According to the United Nations Children’s Fund (UNICEF), over 23 million children are malnourished in Nigeria and over 10 million face the risk of malnourishment.
For over eight months, Esther Mark followed the recovery journey of two malnourished kids in remote villages of Bauchi state, noting their recovery and post recovery stages. She also x-rays factors responsible for malnutrition in northeast Nigeria, and its effects in the lives of children and by extension, their caregivers.
Saifullahi looked very weak, frail and thin. With a shirt covering his weak body, he clinged to his mother, while his eyes hurt and body, very hot. He would cry this minute, and close his eyes silently, the next minute. Flies perched on his eyes, while his nose had mucus running down his mouth. His mother looked exhausted, but she still managed to pull off his clothes for him to be weighed.
She, like every other mother in Cheledi, Kifri Local Government Area of Bauchi state had one mission in mind: the recovery of their children.
Locating the community and health centre was not difficult with the crowd of mostly women and children gathered at the maternity, to the sachets of already eaten ‘‘plumpy nuts’’ all over the ground, serving as a road guide. Villagers and passers-by were also on hand to readily point you to ‘asibitin madaran yara’’- Hospital for children’s milk.
The milk is the Ready-to-Use Therapy Food (RUTF) which the women, carrying very sick and thin children, troop in weekly to Kirfi Town Maternity, Cheledi, in Bauchi state collect for their malnourished kids in their journey towards recovery.
An estimated 2.5 million Nigerian children under the age of five suffer from Severe Acute Malnutrition (SAM) every year – an extremely dangerous condition that makes children nine times more likely to die from common childhood illnesses such as such as diarrhoea, pneumonia and malaria. Every year, nearly 420,000 children under five die as a result of this deadly combination in Nigeria, according to UNICEF.
The kids in Bauchi state and environs, are all at the mercy and intervention of the Bauchi state government and by extension, counterpart funding from donor agencies to not only live, but thrive in life free from diseases. For them, the UNICEF Early Childhood Development programme of #LivePlayLove, does not apply. Their mothers also need to attend health talks and enrol in a family planning centre, while availing them of routine immunizations. These, all fall under the Primary Health Care Development Agency and the state health budget for these programmes will determine the life or death of the children, taking into consideration, their parents occupation, settlement, and proximity to health care facilities.
Treating Malnutrition with the ‘milk of life’
To fight acute malnutrition in children, UNICEF introduced the Community-based Management of Acute Malnutrition (CMAM). This innovative and cost-effective way of treating malnourished children was first introduced in 2009 and has since expanded to 12 northern states. Yet, not every state in the country boasts of this. In the northeast, there are six states which UNICEF oversees across Bauchi, Plateau, Gombe, Adamawa, Taraba, and Jigawa.
This Community-based Management of Acute Malnutrition (CMAM) programme has treated over two million children since it was first introduced in Nigeria, at a cost of just US$160 per child.
The RUTF, also called ‘madara’ (milk) in Hausa Language by the locals, or ‘miracle food,’ is a peanut-based paste, which also contains milk powder, sugar and multiple micronutrients. To aid the quick production of this food supplement and reduce overhead cost, a Lagos-based Nigerian company, DABS, recently received international certification to produce RUTF for the treatment of Severe Acute Malnutrition, so the provision of RUTF will no longer be dependent on imports.
The Bauchi field office supports two major nutrition programmes: the Infant and Young Child Feeding programme (IYCF) and the Community-based Management of Malnutrition (CMAM) project. In the state, the CMAM initial piloting centres are located in Kirfi, Dambam and Katagum Local Government Areas’s. UNICEF also stepped up the fight against malnutrition by establishing six additional CMAN sites in Bauchi State, thus bringing the total number of the sites in the state to nine. The six new sites are located in Bauchi, Darazo, Itas Gadu, Warji, Gamawa and Tafawa Balewa local government areas. Each location has wards/centres. These centres cater for the nutrition needs of malnourished children within and boyond Bauchi state.
