Kampala — Two-year-old Ivan Tumwine's ribs are protruding and his hands have been reduced to the size of a stick. His spinal cord sticks out and his skin which has turned yellow, is peeling.
He has succumbed to several diseases and his mother, Peninah Asiimwe, says she does not know what her son is suffering from.
But according to the health worker treating Tumwine, the boy has signs of malnutrition - insufficient food or lack of nutrients.
Asiimwe says she has been feeding her son with solid food including cassava and bananas for over a year.
"When he fell sick, I took him to a heath centre III for treatment for about a month but he did not recover.
I then decided to take him to Nyahuka Health Centre IV, where a Christian organisation runs a centre that treats and rehabilitates malnourished kids," Asiimwe says.
Magnitude of malnutrition
The World Health Organisation (WHO), reveals that 45% of children under five years in Bundibugyo district suffer from chronic malnutrition.
Dr. Jennifer Myra, a consultant paedetrician who runs the nutrition programme at Nyahuka, says they receive about 20 malnourished children every month.
"People are not sensitised about malnutrition. They bring their children for treatment when they are about to die."
Myra says: "People in Bundibugyo lack food security and families are starving. Those with little food do not eat a balanced diet, leaving many children to vulnerable."
Edmund Bishaka, the district agriculture officer, says only 45% of the people have food security. He blames over production of cocoa for the high malnutrition rates.
Over 90% of the people have devoted 95% of land to cocoa farming and abandoned crop farming. Bishaka says when they sell the cocoa, they buy food from Fort Portal and when the money runs out, the people starve.
"Child-headed families, the elderly and women are the most affected," he adds.
Ronald Mutegeki, an administrator at Bundibugyo Hospital, says polygamy and lack of child spacing has also fuelled malnutrition.
"Due to limited resources, all the children are not catered for and they may succumb to malnutrition," he says.
Mutegeki says due to lack of child spacing, when mothers conceive, they neglect other children. "They start feeding children on solid foods and ignore breastfeeding. In this case, a child gets malnourished."
Mutegeki says on average, a woman in Bundibugyo, gives birth to about 15 children while about 20% of the people practise polygamy, compared to the national average of 10%.
Effects of malnutrition
Myra says children develop malaria, kwashiorkor, marasmus, diarrhoea while some become mentally retarded.
Myra says feeding a child of Tumwiine's age on solid food only worsens the situation. "A malnourished child should be fed on special foods like soya or porridge, eggs and some vitamins to restore energy," she adds.
While these children are lucky to be alive, many have died. Mutegeki says two weeks ago, three malnourished children died at the hospital.
"Several other children are anaemic yet we do not have enough blood. We often have blood shortage."
Mutegeki reveals that about 10 children die every two weeks because of malnutrition. He says the hospital is supposed to have a unit that treats malnourished children but they do not have it due to a shortage of resources.
Ray of hope
The World Harvest Mission, a Christian organisation that rehabilitates malnourished children has put up a nutrition programme at Nyahuka Health Centre IV for the children.
Nathan Eldad, who runs the programme, says they have admitted 50 severely malnourished children who are being treated and rehabilitated for over 10 weeks.
"We are giving them soya, groundnuts, moringa leaves and eggs. When they improve, we shall bring in another 50," he explains. Eldad says about 3% of the children have recovered.
The World Harvest Mission has also given over 400 dairy goats to some families to produce milk for the children, says Myra, the co-ordinator.
WFP has also launched a hunger sensitisation campaign targeting children under five years.
The WPF country representative, Stanlake Samkange, says malnutrition is one of the major causes of infant and child mortality and undermines the mental capacity of a child.