the follow-up reviews for another month when her daughter was discharged. Going to her community health centre reduced her travel distance 4 kilometres, and luckily her husband who repairs motor bikes for a living also has a bike of his own to take her there.
Mariam has observed that “it is easy for many mothers to quickly say that they do not have the means. This answer usually comes from the mothers who not attend post-natal consultations with the children, and they miss out on the information sessions that we organise on vaccination days for example.”
From Fatoumata Dembélé, Technical Director of Mancourani Community Health Centre we learn that “when the mothers bring the children here for our weekly vaccination of the children, we weigh them, check their height and take measurement of their arms. We also look out for children with tell-tale signs of becoming malnourished.”
UNICEF’s Harouna Kondé believes that the lowering malnutrition rates among children under five years in Sikasso is partly due to the strategy of combining the community activities with facility-based interventions.
Mariam Berthé also attends the weekly vaccination sessions at the community health centre to make sure the mothers she visited have brought the children to the health centre. She carries on with educating the parents on various topics while the mothers wait for their turn.
“If there is one challenge in the work l do, it is how to convince mothers to send a child to the health centre, when they think there is nothing visibly wrong with the child… In the long run, they come to realise that the cost of the treatment for the child, going up and down for weeks is much more expensive than the prevention, always!” Mariam concludes.