The search
Malnourished children eat the RUTF’s for a minimum of eight weeks, and maximum of 12 weeks, to be rehabilitated. At the centre in Kirfi abound stories of children who had undergone this process and were rehabilitated. UNICEF, in collaboration with state governments, take charge in the production and distribution of the plumpy nuts to children all over the country.
But how sufficient are these RUTF’s in rehabilitating the children? Who takes responsibility to ensure that all the kids get the food as at when due? Are these the only things a malnourished child needs to be rehabilitated? To check these, and many more, I embarked on a research with two children at the centre in Kirfi.
So I randomly selected two children from the over 100 kids that were enrolled that Friday. I followed their rehabilitation process.
All the way from Ranga Village
Baby Saifullahi Muhammed, is a nine month old boy. With Registration number Bau/KRF/2017/178, his mother travelled all the way from Bakin Kogi, in Alkaleri Local Government, to access the CMAM centre. This is a three hour return trip on motor cycle. He looked frail. Very weak, with visible ribs cascading all over his very thin body. He was all tears and scruffy, as they made to weigh him on the scale.
During week one, which was on the 3rd of March, 2017, he weighed 5.0 KG, and had a MUAC of 10.0. He was given a ration of 14 RUTFs for starters. By the second week, he had dropped to 9.5, while still maintaining the 5.0 KG weight. By week three, he still had not improved. He battled diarrhoea, loss of appetite, did not take the required quantity, and had eye sores. He was placed on antibiotics, Amoxyl tabs, malaria tabs and was dewormed.
It was a different looking Saif that visited the clinic the next week. By week four, (24/03/2017), he had gained weight as he now weighed 5.2 with a MUAC of 9.6. His ration was increased to 28, for two weeks. This was done to help the parents save money on transportation as they are forced to spend an average of N1500 per clinic day. By week six (Friday, April 7, 2017), he was showing significant improvement, as his weight had topped to 5. 8 KG and his MUAC was 10.1. His ration increased to 18 (as he had gone above the 5.5KG recommendation) and this was doubled for two weeks.
By week nine, my heart melted when I saw him again. When he was weighed, he had shot up from 5.8KG to 6.2KG. His MUAC shot to 10. 7 and his ration was maintained at 18. One could see he was a totally different child. He laughed more and sat on his own. He even looked at the camera with smiles. His mother was happy.
‘‘Aunty, she said, “my baby is looking well. He even eats very well now, and responds to instructions and commands. He plays with other children at home and he is really less clingy now. I am really happy this milk is working.’’
With the improvement he had shown, he was booked for another appointment in three weeks. Thus, he was given 54 RUTFs and his mother excitedly packed the plumpy nuts, as she felt relieved for another three weeks.
In between these weeks, I called up to know how he was fairing and the response was soothing. He was doing well and adjusting to his normal life. He was also eating well and there was no cause for alarm. Week 10 and 11 were observed and by the final week, week 12, he was back for the last lap of his treatment and recovery. By week 12 (May 19, 2017,) he weighed 6.4 KG, and his MUAC was reading 11.5. He went with a ration of 18 for two more weeks.
But then, he had not met the discharge criteria and had not recovered. By 12 weeks, a child who has recovered should have his MUAC reading 12.5 (less than 11.5).
Thus, three months after he began the treatment, he was well. But not fully recovered. From a very sickly child, he rose to a happy, contented lad. He could now sit, hold on to toys, and was more alert. It did not come easy. There were sacrifices made by his parents, to see him live. But that was not all.
Baby Zainaf Daihiru from Cheledi
At seven months, she weighed a paltry 3.5 KG. This is what some children weigh at birth. And at seven months, she looked too small for her age. She could only be carried and could neither sit nor stand or even crawl. When I looked up her card, her registration number read Bau/KRF/2017/194. A fair skinned beautiful girl, she was all clingy to her mom, even as her eyes continued to emit pus. She had eye problems, was constantly stooling, and looked very dehydrated, apart from being so thin.
