By Eric Oteba
On the 9th February 2018, during reassessment of referred clients by VHTs at the Supplementary Feeding Program Outpost, two year old Lomonyang Loduk was found to have Severe Acute Malnutrition (SAM) with a mid upper arm circumference (MUAC) reading of 10.9 cm and weight for height (WFH) Z-score of less than -3SD hence severely wasted and physically weak. Clinical assessment was also carried out by a nurse at the food distribution point and results showed that he was anemic.
Loduk who comes from Nasinyonoit village, a few meters away from Lolachat sub-county head quarters, Nabilatuk district had been abandoned by his mother who had re-married in a neighboring sub-county called Nabilatuk. His father didn’t seem to care about his health. He is said to go long distances looking after his cattle or sleep all day under a tree in Lolachat trading center as he listens to his radio forgetting to take care of his son.“Loduk feeds on only sorghum prepared foods, we cannot afford meat or fish from the shops to contribute to a balanced diet”, narrates Loduk’s grand mother.
Referred to the nearest health center
Loduk was referred to Lolachat health center, a nearest Outpatient Therapeutic Care (OTC) where SAM clients are managed. His grand mother, deeply concerned for his health, committed to the weekly therapeutic treatment. She took Loduk to the health center regularly with support from Longole, an assigned village health team member (VHT) and Lazarus, a health worker who together monitored his progress.
On 4th April, Loduk’s health had greatly improved and he was referred to the nearest Community Based Supplementary Feeding Programme(CBSFP) outpost (Lokitela) where he was re-assessed by AFI staff. He had a MUAC reading of 12.1cm and a weight for height Z score of -2SD. He had graduated from SAM to Moderate Acute Malnutrition (MAM). AFI nurse and nutritionist committed to a weekly home visit to ensure the family of Loduk adhered to best hygiene practices while maintaining a healthy diet as supplement to the super cereal plus (CSB++) served by AFI at distribution points. There was a progressive increase in Loduk’s weight by nearly one kilogram in just three weeks. “I could not believe my eyes, I had to take his MUAC because I thought the weighing scale was faulty“, exclaimed Catherine Cheptanui an assigned AFI nurse. “There was a corresponding height for weight measurement too“, Catherine added with a beaming smile.
Community based supplementary Programme (BSFP) is implemented by AFI in partnership with UNWFP, Ministry of Health and funding from Department for International Development (DFID). To increase community response to the treatment AFI staff work hand in hand with local leaders to encourage parents or guardians to continuously accompany children under their care to receive food supplement from the distribution points. On our second visit to Loduk’s family, his grandmother spoke proudly about the key messages she remembered at the food collection point; optimal child care, hygiene and sanitation, importance of routine immunization and deworming.
A locally formulated porridge called METU-1 (Malnutrition Eradication Therapy in Uganda) invented by AFI, constituting sorghum, ghee, honey and peanut paste was prepared for Loduk to further quicken his recovery on the second visit.
Loduk fully recovered after three months, on discharge, he had a MUAC reading of 12.9cm and WFH Z-score of less than -1SD. She was linked to an AFI supported local group of model women that mentor others on practicing kitchen gardening and METU-1, aimed at diversifying their diets and preventing cured clients from relapsing.