Medicine sharing is threatening children’s lives

Poverty is robbing children suffering from malnutrition of their medicine

Gabriel Reec
Deng looking into the camera
27 May 2020

Deng (14 months) is slapping his sister with a half- full sachet of ready-to-use therapeutic food (RUFT) locally known as miguak adoor. Her mouth is trembling and tears start  racing down her cheeks, then she makes  a loud cry. When Deng sees his sister’s reaction, his face becomes friendly and he starts giggling.  This kind of happiness he would not be capable of two months back.

His sister, Adut (4), had opened Deng’s mouth and scooped miguak (RUTF) out of it when he was eating his second dose of the day. “His siblings always take miguak from his mouth and eat it when I am not attentive and he is kind of getting tired of it,” says the mother, Nyanut Kom. “I always have to lock the remaining miguak up in the house if I want to go out to prevent his siblings from accessing it,” she continues. Deng might be annoyed by the stealing when it happens, but it was about to cost him his life a few months back. More about that later.

Deng is sitting on his mother's lap
Deng is sitting on his mother's lap outside their home in Aweil

Deng resides with his four siblings and his mother in Madiria One Estate in Aweil Town. His mother sells water to restaurants in the market and plait hair to earn a living for the household. Every day she is left in a catch 22 situation; either stays at home with the children to look after them or food on the table. When Deng got sick, the dilemma got even tougher. Doctor or money for food?

Her husband, who is a soldier, left home on a duty call in 2011 and is yet to return to his family. He has been communicating with the family via phone, however that communication stopped two years ago. That has left the mother to shoulder the responsibility of caring for her children alone.

Deng’s problems started already in May 2019 when he was two months old and infected with malaria. Malaria was followed by diarrhoea and vomiting. He was so sick he had to be admitted to a hospital, twice.

The illness continued and finally Deng became severely malnourished. When he was admitted to the UNICEF supported Outpatient Therapeutic  Program (OTP) in Aweil, Deng’s  mid-upper-arm circumference (MUAC) was  8.7 cm and his weight only 4.1 kg. Both measurements showed that he was suffering from severely acute malnutrition (SAM).

His length, which was 60 cm showed that he had stop growing, which is normal when children are suffering from SAM, but can be irreversible if not treated.

The treatment for SAM is RUTF, which is given in different doses per day, depending on the weight of the child. Normally the child is bouncing back to normal within 6-12 weeks if there are no underlying medical or social complications. Deng was in the programme for  three months, but without any notable improvements. The Gabat Nutrition workers decided to visit Deng’s house to investigate and quickly found out that Deng was sharing his therapeutic food (RUTF)  with the siblings, meaning he didn’t get enough medicine to cure him.

In January 2020, Deng was once again, admitted to the nutrition programme, with MUAC of 10.5cm and weighing 5.3 kilos- still severely malnourished. During this second treatment period, staff from the clinic increased the follow up of Deng’s treatment. Visits were made to the house each week to ensure Deng got all his medicine (RUTF) and that no sachet of RUTF were disappearing. Finally, Deng shows real improvement and after just one month, he was discharged with a mid-upper-arm circumference of 11.7 cm and weighing 6.2 kg. Even his length had improved, now being 64.5 cm. 

RUTF sharing at home happened due to poverty. Nyanut barely had enough money to provide  food for her five children.

Deng is eating RUTF with his sister around
Deng is eating his RUTF with his sister waiting for an opportunity to scoop up some of it

Some days, the five would  go without lunch, and as a result,  some of the little ones like Adut stole  RUTF meant for Deng. After increased visits to the house the mother started keeping the RUTF in a locked room and made sure Adut and the rests of the children had something to eat to keep them away from using Deng’s miguak adoor. Now, Deng who used to move on his knees has the strength to stand on his feet with support from his siblings.

In 2020, UNICEF expect 1.3 million children in South Sudan to suffer from acute malnutrition, close to 300,000 of them will be severely affected such as Deng. Over 1,100 UNICEF supported nutrition centres across South Sudan will handle most of these cases and more than 9/10 will most likely make it. That said, more needs to be done to prevent children from getting malnourished in the first place. Denying children their right to health is not only affecting children directly, it will also affect the future of South Sudan. After all, these children are the future.

UNICEF's nutrition programmes are generously supported by ECHO, USAID and the Swiss National Committee for UNICEF.