Mbale — The Mbale Hospital's nutrition clinic was built to accommodate 17 in-patients, but now over 35 are admitted every week. Others pay weekly visits to the out-patient care centre, where nurses monitor undernourished children's progress towards reaching their target weight. Health workers are overwhelmed by the numbers of young people needing urgent attention.

Joyce Kharunda has seven daughters. The woman, who comes from Manafwa district, is also eight months pregnant. Let it be a boy, she hopes.

Kharunda says her husband has put pressure on her to produce a male, although he, working as a fishmonger, can't provide enough for the family as it is. The long drought in the region has only exacerbated their household's food shortage.

Meanwhile, pregnancy coupled with poverty has distracted the mother from caring for her youngest child. In fact, she has been at Mbale Regional Referral Hospital's for three weeks, accompanying her swollen-limbed 18 month old who was admitted for acute malnutrition.

Disease? Witchcraft?

According to Janet Taidhi, a nurse who has worked at the clinic since 1995, some people have no idea their children are malnourished. They may misinterpret their children's swollen legs, a telltale sign of malnutrition.

"Some of the parents and guardians...believe that there is a new disease," she says, referring to a what locals colloquially call 'Lwenyanja' for 'something that comes from the legs'. Taidi adds: "Others think it is witchcraft."

A visit to the clinic reveals that several have swollen bodies. Some cannot walk. They are small for their age. Their mothers, often from poverty-stricken homes, are also in poor health. They come from as far as Namutumba district, some 50 kilometres away.

Their treatment can last for over four weeks. They are fed milk, proteins and vitamin-rich foods provided the health ministry.

Ignorance

Ignorance, poverty and a mere shortage of nutritious food are to blame for the multiplying cases of malnutrition affecting both young and old, says Taidhi.

She points out how some teenager mothers abandon their babies, leaving them to grandmothers who have no resources to feed them.

Apart from treating young patients, the nutrition clinic staff also educate those who bring them in. Among the topics they tackle are the importance of child spacing, children's need for nutritious food, a balanced diet for the family and good hygiene.

The epidemic has demanded attention from the Ugandan government, who have consequently developed a set of guidelines to address the prevailing lack of information. Like Taidhi, the health ministry says ignorance is the cause of malnutrition.

A programme launched in Kampala in March also takes steps in this direction. Through it, local leaders and village health teams are called to help educate mothers who do not know what to feed their children - or themselves.