Through community engagement, a partnership between UNICEF and the European Union helps address the high levels of malnutrition in the Democratic Republic of Congo.
Dada Furaha, 18, is a relieved mother since she learned how to protect her 18-month-old son Jean-Marie from malnutrition. The boy had been very ill, developing oedemas and losing appetite and weight. His mother took him to the health centre in her village of Kailo, and the child was put on urgent treatment for severe acute malnutrition.
“When I got to the health centre, the nurses weighed my child and told me he was very weak. They gave me Plumpy’Nut and showed me how to use it to help my son recover and get healthier,” says Furaha, while giving to her son the high-energy peanut paste, a ready-to-use therapeutic food (RUTF).
“The doctor told me I should wash my hands and those of my child before giving him the therapeutic food. Clean water and soap kill germs that are on my hands,” she adds.
Furaha didn’t come to the health centre just by chance. It’s Irene Azama who alerted her to the risk. ‘Mama Irene’, as women have affectionately named her, is one of several community workers who go door-to-door to discuss with women how to feed children well, check children for malnutrition and refer them to the health centre if they are malnourished.
“I tell pregnant and breastfeeding women about how to cook rich meals, what nutrients to put together for a rich porridge, how to feed themselves and their children well,” Ms. Azama says.
Maniema province records high rates of malnutrition. The 2013-2014 Demographic and Health Survey and territorial nutritional surveys conducted in September 2014 revealed 17 per cent global acute malnutrition and 6.4 per cent severe acute malnutrition rates in Kailo Territory – far above the emergency thresholds established by the World Health Organization (WHO). Although Kailo is a lush, green place, the causes of malnutrition are numerous, including early marriages and frequent pregnancies, with children often left without food for long hours while mothers work on the farms.
“If I breastfed my child at 6 a.m., I would do it again at 5 p.m., after my farm work was over,” says Furaha, who had her first child at 15. “In the meantime, the food she ate was not rich.”
Ignorance is also a main cause of malnutrition. Many parents do not know what foods to use to help their children build energy and become strong and healthy. To better understand malnutrition, Furaha participates in focus groups where more experienced mothers share their knowledge with younger ones. Together they prepare meals high in proteins, lipids and glucose, combining affordable local products such as starchy legumes, cereals, vegetables and fruits suitable for younger children.
“In our meetings, they show us how to mix corn flour, peanut flour, sugar and palm oil to feed 6-month-old children,” she says.
From January to June 2015, with funds from the European Commission’s Humanitarian Aid and Civil Protection department (ECHO), UNICEF partnered with Italian NGO COOPI to fight malnutrition in Maniema and help curb the high rates of malnutrition.
“The programme had preventive and curative components,” explains Kibungi Mutanga, head of Kailo Health Zone. “Community volunteers refer children to the eight nutritional outpatient units if they suffer from severe acute malnutrition, and to the two intensive care units if they have additional complications.”
COOPI registered 2,698 newly admitted children in the malnutrition programme, with an average of 450 children per month. Since the COOPI project ended in June, the programme has continued with community support, and 185 children per month were registered in July and August. “The number of children referred to the health centre for malnutrition was halved. We achieved very good results,” Mr. Mutanga says.
“The UNICEF-ECHO partnership has been beneficial here. It has helped save thousands of children’s lives in Kailo Health Zone,” UNICEF Nutrition Officer Georges Mukamba says. “Without such a partnership, what would’ve been the fate of these children?”
In the past eight months, one child did not survive his illness, as he was referred too late for treatment, and 1 per cent of children have not continued adhering to the treatment.
“I was asked to take empty Plumpy’Nut wrappers with me next Thursday, to show that my child follows his treatment,” Furaha says.
Plumpy’Nut is a peanut-based paste in a plastic wrapper for treatment of severe acute malnutrition manufactured by a French company, Nutriset, removing the need for hospitalization, the 92 gram packets of this paste can be administered at home and allow larger numbers to be treated. It may be referred to in scientific literature as a Ready-to-Use Therapeutic Food (RUTF) alongside other RUTFs such as F-100, a solid form of therapeutic milk. Nutriset has come under criticism from Médecins Sans Frontières because it holds patents for Plumpy’nut.