By Andrew Masinde
New Vision will, until October 3, publish articles on individuals and organisations that have dedicated their efforts to fighting malnutrition in the country a problem that affects up to 54% of children under 18 in Uganda.
It is Monday morning and mothers are rushing to the nutrition unit at Kawempe Health Centre IV. This is the day set aside for mothers to attend practical lessons on preparation of balanced meals for their children. An elderly lady stands by the entrance, welcoming them with a smile. She begins the session by asking them if they remember what they learnt the previous week.
One of the mothers raises her hand and answers: “Ekitoobero”. Ekitoobero class consists of mothers with malnourished children. Here the mothers learn to prepare mixed foods that boost the children’s immunity after severe malnutrit on. After preparing, the mothers are taught how to feed the babies and they also taste the food, to give them the urge to prepare it in their homes.
“When mothers come here with malnourished children, after giving them first aid, we teach them how to overcome the problem. I make sure all the required foods for the demonstrations are in place. I use the little money I have that day,” Elizabeth Masaba, a public health nurse and nutrition counsellor, says. Masaba is also the founder of the nutrition unit. Ekitoobero is a mixture of various foods with different food values to make one dish. Training mothers to prepare the mixture is one of the many nutritional activities that take place at the unit.
Masaba started the unit in 1998 after encountering several nutrition cases in the area. “Mothers bring their malnourished children to the hospital but I refer the complex cases to Mulago. I decided to visit Mwanamugimu Nutrition Unit at Mulago to learn how to handle such cases. When I came back, I set up the unit to handle the cases instead of referring them to Mulago. This would save the mothers transport expenses to Mulago,” Masaba explains. She adds that since she did not have enough space, she decided to use the health centre hall to carry out her activities.
The view from the community
“Maama Masaba saved my dying son
Scovia Nakamate, a resident of Wakiso was among the first mothers to bring her child to the unit. “At four months, my son started losing weight and was becoming pale, I thought he had been bewitched. I tried some traditional healers in the neighbourhood, who said it was a genetic illness and advised us to look for money to exorcise the evil spirits that had afflicted him. I became so desperate because I did not have the amount of money they were asking for. The boy’s condition got worse and I had to bring him to the hospital where I met Maama Masaba.
After examining him, she told me the boy was malnourished and needed proper feeding. I am a charcoal seller so I wondered where I would get the money to put the baby on a special diet. I was very distressed. However, she counselled me and assured me it did not require a lot of money, but only local and affordable foods and information on how to prepare the foods. Today, my son is alive and healthy. He is in Primary Four.
I can never stop thanking Masaba for having saved my son,” she says. After realising the good service, people thronged the unit and the facilities could no longer satisfy the numbers. Masaba wrote a proposal looking for funds to set up a structure which Plan-Uganda approved and built a nutrition unit at the health centre. Plan provided all the furniture and some of the materials needed.
The health centre recruited Village Health Teams (VHTs) who, together with Masaba started door-to-door malnutrition screening in Kawempe. After diagnosing the cases, they referred them to the unit where Masaba, would train the mothers and treat the children. Namakula Zaitun, who is HIV positive, and her daughter Madinah Nantume were found in a bad condition. They were referred to the unit and treated. When VHTs approached me, I feared they were going to arrest me for starving my child.
I did not have money for treatment so I had decided to stay home with her and await death. They registered us and referred us to the unit where Maama Masaba welcomed us,” Namakula says. She says Masaba gave her some cooking lessons. She also advised to start up an income-generating activity like washing people’s clothes to get money to feed her child. She now has a charcoal stall.
“Masaba is a saviour to my grandchild. I got her when she was wasted and her mother had abandoned her in the house. She is seven but she looks three years old. A neighbour advised me to take her to the nutrition unit and Masaba gave her nutritious feeds which restored her health,” says Constantine Namukisa, a resident of Kawempe. When Masaba realised mothers were only depending on the unit’s provisions, she started a small vegetable garden at the hospital. “Here, I teach mothers how to grow vegetables to feed their families and also sell some to earn an extra income.
I monitor them to ensure they grow vegetable whether it is in the backyard or on the verandas. Poor nutrition remains a major public health problem in Uganda. The recent Uganda Demographic and Health Survey statistics show that about two out of five children below five years are stunted, more than a third of them severely.
Malnutrition cases have dropped
“I know her as a determined woman. When she came up with the idea of starting a nutrition unit, I gave her a go-ahead and today she is a living testimony of how much we can do to save our communities,” Catherine Nabbanja, the senior nursing officer at the health centre says.
“The hospital had high rates of malnutrition cases, but today the numbers have reduced significantly. Before the unit was set up the cases were about 40 to 55 daily but now we receive 7 to 10, which is a remarkable improvement,” says Nabbanja.
The unit serves the whole of Kawempe Division and some parts of Wakiso and the neighbouring areas. “I did not have money to start the project so I talked to the head of nursing to help me raise the money, which was also not enough, so I used my small savings to buy some of the materials.
Whenever a mother brought a child who had symptoms of malnutrition, I would test them and take them to the nutrition class. When the mothers started realising the benefits they would invite others who had similar problems. I discovered that many children in the slums were malnourished,” Masaba says