At week one of her enrolment, on Friday March 3, 2017, her MUAC read 10.2 and her weight, 3.5 KG. She was rationed 11 RUTFs and by week two, she still weighed 5.0 KG, even though her MUAC had dropped to 9.0. She was booked for a fortnight. By week four, (Friday, April 3, 2014), she showed slight improvement in her weight which read 3.6 KG and her MUAC tilted to 9.5. By the fifth week when she reported to the clinic, she had improved and was now weighing 4.0KG, and MUAC measurement read 10.1. This automatically shifted her weekly ration to 14.
However, she became sick with diarrhoea, had fever and a runny nose and thus, by the time she was brought for her weekly checkup in week six, baby Zainaf had dropped to 3.6 KG and her MUAC read 9.6. Her weekly RUTF ration was brought back to 11.
By week 7, Zainaf had improved that she was no longer the very skinny girl who was brought in a month ago. She now weighed 4.1 KG, laughed at intervals, and could respond greatly to cheers and body languages. Her MUAC read 9.8 and her ration increased to 14. By week eight, approximately two months into her rehabilitation, baby Zainaf was showing great improvement. This time around, she weighed 4.6 and her MUAC read 10.1. Her mother was excited.
‘‘Seriously I am happy. She keeps adding weight and keeps taking her milk. She laughs more, and is no longer always clingy,” she said.
But then, two months into the programme, baby Zainaf ought to have improved greatly. She had put on 5KG and should have been considered for discharge. But her weight was yet to attain the recommended measurement and thus, had to continue.
By week 9, she dropped. She now weighed 4.1 KG and MUAC was reading 9.9. By the 10th week, she picked up again, was a baby of 4.6 KG and MUAC read 9.5. By the 11th week, she had dropped once more, and was weighing 4.3 KG and MUAC of 10.7. By the 12th week, she never showed up. She was due for discharge, or reabsorption into the scheme.
But her mother felt she was slightly better than she was three months ago, and thus, refused bringing her back to complete the final dose of her rehabilitation. She kept bringing up excuses for not attending her sessions and she had to be discharged voluntarily.
Common Problems
Incomplete treatment and many other issues, are some of the problems faced by the health volunteers in the centres spread across Kirfi Local Government, and by extension, the state. The officer in charge, CMAM Kirfi Town Maternity, Mr Sunday Bulus said they constantly record a high number of voluntary withdrawals as the mothers, on noticing slight improvement of the children, stop coming to the centres to restock and continue treatment and rehabilitation. This, he said, had a negative effect as most of the non-recovered children tend to elapse, and with time, go back to the same bout of malnutrition, while suffering other ailments.
But then, getting the plumpy nuts in large quantities also pose a serious threat to the wellbeing of the children as some of the mothers decide to either sell the RUTFs, at N50 per sachet, in their local communities, or give them away to relatives as snacks.
I had gone for the weekly check-up to meet with the kids, when I met a mother already bargaining with another, who was rejected at the centre as her child was not malnourished. She was willing to part with the RUTF’s for N30, per sachet. It took the intervention of the health workers at the centre to address the sad development.
Speaking on the effect of this practice, Mr Bulus explained ‘‘What they fail to understand, is that, each child is meant to take an average of two RUTFs per day. In some instances, this could be exceeded depending on the ration allotted a particular child. This then has effect, as the food meant for the overall recovery of each child, is being shared amongst neighbours and relatives, thus reducing the effect of the food on the child’s recovery process.’’
This is how poverty, combined with ignorance, continues to stand in the way of progress as children’s lives and wellbeing are sacrificed on the altar of money and income. Thus, it’s no surprise that most of these kids, really fail to recover after 12 weeks into the programme (even though UNICEF recommends just 8 weeks). It’s either they don’t take the right allocation, or they don’t eat the right food, or their parents voluntarily withdraw them after they appear to be better than they were, pre-enrolment.
The Journey to Ranga Village
How far does Addan Wali (Saifullahi’s mother) come to access good health care for her baby? What kind of environment is he growing up in? What foods do they eat? How close and accessible are they, to proper healthcare centres in their community?
