Rwanda has stepped up its campaign to eliminate cases of malnutrition among children, with a call on every Rwandan family to ensure a balanced diet for children under five years, pregnant and lactating mothers.
However, there are still some places around the country where malnutrition is just not history, but a current reality. One of such places is Mushubati sector of the Rutsiro district in Western province. With 18 known cases - among which are four in a critical condition - Mushubati is among the first sectors countrywide when it comes to malnutrition. This is being blamed on local leaders.
Mushubati is one of the sectors of the Rutsiro district (Eastern province) which was ranked last in the latest performance contracts evaluation (imihigo).
Alphonsine Uzamukunda, a mother whose daughter is malnourished, says she has consulted the community health workers, yet they told her that the daughter was safe.
"My seven-year-old daughter has been malnourished for the past three months now. She has not attended school like other children her age. I have not yet taken her to hospital," the mother of four explains, adding that she has not yet paid health insurance (mutuelle de santé) for the whole family.
"They wouldn't treat her even if I had money to pay for her. What these health centers want is that a whole family is covered before they treat a patient," Uzamukunda says. "Paying for all six of us costs 18,000 francs, which we do not have."
Her daughter is not among the 18 recorded cases in the sector. There are tens of other unregistered cases like Uzamukunda's daughter in the area. "I know five from my village that the health workers have not yet visited," observes Faustin Munyankindi, an elder in the village.
The executive secretary of Mushubati sector, Patrick Munyamahoro Muhizi, says that after the campaign against malnutrition was launched at the beginning of the year, community health workers were assigned to visit every family in the sector and identify the malnourished individuals.
"Truthfully, I did not know about Uzamukunda's daughter yet we concluded our tour and registered the cases at hand. Now I have sent community health workers to identify them and include them on the list of health beneficiaries," Muhizi explains.
During the launch of a global campaign to fight malnutrition, Health Minister Agnes Binagwaho said that Rwanda is endowed with rich fertile soils that guarantee good harvests, which should be the basis for every family to provide basic nutritious meals for their children. "Adequate food and nutrition are a universal right and essential for the physical, mental and emotional development of children as well as the quality of life for adults," she said.
According to Minisante, nutrition is also essential for increasing the efficacy of medication, such as antiretroviral drugs, and plays a critical role in the strategies for the prevention, treatment and care of all disease.
To ensure that the campaign succeeds, the government came up with strategies that include monthly screening and identification of malnutrition cases among children under the age of five, pregnant and lactating women; regular procurement of nutrition commodities; promotion of the establishment of akarima k'igikoni (kitchen garden) and provision of cows to households with severely malnourished children in selected districts with highest prevalence of malnutrition.
Yet, in Mushubati, according to Muhizi, only six families among the 18 affected by malnutrition have already received cows. "We had not given them cows before they had been identified as malnourished because they were not part of the vulnerable," he states.
Additional programs include promoting the rearing of small livestock (goats, rabbits, chicken) to improve protein intake; organizing cooking demonstrations sessions at village level; and promoting appropriate hygiene practices (including hand-washing in primary schools).
In Rwanda, the 2010 Demographic Health Survey (DHS) results estimated that close to 44% of under-5 children show signs of malnutrition. "We have no excuse for failure to provide proper meals for our children. It simply needs a change in our way of life and mindset," Minister Binagwaho said.
The national campaign against malnutrition was started on the January 29 by Prime Minister Pierre Damien Habumuremyi, and was given six months to achieve the objective to rid Rwanda of malnutrition. Eleven months later, however, that is still far from being the case in sectors like Mushubati.