The Monitor (Kampala)
Evelyn Lirri
27 June 2009
Moroto — Ms Helen Nakiru sat quietly as she waited for her turn to get treatment and food for her one-year-old baby at a nutrition centre at St. Kizito Hospital Matany in Moroto District.
The hospital, located 40kms from Moroto town, has become identical with handling high cases of malnourished children. And Ms Nakiru's baby, Lochoro, is just one of them.
Lochoro is clearly in a desperate state. Lying on her mother's laps wrapped in a floral African made textile shawl, the one-year-old baby weighs only 3kg - the weight children would normally weigh at birth.
Emaciated and frail with sunken eyes, Lochoro is one of hundreds of children caught in the throes of a food crisis due to famine and drought in Karamoja region. Three successive years of failed rains has left the region struggling for food and many facing starvation.
Over 200 children, most of them in advanced stages of malnutrition, are currently registered at the hospital's Therapeutic Feeding Centre. It is here that they are given food, a peanut butter-based food called plumpynut and therapeutic milk.
HUNGRY: Lochoro at the feeding centre at St Kizito Hospital Matany in Moroto district. PHOTO BY EVELYN LIRRI
Ms Nakiru, however, said she did not know her child was suffering from malnutrition and only took her to the hospital because she developed a high fever and had lost appetite.
"She is sick that is why I have brought her here," Ms Nakiru said of her daughter. She had been admitted for a week when Saturday Monitor caught up with her on June 10.
The child can neither sit nor crawl and looks much smaller than her age.
Dr James Lemukol, the medical director at St Kizito Hospital Matany, the biggest hospital in Karamoja region, says like Ms Nakiru, many women in Karamoja are not aware of malnutrition cases among their children and only get to be told when they take the children to the hospital to treat other ailments like malaria, diarrhoea and pneumonia.
He says Ms Nakiru's daughter is suffering from severe malnutrition, which is the most common cause of death among children under the age of five in this region.
According to the World Health Organisation, severe acute malnutrition is characterised by a child having low weight for its height, low height for its age and cases of malnutrition usually occur when the children don't have enough food with all the required nutrients to eat and keep them healthy.
Like many mothers in this region, Ms Scovia Longes, a 35-year-old mother of eight says she only got to know her two-year-old daughter was suffering from malnutrition after she brought her to the hospital because she had malaria.
"It is here that I have been told that she is suffering from malnutrition. The medical workers have given her some supplementary foods and milk," Ms Longes said.
At two years, Longes' daughter weighs only 7.4kg and cannot walk.
Dr Lemukol says at that age (two years), a child should be weighing more than 13Kg.
"This child is only half of the weight it should be," he explained. "It means it's already showing signs of stunting. Its weight is low and its general development and body weight is below the acceptable size."
According to Dr Lemukol, the nomadic lifestyle of the Karimojong, coupled with severe drought is to blame for the high numbers of malnourished children.
"Unfortunately, children are now the one's paying the heavy price," Dr Lemukol, who also revealed that the hospital is currently overwhelmed by the high numbers of malnourished children, said. "Everyone is preoccupied with the immediate survival needs, living each day from hand to mouth and no much attention is paid to the future."
Poor utilisation of food
But even in certain circumstances where food is available, Dr Lemukol said utilisation has been very poor.
"Some people have the food but decide to sell it to buy other household needs," he said. Ms Longes said she feeds her malnourished daughter and seven of her other children on beans and sorghum flour that she gets from the World Food Programme.
"I can't afford to buy her milk so I give her what is available. At times when we run out of food, we sleep hungry. Even the little ones have nothing to eat," Ms Longes said.
With severe acute malnutrition, not many children in this region are lucky to celebrate their fifth birth day.
Dr Lemukol said 60 per cent of the deaths at his hospital have been among children less than five years with at least 54 per cent of them as a result of severe malnutrition.
"A study conducted over the last three years indicates that almost 200 babies died as a result of severe malnutrition in only one of the five hospitals in the region," he said.
"This is a very serious toll of environmental factors to the Karimojong population."
In fact, a Health and Nutrition Assessment report conducted in Karamoja region in April 2009 by the Ministry of Health and the International Baby Food Action Network Uganda indicates
that the region suffers the highest malnutrition levels in the country.
The report says Moroto recorded an average malnutrition rate of 9.2 per cent while Kaabong had the highest malnutrition rate at 12.1 per cent.
"The region still has relatively high levels of acute malnutrition of 9 per cent, which are slightly above the emergency threshold of 10 per cent with aggravating factors like food insecurity, poor sanitation and poor caring practices," the report says.
The introduction of ready to use therapeutic foods, which allows the management of large numbers of children who are severely malnourished above the age of 6 months without medical complications, has made it easy to reach large numbers of severely malnourished children in the region.
The Country Director for WFP Mr Stanlake Samkange told Saturday Monitor in an interview that WFP's policy is to provide food that is fortified with certain micro nutrients so that people get food that will keep them healthy.
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