These questions, and more, propelled me to begin the journey to Ranga. We had finished the round for the week, and baby Saifullahi had been given the allocation for the week. This would last him two weeks after which he and his mother, would return to the centre for more check-ups and restocking.
She commutes to the centre via a motorcycle her husband hired for the purpose. The commercial cyclist is a member of the Ranga village. Each journey costs the family an average of N1500 and this is a one hour, 30 minutes journey on bike. There are no steady pathways for cars and the journey has to be made on foot, bicycle or motorcycle. Thus, we set out, all four of us, on one bike. Although we understood the health safety implications of having three grown adults and an infant on a bike, we had no choice, nonetheless than to commence the journey.
In-between the cyclist and I was Saifullahi’s mother (Addan Walli) who had him nestled in her arms, covered with her hijab, as he needed protection from both the scorching sun, the blazing winds and fleas, and other particles flying in the air. The cyclist had the supply for the week settled in his fuel tank, right in front of him. Our journey was tiring.
‘‘I am used to this,” she said. “We do this every Friday and I am really happy that I have been given a two week supply. This will save me the stress of this tedious journey, as well as my husband, the money for next week’s transportation. I do this every week and it is the little sacrifice I must go through for my son’s well-being.’’
An hour later, we arrived Ranga village and I became a little tourist attraction. Armed with my camera in one hand, and my bag in the other, the villagers troop out.
This is a typical northern village with no electricity, nor pipe borne water, despite the fact that major table water factories in the state are situated right behind the village, overseeing the Yankari Dam. Fariah, Wikki Table waters hold sway in the adjourning community, at Mainamaaji, right before the Yankari Game Reserve. Their houses are made of clay bricks, and they live in family settlements. The young men are either motorcyclists or farmers, and the young girls are groomed for early marriage.
The village head comes in and introduces himself as the Sarkin Garin Ranga ‘’King of Ranga Village’.
‘‘We plant so many grains here. From millets to corns and vegetables. We do a whole lot of farming here and sell them off’’, he says. Even as he talks, he sends for a grain of millet to prove the point to me.
As I sit on the stool provided by Addan Walli, I took note of the environment. The room is unpainted. It has an old couch, and a cupboard where old big pans and several plates of different colours are stacked. These, were part of her dowry and it is the only ornament decorating the room. There is a door to the left, where their bedroom is located. As we talked, it became clearer that they lived very poor but contented lives, without basic amenities.
Ranga Village has no healthcare facility, no primary nor secondary school. The closest, is the Primary Healthcare Centre at Bakin Kogi, Alkaleri Local government. This is a 10 minute journey on bike, and almost 30 minutes journey on foot.
Food Combinations: Quantity versus Quality
‘‘A healthy diet helps protect against malnutrition in all its forms, as well as non-communicable diseases (NCDs), including diabetes, heart disease, stroke and cancer,’’ the World Health Organisation states.
‘‘In the first two years of a child’s life,” WHO maintains, “optimal nutrition fosters healthy growth and improves cognitive development. It also reduces the risk of becoming overweight or obese and developing NCDs later in life. Advice on a healthy diet for infants and children is similar to that for adults…. From six months of age, breast milk should be complemented with a variety of adequate, safe and nutrient dense complementary foods. Salt and sugars should not be added to complementary foods.’’
The above requirement is not obtainable in Ranga village and neighbouring communities. A particular class of food is eaten daily, which is neither complemented with adequate, safe, nor nutrient dense complementary foods.
A typical family here eats Tuwon masara da miyan kuka for breakfast (mashed maize and local soup), Rice and stew (no meat, no proteins-basically tomato and palm oil and salt, with a dash of a seasoning ‘ajino-moto’ made from sugar cane) for lunch and repeat the breakfast menu for dinner. Once in a very long while, they add a dash of beans to the rice and at other times, they eat ‘taliya da manja’- spaghetti and palm oil sautéed in dry pepper and salt.
