Sally Mugabe Children’s hospital malnutrition Centre of Excellence saving lives of Children
The Malnutrition Unit has become the core site for training of malnutrition management to capacitate other stabilization centres around Zimbabwe.
Baby Luke Chipere, 2, snuffles and fidgets restlessly, then hides his head behind his mother’s shoulder as his mood shifts to playfulness upon being gently lowered to the toy-ridden floor of the playroom that is part of the Centre of Excellence at Sally Mugabe Hospital in Capital Harare.
Luke was admitted to the hospital last May due to Severe Acute Malnutrition (SAM) a life-threatening condition if left untreated.
His mother Shupikai who helps him play around with a dinosaur and car toy speaks with much hope and gratitude: “He was frail. He was so fragile when I came here and I almost gave up, but the care that he has been getting has helped a lot. They have created a home away from home at this Sally Mugabe Children’s Hospital Malnutrition Unit. I am allowed to be here with Luke and that helps him settle. He is eating and gaining weight and very soon we will be going home.”
To provide children the best chance to grow and develop to their full potential, Pediatrics Association of Zimbabwe (PAZ) together with the staff at the hospital, with support from UNICEF and co-funded by European Union Humanitarian Aid”, are supporting the setting up of a malnutrition Centre of Excellence at Sally Mugabe Children’s Hospital’s Malnutrition Unit.
The Malnutrition Unit has become the core site for training of malnutrition management to capacitate other stabilization centres around Zimbabwe on how to best manage malnutrition cases and to improve outcomes of children admitted with severe acute malnutrition.
Luke’s mother is also equipped with knowledge that will sustain his growth outside the off-white walls of the Centre: “When he started to refuse to eat, I tried to feed him porridge with peanut butter. But since I came here, I have learnt what a good diet looks like for Luke. Now I know we have groups of food. In the morning you feed him porridge and peanut butter and during teatime you give him bread and an egg, in the afternoon sadza and fish as well as vegetables and also fruits.”
At the centre of the playground is Mudiwa Mupotsa who passionately works as a teacher using various activities to keep the children active and help with psycho social support.
“I love this job because I go home knowing that I have brought joy to the little ones. My day is filled with upliftment of spirits in the room and I get to feel like a child again. I even have favourite toys. This playroom is a healing room – mentally, spiritually and physically,” she said.
Mudiwa is guided by activities in the Early Child Development play box they received from UNICEF’s education section.
“It is easy to plan using activities in the play box,” Mudiwa said. “It is very rewarding to do this job and this centre is a blessing to the children that come here to recover and live their normal lives again.
The centre has adopted several initiatives aimed at improving the quality of care and survival of children admitted for treatment, among then a strategy of limiting rotation of nurses from one ward to another.
As a part of the old set-up nurses would be allocated to a different part of the ward on a daily basis. Now they are attached to the Malnutrition Unit for 2 months allowing them more time to learn the treatment of SAM, as well as build a relationship with their patients. The Junior Doctors also have one-month attachment in the unit.
Dr Svitlana Austin speaks more on this: “Sally Mugabe Children’s Hospital is the busiest stabilisation centre in Zimbabwe. We admit about 500 malnutrition patients a year, by far the largest number compared to other stabilisation centres. Prior to the creation of Malnutrition Unit, we were losing a lot of patients. A collaboration with UNICEF, PAZ and the Ministry of Health and Child Care where one of our main objectives was a creation of a Centre of Excellence has resulted in a set up of a specialised unit for malnourished children. A lot more patients are surviving now due to better resources and more experienced staff.
“We decided, with the help of UNICEF and the Ministry of Health, to come up with a development of standard operating procedures, updating on the guideline to be disseminated to the rest of the country. We are the busiest and we have a high mortality, so we knew something had to be done.”
To date, 92 health professionals from Sally Mugabe have been trained to improve care for children with malnutrition.
“When we did trainings, we involved nurses from other clinical areas to follow the journey of a child coming into the hospital for treatment. We have trained the casualty sisters and doctors,staff of the unit itself, representatives from the high dependence unit, HIV clinic and others. We are now training trainers for continuity in imparting this critical knowledge” she said.
So, what has been the impact?
“We have established a data collection system to get the correct picture of where we are now, but we have managed to reduce, rather dramatically, the mortality as a centre. The mortality for Sally Mugabe Hospital used to be 45.7 per cent in children admitted with severe malnutrition, 2019-2020 figures. This meant that we were losing 1 in every two children brought to us. Now eight out of ten children are recovering, a number that continues to improve. This month (June 2021) we have not had any death and we hope to keep it that way,” she said.
When UNICEF asked Svitlana why they call it the Centre of Excellence, she has a question of her own: “Why not?” she asks. “It is a rather ambitious goal, but we have to have the drive to achieve it because frankly why not? We have the expertise; we are highly trained, and we cannot always blame the lack of resources – it is not always the case. We can do a lot with what we have got.”
By the time Svitlana motioned to Luke’s mother that the door to the playroom was being closed, Luke was visibly still enjoying himself, clutching a car toy dearly and still mildly protesting at being strapped, once more, onto his mother’s back.