Helping children recover quickly from malnutrition

Makeni - Aminata Conteh hands her son Ishaka Turay a mango and is happy that Ishaka immediately gobbles it up. She is also happy that today Ishaka has spent the morning playing outside in the courtyard, crawling in the sand and making a spirited attempt to join in the fun and games with other children from this community in Makambo in Makeni town, Bombali district in the northern region of Sierra Leone.

At 20 months, crawling and attempting to stand on his own, are milestones which Ishaka should have reached more than 12 months ago. However, ill health due to malnutrition has drastically limited his growth and development. Aminata is therefore happy with the signs of progress which Ishaka is showing since his discharge from a two-week admission at Makeni Hospital in March this year.

 “He was vomiting, had a running stomach, body rashes and a swollen stomach”, says Aminata, as she explains some of the immediate symptoms which prompted her to seek medical care for her son.

Aminata, who is unemployed and living with a disability, is not sure how to maintain her son’s good progress because her husband, who was the family’s sole breadwinner, passed away a few weeks ago.  She is therefore listening to the advice from the nurses and regularly sourcing whatever healthy local foods around to ensure that Ishaka recovers quickly.

“Our daily meal is mainly a mix of cassava, mangoes and other fruits and vegetables which we source around us”, says Aminata, as she explains the modest diet which she is feeding Ishaka and her three other children. “I also take him for checkup and reviews at the hospital to make sure that his progress is okay and also to get treatment for the skin rash, which he still has,” says Aminata as she cuddles her son.

Sallay L. Massaquoi, a clinical nutritionist at Makeni Regional Government Hospital, explains that unlike previous years when complicated malnutrition cases were more pronounced during the rainy seasons, COVID-19 induced poverty has triggered a rise in the number of cases of complicated malnutrition requiring hospitalization.

“Some of the mothers do not even know that their babies are sick or malnourished until they come to the hospital.  That is how some of the children have come through when they are severely wasted,” says Sister Square as she explains how the story of Aminata and Ishaka is a reflection of the struggles faced by many single mothers and their children as their resources become limited. “That is why we are closely working with health workers in primary health facilities to identify and refer malnourished children through community outreach and when they see malnourished children, they quickly refer them for treatment.”

According to the latest Comprehensive Food Security Vulnerability Assessment (CFSVA) of 2020, about 4.7 million people or 57 per cent of the population is food insecure, an increase from assessments in 2015 which showed that the population which was food insecure was 50 per cent. A similar study in 2010 showed that 45 per cent of the population was food insecure.

These statistics are a cause for concern, as they point towards a worsening of the nutrition situation, more hospitalization, and potentially increased deaths among children and other vulnerable people, if cases are identified and referred too late.

Equally worrying are reports that in 2020, an estimated 19 per cent of health facilities offering Severe Acute Malnutrition (SAM) treatment services experienced stockouts of therapeutic supplies thereby disrupting delivery of life-saving treatment services in almost 156 health facilities nationwide.

Through the Integrated Management of Acute Malnutrition (IMAM) programme, the Ministry of Health and Sanitation, with support from UNICEF, has been providing acute malnutrition treatment services in 791 primary health care facilities and 21 hospitals nationwide.

Support from Vitality through United Kingdom (UK) Committee for UNICEF is contributing to closing the supply gap of ready-to-use therapeutic food (RUTF) in providing life-saving treatment services to 57,026 severely malnourished children at treatment centres and health facilities at all the 16 districts of the country.

This initial procurement of 2,500 cartons of RUTF through support from UK Committee is also a welcome contingent for the upcoming rainy season, which is a season typically associated with a spike in malnutrition cases.

“Nutrition is the cornerstone of economic and human development of a country. It is for this reason the concrete actions taken by Government with support from partners such as Vitality, are welcome in bringing measurable and immediate change to the nutrition situation in the country,” says UNICEF Nutrition Specialist, Katherine Faigao.

At Makeni Regional Government Hospital, in the exact ward where Ishaka was admitted two months ago, Marie Sesay watches earnestly over her 10-month-old daughter Kadija, as she also goes through the path of recovery from malnutrition.  Baby Kadija was admitted three days ago, weighing just 6kg, had a very high fever and was extremely restless.  Baby Kadija was classified as wasted and requiring immediate treatment with RUTF and antibiotics.

Kadija’s improved appearance in just a short three days shows that readily available supplies for the treatment of malnutrition are critical to address the current malnutrition crisis in Sierra Leone.