But surprisingly, they are known for some grains they plant. Millet and almost every kind of it, is found here, as Bauchi state prides itself in the production of grains and vegetables. But they are lost, as to what they can do with these crops asides selling them for commercial purpose. In all these, it is quite clear that while they may not have the means to meet their needs, they are also not creative and experimental when it comes to food, like most families.
My major concern in travelling to this village was to see what baby Saifullahi, and by extension, his mother and other villagers feed on. Asides breast milk, he takes kunu and the RUTF. His meals are quite basic and there is hardly any protein or other supplements he needs. And as his mother barely feeds on a balanced diet, it automatically translates to him being malnourished. On occasions where he is fed vegetables, they are so overcooked that the nutrients are lost and also drains the flavour, a practice, medical personnels warn against.
At exactly 5.00pm, I head out to begin the almost four hours journey back to Jos, Plateau state.
Pregnancy and ante-natal check-ups
The quality of life starts from conception, pregnant women are thus mandated to visit hospitals for checkups throughout their pregnancy term and even beyond. During these routine visits, they are examined, scanned, and given proper orientation on the right food combinations, amongst others. The babies are scanned to show their general wellbeing, and complications are noticed and attended to, quickly.
Most mothers in Kirfi and Alkaleri Local government Areas of Bauchi state are ignorant of the right combination of food classes for their families. From the normal rice and stew, with no protein, to pasta and corn pudding, they hardly combine the right food supplements.
In 2015, Nigeria ranked 16th on the global tomato production scale, accounting for 10.79 per cent of Africa’s and 1.2 per cent of total world production of tomatoes. While tomatoes are cultivated in most states in the country, Jigawa, Katsina, Zamfara, Sokoto, Kaduna, Bauchi, Gombe, Taraba, Kano lead the pack in the commercial cultivation of the crop, the Federal Ministry of Agriculture, states.
In Ranga village, they have a healthy supply of vegetables as most of the men there, are farmers who plant tomatoes and other vegetables. But they would rather sell them off, than bring some home to their family. So while poverty helps malnutrition to spread, ignorance of proper food combinations also helps it gain a breeding ground.
More still, most of the mothers at the CMAM centres are teenage mothers between the ages of 14-19. Saifullahi’s mother is a 19 year old, who struggled with various superstitious beliefs in her first pregnancy. For a village like Ranga, and by extension, others, teenage girls live solely to marry and raise children.
And as the number of girls in school keep dropping, they increase the number of teenage mothers who are ignorant of best practices and hardly attend antenatal clinics. Both mothers under study, never attended antenatal throughout their nine months pregnancy and minor or major issues that would have been discovered, had they availed themselves such an opportunity, were never brought to limelight. Thus, the various complications the children had to contend with.
But then, the irony. They are usually the first to visit the hospitals if their children develop complications and they tend to spend more, until it gets beyond their capacity and they thus rely on native traditional medications.
In Ranga village, there are so many out-of-school children, many teenaged girls who looked forward with measured optimism, to the prospect of getting married and becoming an ‘amarya’, a newly wedded bride. Others, were already adorning different shades of makeups on their black, beautiful skin, as they hoped to attract a ‘samari’- boyfriend- who would eventually marry them. There were no plans for school, nor economic empowerment. There are no schools in Ranga, the closest, is at Bakin Kogi. While the girls only dream of marriage, the boys equally pick up farming, or motorcycle riding, as a vocation.
Pregnant and lactating mothers transfer food to their unborn children and the quality of food they eat during their pregnancy terms, affects the overall wellbeing of the child.
For Addan Walli, (Saifullahi’s mother) who eats just carbohydrates comprising rice and locally produced spaghetti in addition to corn and soup, it is very easy to detect where the malnutrition Saifullahi suffers, originated from.
‘‘I never attended any ante-natal clinic. I was just at home, and took local medicines once I felt ill. I eat my rice, everyday, and hardly include beans or others. This is what we eat daily, monthly and yearly and everyone here eats the same thing’’, she says.
She also does not understand the concept of exclusive breastfeeding as Saifullahi both ate and was breastfed before he turned six months.
