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Promoting exclusive breastfeeding to combat child mortality in Gambia

© UNICEF/Gambia/2008/Grey-Johnson

Banjul, Gambia, 28/10/08 - As dawn rises, parting the clouds over Basse like a think blanket being peeled from a lazy bed, the cool breeze blows across the green grass causing gentle ripples over flooded potholes.  The march begins.  A journey of a thousand of steps.  Feet plodding along the dirt tracks of Mansajang, up the paved roads that cut across the administrative district of Basse, toward the health centre. Women dressed in brightly colored flowing gowns, chatter away. Their babies on their backs are hugged onto their slumber, unaware of the trip being taken by their mothers for their welfare. 

Every month is a special one.  But today, is the first clinic day for Bakay.  Born three weeks ago, the little boy’s skin shines like newly baked bread. Eyes tightly shut.  Bakay is Mama fatty’s second child.  She has breastfed Bakay’s eldest brother for 18 months, and plans on doing the same for Bakay.  “My children are healthier because I breastfed them, and my husband has always encouraged me to breastfeed our children,” she says. 

The proud mother learned about exclusive breastfeeding from the nurses and health workers in her area.  Although she admits that not everyone in her community breastfeed their young, most of the mothers she knows practice exclusive breastfeeding for their babies for at least one year.  “My diet is very important to me,” she says.  “Because when I am healthy my child is also healthy.”  “I ate a lot of fish, and okra, and groundnut stew, all of which give me protein and iodine throughout my pregnancy, and these things are very important to both myself and Bakay.” 

Mama will bring Bakay to the Basse health centre 60 times on the normal Maternal Child health visit, where he will be weighed, and vaccinated against the major childhood diseases.  He will grow to see the health centre in all its buzz- busy with nurses scurrying about, and doctors attending to patients.  He will see other children like him suckle from their mother’s breasts, and although may not be able to talk with them at first- will grow to appreciate that mother’s breast milk is best.  “My children are my strength,” says Mama, “they are my all.”  Mama has plans for Bakay.  She wants the little boy from Mansajang to grow strong and be a teacher.  “If he can teach, then he can also help pass on knowledge to others, and that power has no value,” she says.

Basse rests at the farthest side of The Gambia to the east.  It has the worse indicators in the country.  It has the second largest child deaths, the most orphans living with one parent and the worst school enrollment rates.  But, more children are breastfed in this region- almost half of all infants.  In the Gambia, only 40 percent of infants under 6 months are exclusively breastfed. 

The government of the Gambia has established a National Nutritional Agency NaNA, which works with UNICEF to ensure that exclusive breastfeeding is promoted nationally.  During the World Breastfeeding week, The Gambia was the only country to extend the week long celebrations into a month- engaging the private sector, religious and community leaders to encourage mothers to breastfeed their babies. 

by Jeggan Grey-Johnson



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