UNICEF-trained medics co-opt goats into nutrition struggle

Adopting sustainable local solutions to address malnutrition

By Joachim Buwembo
malnutrition, nutrition, Uganda, DINU, European Union, UNICEF, Development Initiative for Northern Uganda, RUTF, ready to use therapeutic food, plumpy nut
UNICEF Uganda/2022/Tibaweswa
10 March 2022

If you ever get to tour St Kizito Matany Hospital, you will certainly have a few surprises. One of these is the way the medics have taken to goat rearing, a strategy that strengthened the fight against malnutrition in the vast Karamoja sub-region of northern Uganda. 

The goats became an integral part in Matany’s malnutrition treatment programme about four years ago, when health workers at the hospital sought to institute a local, sustainable initiative to guarantee emergency feeding for acutely malnourished children in case supplies of Ready to Use Therapeutic Food get interrupted or run out altogether. Since the Matany medics tried goat keeping, they have never looked back. 

Goats were chosen because they not only withstand the harsh climatic conditions but also and primarily, because they produce highly nutritious milk which works ‘magic’ like RUTF. The goat acquisition started one by one, two, three then they started reproducing. Most males are sold off or slaughtered for meat which is also good for the mothers who spend at least three weeks at the hospital as their children recover through different stages of malnutrition.

Today, there are some 21 (mature) female goats at Matany Hospital, each producing about one litre of ‘natural RUTF’ a day. Given that that is about the number of children admitted in the nutrition ward at any given time, so even if the number doubled, there is capacity to give them goat milk even if supply of the packed magical therapeutic food were to decline.  
Besides the need for emergency feeding, the children who are severely malnourished on admission also often have other illnesses and infections. Anna Letukei, the Nurse-in-Charge of the nutrition unit of the paediatric ward of Matany Hospital, says they screen all children on arrival for tuberculosis (TB) and HIV. She explains that many infected women still fail to adhere to the procedures for preventing mother-to-child transmission of the virus. Alcoholism is one major reason for this.

Alcohol continues to dog treatment at the ward as mothers sometimes disappear into nearby villages for days. This explains why there are many young girls on the ward looking after the babies. The girls are older siblings of the sick babies, and are very useful at the ward, though they put an additional strain on the system and resources of the hospital. Yet without the girls, some of the mothers would go into the villages with the sick babies, thereby disrupting the treatment or worse still, feeding them on other foods especially the chapati that is considered a delicacy in Karamoja. The mothers accept offers of chapatti for different reasons, and also feed the children on it.

Such is the complexity of running the de facto regional referral hospital, but the staff, trained and supported by UNICEF through its implementing partner CUAAM, are up to the task. Besides rearing the goats for milk, they also grow different types of vegetables which provide vitamins and other nutrients for the sick children and their mothers.

The knowledge has been equipped to the hospital staff, district authorities and partner organizations as part of UNICEF’s efforts to strengthen nutrition governance for multi-sectoral responses. These interventions are funded by the European Union under the Development Initiative for Northern Uganda (DINU) which UNICEF implements in Karamoja and northern Uganda sub regions with the overall supervision by the Office of the Prime Minister.

Nursing Sister Hellen Grace Atekit has been at Matany Hospital for over twenty years and has seen it all. From handling complicated gunshot injuries that take months to heal, to nursing babies brought in alcoholic comma after their mothers give them booze to kill hunger but which ends up killing some of the babies, Sister Hellen is still full of optimism, because she keeps seeing the situation improving every month. From the hundreds of babies admitted in a year, Hellen says they have had no death from malnutrition per se in two years, and the only deaths they have had were as a result of serious underlying conditions.

The nursing sister takes part in training of VHTs who she says do a big job screening all children up to the age of five years in the district and filing reports, besides referring those who need treatment. Her only prayer for now is for VHTs to be better facilitated by the relevant authorities so they can handle the situations in the community even better.