UNICEF advocates steps to prevent children becoming malnourished to include supporting and encouraging mothers to breastfeed their babies exclusively for the first six months of life; educating families about the correct feeding practices for older babies and children; and provision of micronutrient supplements and vitamins and fortified food for pregnant women and young children.
Talking to about 15 women at the CMAM centres, it was also obvious that they hardly attended antenatal clinics while pregnant thus, missing out on essential information and assistance. Also of note, is the fact that they give birth to very underweight children, an indication that either the mother or infant, or both, had not been feeding well.
Most rural communities in the local government have at least, one primary health care facility. But how this, is run, and the capability of the medical personnel, leaves sore injuries in the mouth. Most of them are ill-equipped, and are manned by trained health workers who work as the nurses and midwives.
The expensive cost of malnutrition
As baby Saifullahi rests on his mother’s arm, he looks very uncomfortable. He tosses around, from side to side and she is left wondering what might be the best way to keep him rested. Just as she adjusts his, she feels something warm and humid, all over her. As she looks on, every other person there stares at her as the smell hits their nostrils. He has diarrhoea and has been stooling, non-stop, for two days.
‘‘He has been stooling, and despite the drugs we’ve given to him, he has not stopped. He keeps soiling his clothes and I am left with no option than to leave him without panties or diapers.’’, his mother says. It is evident that he has lost a lot in his two-days recorded diarrhoea. But that is not uncommon. Infact, every other child in the CMAM clinic, has diarrohea.
The National Nutrition and Health Survey (NNHS) stated in 2015 that worldwide, diarrhoea is the second leading cause of death in children, after pneumonia, and is a leading cause of malnutrition and mortality in children aged less than five years, in Nigeria and most developing countries. This is frequently related to the consumption of contaminated water and unhygienic practices in food preparation and disposal of stools.
Malnourished kids are given basic routine drugs comprising antibiotics, anti-worm , anti-malaria and Vitamin A to boost immunity, and improve eyesight, as is a regular case here. More drugs are given depending on each particular problem encountered by each child. So while the children are expected to improve daily, diarrhoea posses a big threat in their recovery process, and sometimes, even leads to their death. Baby Saifullahi and baby Zainaf were constant victims of the illness and so was every other child at the centre.
Six months after
After baby Saifullahi and Zainaf were discharged from the CMAM centre, I decided to follow up their post-recovery phase to see how well they fare six months down the line. Most times, when patients are discharged, and show little signs of proper rehabilitation, they are reabsorbed back into the scheme to start a whole new process of treatment and recovery. Would this be the same case for these two kids?
The first three months for them were great, the mothers said. While baby Zainaf was gradually eating other local staple foods, she was also able to crawl outside the house and play with her siblings – a feat she was not able to attain, prior to her rehabilitation. For Saifullahi, he was a generally happy chap.
By the fourth month, their bodies had changed. They both became ill. For Zainaf, it became a constant battle for her health and life. From malaria to eye pains and sores, she was constantly off and on local chemist shops. The mom, at a point, resorted to local medication, as she was administered herbs. By the 5th and 6th month, Zainaf was back to normal; crawling and standing, with the help of her siblings. She eats well, but still battles her eye pains.
But baby Saifullahi was not so lucky. After the third month, things took a drastic turn for the family. He became very sick, and was regularly in and out of hospitals. They visited the Primary Health Care clinic at Bakin Kogi, in Alkaleri local government area.
His father said, “we kept giving him the medicine and it was draining us. Today, he is unwell. Tomorrow, he is back to his normal self. He was eating his tuwo very well, and he was a cheerful child. It was not easy for us.’’
I had been incommunicado for some time and then called Saifullahi’s father mid December, to know how they fared and to inform him I’d be coming the next week to check up on them. When he recognised my voice, his countenance changed. Aunty, he said, “baby Saif is gone. He is dead.’’
His father narrated what happened.
