By Rukiya Makuma
WFP moves to answer that question with sensitisation and food support
Kambasa Salimu is severely malnourished. At five years old, he has a body mass index of a four months old child. Weighing only 8.4 kg and 85 cm in height, he is emaciated with a protruding stomach and has powdery patches all over his skin.
Salimu has been suffering from malnutrition for a year but was only brought to Nyahuka Health Centre in Bundibugyo when he fell seriously ill for two weeks.
Chronic hunger is a problem throughout south-western Uganda, says World Food Programme Country Director, Stanlake Samkange, Despite the large amounts and varieties of food that the people grow, research shows that they generally lack adequate knowledge on appropriate nutrition for pregnant women and young children.
Samkange said this is a major challenge as the condition can lead to life-long damage to the minds and future of children.
Bundibugyo district has the highest number of stunted children in Uganda at 45 percent of the child population. The country rate stands at 38 percent.
Most families in Bundibugyo grow cocoa, coffee, bananas, rice, beans, cassava alongside rearing cattle, goats, sheep and pigs but malnutrition is a grim reality in many homes.
Patrick Kawamara, Deputy RDC of Bundibugyo says people waste the money got from cash crops like cocoa on alcohol. But Richard Chandiga, a nursing officer in charge of the paediatrics ward at Bundibugyo Hospital, says malnutrition persists because the community does not know what it is. They think that a child developing a big stomach and brown hair is part of growth and they only seek health services when underlying infections come in.
Dr Kisembo Charles Salube, a senior nursing officer at the hospital agrees. He says whenever they receive cases of malnutrition they advise the parents to prepare the right food for the children. Most of the cases are referred to Nyahuka Health Centre because it offers some food to the ailing children.
Salima’s father, Haruna Kaija, a peasant farmer, says he knows what types of food his son needs but cannot afford them.
I only have a few plants of cocoa on which to support all of my 12 children and two wives,â€ the 45-year-old father from Busungu Parish says.
At the health center Salimu still has to eat cassava meal daily since that is what the family can afford but World Harvest Mission, an NGO working to eliminate malnutrition in the district gives him milk. His father says he already looks better now compared to when he was admitted.
One-year-old Prosy Natukunda is also at Nyahuka Health Center recovering from malnutrition. She weighs 6.6 kg and is 69 cm tall. She is also getting better because of the milk.
Nathan Elwood, a nutritionist with World Harvest Mission, says the average weight for a five-year-old should be 18kgs for a girl and 19kgs for a boy and the ideal average height is 107cm for a girl and 110cm for a boy. The average height for a one-year-old is 72cm for a girl and 74cm for a boy, while average weight for a girl is 9.5kgs while that of a boy is 10kgs.
Nyahuka Health Centre receives an average 25 cases of malnutrition a month and these are mostly severe. Many mild cases go unreported.
Dr Jennifer Myhre of World Harvest Mission says in most cases people think breastfeeding alone is enough for the child yet there is need for additional feeding. For this reason, World Harvest Mission is improving the quality of the goats so that people can access milk. The organisation gives out 100 goats each year to help improve the health of the children.
Dr Myhre advises that to develop well, a child has to breastfeed exclusively for six months. After this, nutritious weaning foods should be introduced while the mother continues to breastfeed up to two years. This should be closely followed with immunisation and supported with de-worming, good hygiene and a caring environment.
A WFP study in Bundibugyo found that most of the children aged six months to two years, and even some younger than six months, were fed on cassava and mashed plantain. Myre says these types of food do not have sufficient nutrients to help a child properly grow.
On February 25, WFP and the Ministry of Health launched a mass sensitisation campaign at Boma Grounds in Bundibugyo district aimed at eliminating chronic hunger in the district.
WFPs new strategic direction, which aims at not just providing food aid but ensuring food and nutrition security, builds on the work that the United Nations Childrens Fund, the World Health Organisation and others have been doing and is part of the overall United Nations Development Assistance Framework for Uganda.
Through local media and community groups, people will learn of the dangers of chronic hunger and be encouraged to feed children and pregnant women appropriately.
The aim is to purge child chronic hunger among children under five years and look beyond the clinical life threatening types of hunger in children, to focus on the invisible effects it can have on them. WFP hopes that the campaign would help at least 15,000 families in Bundibugyo to give the recommended nutritious meals to their children.
The Commissioner for Community Health, Anthony Mbonye, says if the Bundibugyo sensitisation campaign proves sustainable, the government will work with WFP and other partners to roll it out to other districts affected by chronic hunger like Kasese, Kisoro, Kanungu and Bushenyi, and the Karamoja region.