- Malnutrition is a silent killer and a more serious condition than people think.

- Nutrition is not just about eating food. 

- It is not all about a mother being negligent in feeding her child.

 

Rilwan is eight months old and though he was crying, it came out as whimpers and with a lot of struggle, as he was very weak and emaciated.

 

He was first diagnosed with malnutrition when his mother brought him to the health facility in Nahuche, Bungudu Local Government Area of Zamfara State some weeks earlier. 

 

But they are back at the facility again because other complications have arisen. His mother said she mixes water from the stream in her village with the Ready to Use Therapeutic Food (RUTF) she was given at the hospital to feed him, as she has no other source of water.

 

When told they have to be referred to another hospital in the state she said, “ If only you know how long I walked on foot  just to bring my baby to this health facility here, how will I get to the place they are referring us to ?”

 

Hafsat Mande is a seven months old baby girl and she appears healthier  when compared with many of the other children at the Nahuche facility. Her mother Maimuna Usman said they first came to the hospital eight weeks earlier  when  Hafsat couldn’t sit,  having diarrhea and losing weight.

 

She is now better and Maimuna said she gave her pap regularly along with the RUTF given to her in the hospital. Her low middle upper arm circumference (MUAC) measurement showed 12.3cm  which showed an improvement from 11.0 when she was first brougth to the hospital.

 

A measurement of less than 11.5cm of the MUAC is an indicator of severe acute malnutrition.

 

Malnutrition is a serious condition that occurs when a person’s diet doesn’t contain the right amount of nutrients. It contributes 53 % of deaths of children under the age of five in the country.

 

In the north one in five children suffer from acute malnutrition and this has implications for health and human capital development.

 

According to the national programme officer of Working to Improve Nutrition in Northern Nigeria (WINN), Dr Mohammed Liman, malnutrition is Nigeria’s silent crises, and when an individual does not consume or absorb the right  amounts of  essential nutrients, then that individual is said to be malnourished.

 

“About one million children die annually and more than half is attributable to malnutrition. It is called silent crises because adequate attention has not be given to it. One of the implications of malnutrition is child stunting which has implications later in life.  Nigeria is leading in the case of malnutrition in Africa, and it is the second on the global level,” he said.

 

He said children who are the future of tomorrow and backbone of the country are wasting away, becoming mentally retarded, and have poor performance in school.

 

He said: “We have to invest in nutrition interventions  and we will have a better developed nation, increased productivity, increased health status of our population and even better Gross Domestic Product for our country because it has also been reported that  for every investment you make  in nutrition you have 25 percent output. 

 

Dr Liman said that is why WINN is partnering with the government and providing interventions to address the issue of malnutrition.

 

WINN is funded by the United Kingdom’s Department for International Developemnt (DFID) and is implemented by the United Nations Children Fund (UNICEF), Save the Children (SC) and Action Against Hunger (ACF).

 

It focuses on the five states with the highest number of malnourished children in the country, Zamfara, Jigawa, Katsina, Yobe and Kebbi.

 

 

During the field visits facilitated by WINN to Nahuche in Zamfara State and Mai’adua in Katsina, this reporter observed a large number of malnourished children , whose caregivers brought them from the communities and surrounding areas.

 

In a day over two hundred malnourished children are attended to and one can imagine what the figure is like in a year, not to mention those who cannot access these facilities because of poor roads and long distance.

 

Malnutrition is not something to be associated with poor rural women, a woman can be wealthy and yet her child is malnourished because of ignorance on the part of the mother and other factors.

 

Asked why there are so many cases of malnourished children at the health facility,  officer in charge of Out Patient (OTP) in Nahuche health centre, Sani Mohammed said poverty and lack of awareness on nutritious food, or the proper way of feeding the children is responsible. 

 

However, independent investigations by this reporter showed that it is also because some of the men in the area are negligent in their duties .Sources say some of them leave the women with little food that lack basic nutrients while they go out to places to eat or buy good foods for themselves .

 

Everyone and all stakeholders including government, community and religious leaders and individuals need to educate others on the importance of proper diet. 

 

It is not just about eating food but ensuring that those meals have essential nutrients.

 

There are a lot of local foods  with nutrients and rural dwellers need to be sensitized on this.

 

Mothers have the responsibility of properly feeding their children, and fathers should assist in ensuring this by supervising them,  and also living up to their responsibilities.

 

Stigmatization of parents with malnouriched children should also stop.The minds of fathers should be disabused from the thinking that a malnourished child is because the child is hungry, and he is not feeding him or her. 

 

According  to the Deputy Director,  Katsina Primary Health Care Agency, Hajiya Fatima Garba Abubakar, a lot of sensitizion also needs to be done to stop mothers who eat the RUTF given to them in hospitals rather than feeding their malnourished children with it.

 

She said men too now take the RUTF meant for their children believing it has other benefits for  their body. She added that people also need to be sensitized on the causes of malnutrition as many believe it is caused by evil spirits.

 

The health facilities visited do not have adequate drugs and staff to meet up with the teeming number of malnourished children. 

Government at all levels, organizations, and philantropic individuals  should respond urgently to this to stop these children from dying .

 

Local technical adviser of WINN in Mai’adua Local Government Aisha Suleiman  said, “We do not have enough drugs, and even when we prescribe the drugs the women do not have the money for the treatment. So they come back with the same problems all over again”

 

She said for instance if a malnourished child is diagnosed with malaria and other associated diseases,  and the drug is not given, and the disease managed there will be no progress.

 

Sani Mohammed, officer in charge of OTP in Nahuce health centre also said drugs are inadequate.

 

While state and local government areas are providing staff, and structure in these  health centres,  more needs to be done as the centres are overstretched and the staff are overwhelmed by the teeming attendance of malnourished children and care givers. 

 

Efforts should also be made so that the interventions an be continued and sustained beyond 2017 when WINN programme ends.

 

Women should be empowered  and amenities provided.

 

Dr Liman said we need to advocate to government, wealthy individuals ,organisations, families and every stakeholder that nutrition is a serious problem in Nigeria  and needs to be addressed.

 

“It  is an issue that needs a multi-sectoral approach,  ministries of youth, agriculture and women affairs, parents, traditional leaders  need to be involved, “ he said.

 

According to Dr Yinka Adekugbe of Save the Children nutrition is a developmental issue, and to address under nutrition everyone can make a difference. She  said it is a collective responsibility of the financial sector, agricultural sector, medical care, food security, transportation, and climate change among others.

 

She said: “ When you see a woman with a malnourished child don’t blame the woman , blame the system.”

 

By Ojoma Akor

Daily Trust