It was December 2013 when Beth Uwatwaye, a resident of Nyankenke Sector in Gicumbi District, Northern Province, started seeing the hair of her four-year-old son become brownish, brittle and scattered.

The skin too was not spared, it started getting dry and wrinkled like that of an 80-year-old. The child also became emaciated and weighed 11 kilogrammes down from 19 in just five months.

Low appetite, constant fatigue, dizziness and memory loss soon became part of the boy’s life.

"These symptoms led me to suspect that my son had been bewitched, and for many times I got tempted to consult a witch doctor,” she shares.

Light at the end of the tunnel

This went on and on, till March this year when community based health workers (CBHW) brought the 1,000 days campaign to her village.

The campaign is a three-year initiative seeking to improve feeding among children under five years, pregnant and lactating mothers, as well as school going children, to reduce morbidity and mortality related to malnutrition.

It is being carried out by the government in partnership with UNICEF, the ministries of Health, Agriculture, Education, Local Government, and Gender and Family Promotion.

Uwatwaye says all children in her sector below the age of five were screened for malnutrition, and her son was among the 140 children who tested positive.

With the support of CBHW, a daily community based feeding programme of all victims was started to counter the ailment.

"We agreed that every care taker to a child suffering malnutrition would carry a particular type of food, so we can meet at a central place, prepare a complete meal with the help of CBHW’s then serve it in particular portions to the children daily for a specific period,” she says.

Mary Mukamakuza, a community health worker in the sector, said malnutrition is screened by comparing the weight of a child to their age.

"A four-year-old, for instance, should weigh between 15 and 20 kilogrammes and anything below that shows they are malnourished,” she says.

The children found positive are put on a ‘balanced diet’ – usually a blend of Irish, sweet potatoes, greens and silver fish–for 12 consecutive days, then weighed; if their weight has not increased up to some expected level, they are subjected to another round. If they do not recover still they are referred to health centres and hospitals for advanced care.

So far, out of the 140 children who were put on the feeding system, 102 have since recovered, including Uwatwaye’s son.

"I got a huge sense of relief on learning that my son was not battling a strange terminal illness, as I had earlier feared,” Uwatwaye said.

The experience has now motivated her to become an anti-malnutrition advocate in the sector.

Mukamakuza points out that projects like kitchen gardening, village and cell gardens have been rolled out and that the ‘1000 days’ campaign is ongoing in all the 37 villages in the sector.

Challenges

Felix John Murego, the in charge of community based health workers at Kigogo Health Centre, points out that the dry spell between May and July this year ravaged kitchen gardens as well as village and cell gardens in the area.

"Some residents have refused to embrace such projects. They never care for demonstration gardens until they hear of an imminent visit by a government official,” he says.

Alexis Mucumbitsi, of the nutrition department at the Ministry of Health, says cultural chauvinism is a big concern, as some men still think nutrition in a family is the responsibility of women alone which frustrates the campaign.

National progress

Acute malnutrition has steadily been reducing over the years as a result of such efforts. In 2010, it stood at 3 per cent, but as of April 2014, it had gone down to 0.8 per cent.

However, stunted growth is still a major threat, standing at 44 per cent for children under five, according to the 2010 Demographic and Health Survey, way above the World Health Organisation’s target of 20 per cent.

Mucumbitsi says as part of the programme, nutrition supplements like vitamin A and Iron are given out periodically.

"For instance, in March alone, 91 per cent of children under five and women who had freshly given birth got vitamin A drugs, while 94 per cent of children in the same age bracket got deworming drugs. Other nutrition supplements given out included zinc, iron and folic acid,” he said.

The project is sponsored by Unicef.