Eat-Play-Love

A boy’s journey from severe acute malnutrition to recovery in eight weeks

By Helene Sandbu Ryeng
Akot is sitting on his mother Anyang's lap.
UNICEF/UN0345057/Wilson
15 October 2019

Aweil, South Sudan – Nine-month-old Akot is using his entire arm to stir the pot, which is almost half his size and filled with peeled peanuts – or ground nuts as they are called in South Sudan. He makes a kick and dives into the pot filling his mouth with nuts.

Nowadays, the world is an exciting place for Akot. Every flower has to be sniffed, every leaf is a potential toy and the world has no boundaries, except for when mama Anyang Kuol Ngor grabs him to stop him from crawling into the shallow ponds the rainy season has made outside their home.

Eight weeks ago, the boy was impossible to comfort, he was constantly crying and slept only when exhausted. High fever was raging in his body and this had been the situation for months. How is it possible to turn everything around in just eight weeks? I’ll tell you in a bit.

Anyang is struggling to make ends meet and therefore food is not on the table every day for her eight children, including Akot. The lack of food makes Akot’s body vulnerable to diseases. He has been having diarrhoea, fever and different infections regularly. They are all treated but recurring. Akot is also refusing to eat when there is food and he is not even breastfeeding. When Akot is sick, his mother need to stay home which is making the situation worse.
 

Akot is crying while his mid-upper-arm circumference is measured.
UNICEF/UN0345023/Wilson
Akot crying while having his mid-upper-arm-circumference measured when admitted to the nutrition programme.

 
“To get my child porridge I have to go to the market to earn a living. However, I have not been able to do this recently because of my child's illness and as a result there I have not been able to buy food for my children.”

Previously, the family had a patch of land to grow vegetables, but now there are no seeds and they don’t have land anymore, Anyang explains. The conflict in South Sudan forced them to move and the family hasn’t been able to go back to where they used to live.

“It felt terrible to see Akot suffering and I was asking myself what is going on?” Anyang says.

She took him to Gabat, a nutrition centre supported by UNICEF, where he was diagnosed with severe acute malnutrition.

Severe acute malnutrition is a very serious condition, which can lead to death because the body doesn’t have the capacity to fight even simple diseases. In South Sudan, 260,000 children under five years of age are suffering from the condition, in 2019 only. The severe and prolonged food insecurity in South Sudan, is one of the contributors to the large caseload. As of August 2019, 6.35 million people in South Sudan doesn’t know when and from where they will get their next meal. This doesn’t only affect the quantity of food the children are eating, but also the quality of food. For the young bodies to grow and develop, they need a plethora of minerals and vitamins. When food insecurity is high, you eat what you can get.

Akot was admitted to the UNICEF supported Outpatient Therapeutic programme (OTP) Aweil. He was given antibiotics for his infections and ready-to-use therapeutic food (RUTF) to treat the malnutrition. In just eight weeks, his weight has increased from 6.3 kg to 7.3 kg and he is a totally changed boy.

“My heart is so happy,” Anyang says with eyes filled with love when looking at her boy who is babbling while studying a green leaf from the mango tree. Akot starts protesting when his mother is trying to make him sit.
 

Akot and Anyang ouside their home in Aweil.
UNICEF/UN0345036/Wilson
Already after five weeks Akot was showing major improvements, here with his mother Anyang.

 
“He wants to stand and walk. He always wants to play especially when he sees water he'll want to go and play in it.”

In addition to having energy to play like a normal baby, he is no longer sick.

“This treatment has really changed him; my child has become so healthy. There is no sickness like fever, coughing, rashes - even diarrhoea is not there. So, his sickness was always a result of hunger, if a child is eating well then there will be no sickness. Now my child is very comfortable, as you can see he's just playing down there!”

“All he wants to do now is to eat so his health is improving and he's now very okay. If you prepare porridge he takes it, if you give him RUTF he also eats, if breakfast is made in the morning he takes it and he's also breastfeeding”

In eight weeks, not only Akot’s health has changed, but also Anyang’s life.

“Now I am able to move about freely. I can go to the market to sell some things but before I do that I'll prepare porridge for him then go to the market. At two, I come back and cook lunch for him. Before, I was not able to leave him at home and I didn’t earn any money.”

“All the stress I was experiencing is now gone. I’m so poor I can’t even buy soap, yet I’m just smiling. If I was a dog I would be wagging my tail.”
 

Akot is playing with UNICEF nutritionist Jesca Wude Murye outside Akot's home.
UNICEF/UN0345047/Wilson
Akot playing with UNICEF nutritionist Jesca Wude Murye, after being discharged from the nutrition programme.

 
The RUTF is designed to treat acute malnutrition among children. It is based on peanuts which are turned into a paste and enriched with dried skimmed milk, oil, a combination of vitamins and minerals and sugar. The latter increases the calorie, but also makes it sweet and therefore more inviting for children struggling with their appetite, which is often the case when being severely acute malnourished. Normally, the body bounces back to normal weight in 6-8 weeks and the child is getting healthy again.

“When Akot is old enough I will take him to school. I hope he becomes a nutritionist, so other children can get help, just like he did. All my children are going to school. I’m making sure they all study, I don’t want them ending up like me.”
 

UNICEF South Sudan’s nutrition programme is generously supported by USAID, including the Food for peace programme and the Office for U.S. Foreign Disaster Assistance (OFDA).