By early November, his condition had changed. He became restless, and they assumed it was the normal bout of sickness that he had been battling with. His mother had fed him a little food and by evening, she had him in her arms, while outside the house with the rest of the extended family, chitchatting.
Suddenly, she felt cold. He felt still and limb.
She turned, looked at him and raised an alarm. He was looking lifeless and was immediately snatched from her hand by a senior family member. They rushed him to the room, called and jerked him. But he was no more.
‘‘He had died, and that was it. Why should I wake his father up to tell him the sad news? It was God’s will and my baby’s time had come. There was nothing I could do about it.’’
‘‘I could not cry. I nursed the wound and pain in my heart, for days. I could not sleep, neither could I eat. It was a painful loss for me.’’
He was buried in the morning, at the community burial ground, some kilometres away from their home. But I asked, what exactly was the problem with him? Did they conduct any test on him?
‘‘No,’’ his father replied. ‘‘No test was conducted at the hospital throughout our stay. They just kept giving us prescriptions to buy medicines and administer to him. We kept giving him one medicine after the other.’’
From the father’s account, it wasn’t hard to conclude that ignorance, and lack of proper access to healthcare, in combination to other factors, had robbed the parents of their only child. Had they been aware that medications should not be administered continuously on children, without proper medical tests, perhaps, baby Saifullahi would still be alive. Had the medical officers at the primary Healthcare facility insisted on transferring them to the general hospital in Alkaleri, perhaps, doctors would have attained to him and helped saved one more life.
I also sought to know his genotype. Maybe, there might be something wrong. The father was surprised. He had never heard of anything like that, and he just believes his son died because his time was up.
‘’That is how God willed it. His time was up and there was nothing we could so about it.’’
She sought to see his pictures, one more time, as she had no single picture of her late son. I showed the parents his pictures from my camera and I could see a glow of pain and sadness cascade their faces as they saw their late son one more time. I promised to bring along with me, on my next visit, some hard copies of the late baby. It was emotional moment for the family.
A new ray of hope
But the good news, is that Addan Walli is already six months pregnant. She was about four months gone when her son died, and she is very hopeful that this very baby would stay.
Already, the mistakes she did while pregnant for late baby Saifullahi, she is trying to correct. She has registered at the ante-natal clinic at Bakin Kogi Primary Health Care, and she has so far gone for 6 checkups.
She excitedly brings her card to me. ‘‘See my card’’, she says as she tries to prove to me that she has enrolled for the ante-natal checkup. “I do not want complications,’’ she says.
As I scan through the card, I can see weighs 52 KG.
When asked if she was given any medicines, her husband replied: ‘‘she takes some and once she feels nauseous, she discards them. If I go inside the room now, you’d see so many medications she abandoned. That is the only problem I have with her now.’’
But in her defence, she says, ‘‘Aunty, I am trying o. I feel sometimes uneasy when I take these drugs and it becomes a problem for me. But I will try to be consistent in taking the medicines. I will try.’’
And thus, the family beams with hope for the future, having lost a son whom 9 months ago, was the centre of their attraction. Hopefully, this baby would stay, and would be well nourished, and have no need for the RUTFs.
As Addan Walli and her husband walk me to their Zaure (varanda), where a motorcyclist is waiting to take me to Mainamaaji to board a taxi, I see a flicker of hope in their eyes, even as I promise to return when she gives birth. She is excited, and looks forward to the future, to a child well nourished. To a child who would not go through the same process her late son went through.
And while the rays of hope beams in the horizon, heralding a new era for the family, those in the frontiers of Early Childhood Development continue to call for collaboration between all and sundry to maximize impact.
The Executive Director, Convergence for Early Childhood Development Africa. Dr Ajimegor Oseaga-Ikuenobe sums it up:
‘‘Too many of us are working in isolation. To greatly improve impact and sustainability, we must build all-inclusive stakeholder platform, using a collective impact approach to address challenges surrounding Early Childhood Development in Nigeria, and Africa at large.’’
And like the Global Nutrition Report, 2016 says, ‘‘malnutrition is the new normal. But it doesn’t have to be.’’
