From malnutrition to hope: how outreach and nutrition support saved baby *Joe

Taninahun, Sierra Leone – On October 13, 2024, as the morning sun rose over Taninahun Community, a small village four miles from the Moyamba Static II Community Health Centre, a team of dedicated nurses, Lucia, Henrietta and Aminata, arrived for their outreach session. Among the community members seeking help was Agnes, 20 years old, holding her 13-month-old son, *Joe, close to her chest. The nurses greeted them warmly and screened *Joe, identifying him as suffering from Severe Acute Malnutrition (SAM) with a high fever. Concerned about his vitals, the nurses referred Jessie to the inpatient facility (IPF) in Moyamba, urging Agnes to take him there immediately.

*Joe growth and nutritional status measurements confirmed his severe condition: He weighed just 7.5 kg, was 69.0 cm tall, had a mid-upper arm circumference (MUAC) of 11.3 cm (<11.5 cm is within the severe acute malnutrition range), and had poor appetite. His weight-to-height Z-score was very low and below -2SD, and his initial appetite test confirmed that he was struggling to eat. He was immediately admitted in the IPF.

For the next five days, *Joe was in the acute phase of treatment at the IPF, receiving F-75 therapeutic milk. However, the journey to recovery was not smooth: he suffered from re-feeding diarrhea and vomiting for three days. Despite the initial setback, he eventually recovered and was transitioned to ready-to-use therapeutic food (RUTF) and treated with IV ceftriaxone for three days. His rapid diagnostic and retroviral tests were both non-reactive, ruling out other underlying conditions. By October 18, 2024, *Joe had entered the recovery phase, showing signs of improvement. On October 21, he was transferred to the outpatient therapeutic program (OTP) at Static I Community Health Post (CHP), a nearby health facility, to continue his recovery with a one-week RUTF supply.

At the OTP, *Joe had gained some weight, now at 8.0 kg, with a MUAC of 11.6 cm. His appetite had improved, and his Z-score had moved closer to normal. Over the following weeks, he continued treatment and nutritional rehabilitation. By the time of his discharge from the OTP on November 13, 2024, his weight had increased to 8.4 kg, his MUAC was 12.6 cm (normal range), and he was in much better health.

Agnes was relieved and grateful for the care her son received. She admitted feeling distressed during the initial phase of treatment when *Joe suffered from diarrhea, but the health workers reassured her that it was part of his recovery process. Looking back, she was thankful for the support she received, which saved her son’s life.

Before his illness, *Joe’s diet had been inadequate. Agnes had stopped breastfeeding him at six months due to her insufficient diet. She introduced him to the commercial benni-mix pap (porridge) purchased from the local market. When *Joe started vomiting on the pap, she switched to homemade rice porridge mixed with salt and powdered milk, feeding him twice daily. This diet led to a distended belly and digestive issues which worsened his condition.

During *Joe’s treatment, Agnes received counseling on proper complementary feeding, learned how to prepare nutritious meals using locally available food groups, and maintained optimal hygiene practices. She also started listening to community radio programs that provided valuable advice on child nutrition.

The impact of these lessons became evident. “Following the local complementary food messages received on the radio and at the health facility has helped my son improve. He can now crawl and stand by himself, and I don’t have to spend so much money on milk anymore,” Agnes shared, “He hasn’t been sick for the past four months, which is a huge relief.”

*Joe’s home environment, however, remains challenging. His father, Edward, 25, works as a volunteer IT support officer, hoping to save enough money to retake his senior secondary school exams. Agnes lives with her elder sister, a petty trader who struggles to provide for herself and her four children. It is not easy for her to feed a family of seven.

Despite these hardships, Agnes is filled with hope. *Joe is now thriving, even taking his first steps. With thanks to the generous support of the Latter-Day Saints Charities through the US Fund for UNICEF, she has learned about the benefits of breastfeeding and proper complementary feeding practices and is determined to share her experience with other mothers in her community. “I urge all mothers to follow proper breastfeeding and complementary feeding practices and take their children to the health facility whenever they are sick or losing weight. It would greatly impact our children’s lives and families,” she advises.

Her next goal is to return to school. Staying home and caring for a sick child has been emotionally exhausting, and she longs to complete her education. Encouraged by her son’s recovery, she sees a future where she could provide better opportunities for him.

*Joe’s story is one of resilience and hope. From the brink of severe malnutrition to a thriving toddler, his journey highlights the importance of early detection, proper nutrition, including ensuring adequate counselling and support on complementary feeding or breastfeeding, and community support in saving young lives.

*Name has been changed to protect the child's identity.