Little Kaveena bounces back to a healthy childhood
Outreach clinics, a lifeline for children suffering from severe malnutrition
Three-year-old Kaveena is showing signs of weight-gain and vigour. She has been receiving treatment for Severe Acute Malnutrition(SAM) since December 2022 at an outreach clinic in Valaichchanai Base Hospital, located in the Eastern province of Sri Lanka. Kaveena’s family lives about 32 km away from the hospital.
Kaveena was initially diagnosed with SAM in January 2022. Kaveena’s mother Vanitha (30) recalls, “Kaveena was only 26 months old when the Public Health Midwife (PHM) told us that she was severely malnourished. We were very sad. We were advised by the Midwife to feed her nutritious foods.”
“Our income reduced a lot last year and we are unable to buy good quality food,” adds her father Mahesan (30) who is a day-wage earning labourer. “Our efforts to gain other sources of income has also been futile.”
Mahesan earns about LKR 30,000 (USD 83) a month. Vanitha is a housewife. With their meagre income they find it hard to manage the expenses of their family of five – especially as Kaveena’s older sisters Nahomy (14) and Jeromiya (11) are schooling.
“We tried our best to provide her with nutritious food. But her condition only got worse; she became less active and started losing more weight.”
“In September Kaveena got a severe stomach-ache,” explains Vanitha. “Through a paediatrician at a private clinic she was referred to the government hospital. She was diagnosed with SAM and provided with necessary treatment,” adds the mother. “At the time of discharge the paediatrician prescribed therapeutic food for her.”
“We had to borrow money to take Kaveena to the hospital. We are worried about paying back the loan.”
“Kaveena is on a full treatment regime of BP100 and gaining weight gradually. We are expecting her weight to be moderate in one month.”
“Thanks to the outreach clinic we are able to see a gradual improvement; Kaveena is gaining weight and is active. The support for transport and daily expense helps us access these clinics without fail,” affirms her parents.
Since Sri Lanka’s economic slump in early 2022, the livelihoods of many families across the country have been affected curtailing their capacity to access even the most essential items such as food, fuel, and medicines. The strain of dwindling income is most visible amongst young children. By October 2022 over 18,000 children below 5 years of age were reported with SAM.
Even though the country’s healthcare system supports screening of children for growth at village level via the PHM network, treatment for SAM and distribution of therapeutic food is operationalized at tertiary hospitals with paediatric care. For those living in rural areas, this means travelling beyond their village and immediate town. For Kaveena’s parents, and many other vulnerable families, the capacity to give-up a day’s wage and afford a day’s trip decides whether their children can access proper treatment.
To support families like Kaveena’s, UNICEF, with the funding from the Department of Foreign Affairs and Trade, Australia (DFAT) and United States Agency for International Development (USAID), commenced a programme in November 2022 to ensure access to therapeutic food for children identified with SAM. Warranting accessibility to health screening and therapeutic food, UNICEF advocated for policy adjustment with the Ministry of Health (MOH) to implement outreach health clinics – a mechanism to expand the critical health services and distribution of therapeutic food, enabling access to these vital components of the response to the most vulnerable families.
To underpin the effort, families of children with SAM are provided with information on the outreach facilities and monetary incentives to cover transport and the day’s expenses.
The concerted response enabled Kaveena to access the necessary healthcare in December; with regular access to ready to-use-therapeutic food (RUTF) BP-100, and four more screening clinics held through January and February, she has started to show considerable improvement.
“Thanks to the outreach clinic we are able to see a gradual improvement; Kaveena is gaining weight and is active. The support for transport and daily expense helps us access these clinics without fail,” affirms her parents.
Madushani (29) the PHM for Vaharai explains, “There are 550 children under 5 years of age under my purview. By October 2022, a total of 11 children were identified with SAM. Kaveena is one of them.”
“She was diagnosed as SAM through the village level screening for weight and height held in February 2022. There were no obvious physical signs of undernourishment.”
“It was fortunate that we managed to intervene at this point; outreach clinics were organized in two locations: Valaichchanai Hospital where a paediatrician is available and at Vaharai where the paediatrician from Valaichchanai was brought as this hospital does not have one.”
“Through the outreach clinics, treatment is being provided to all 11 children diagnosed with SAM last year and three of them have already graduated to moderate acute malnutrition (MAM) in February 2023.”
“Kaveena is on a full treatment regime of BP100 and gaining weight gradually. We are expecting her weight to be moderate in one month.”
