Christine Ennulat , ChildFund International
The courtyard of a compound in Mbour, Senegal, is a hive of activity. At first glance, it looks like a party — brightly dressed mothers and children dancing to energetic drumming, a few women nearby stirring an enormous communal bowl, a few more chatting around a table as they set up jars, papers and equipment.
But not all of the children are dancing. Some toddlers sit quietly, leaning back in their mothers’ laps, watching the activity with their mouths hanging slightly open. They look like small old people, with shadows under their eyes and their clothes loose around their fragile shoulders.
These children are the reason for this gathering, part of a 10-day nutrition and recovery workshop. “All 12 of the babies here today are recovering from malnutrition,” says Saly Loum, a ChildFund-trained community health volunteer who is one of several leaders for the event. “We gather the children with their mothers to teach the mothers how to cook some meals and how to help their children overcome the malnutrition. When they return home, they will practice what we teach them here.”
The workshop is part of a USAID-supported community health program led by ChildFund, to establish community health care services for Senegal’s children and families in need. Trained health volunteers, locally known as relais, provide basic care and referral services through more than 2,000 health huts and 1,700 outreach sites nationwide. They also work to educate their communities about preventive health, whether at the health huts or through home visits and events like this one.
“In Senegal, you have about 50 percent of the population below the poverty line,” says Agbessi Constant Tchona, program director for ChildFund Senegal. “We also have a high child mortality rate caused by things like malaria, diarrhoea and pneumonia. Extreme hunger is very prevalent in the country. A child who does not receive proper nutrition will not be a healthy child.”
Saly adds, “A malnourished child is lonely. And this can affect his intelligence and his results at school — his ability to play.”
The nutrition and recovery workshops include growth monitoring, nutrition education and individual counselling, delivered with song and dance and a meal.
A hanging scale is set up near the table covered with papers, medicines, jars of preserves and packs of beans and flour. A pair of relais weighs each child. Then, mothers and children have a seat at the table, where another relais measures their arm circumference, assesses them for other symptoms and provides counselling as needed.
A young mother, frail herself, listens as a relais explains the worrisome measurements just taken on her 1-year-old, who droops in her lap, staring into space.
“If you use the enriched flour we are giving you and follow the instructions in the workshop,” the relais is saying, “God willing, she should achieve normal weight within 10 days.”
Meanwhile, a few feet away, Saly discusses breastfeeding with several mothers who have settled on a large straw mat near where the meal is being prepared. Some of them breastfeed their children. One mother, whose twin daughters’ hair shows malnutrition’s tell-tale orange tinge, struggles to quiet her fretful toddlers so she can listen. “In the first six months, breastfeeding gives the child all the nutrients he needs,” Saly says. “We should continue breastfeeding even after six months, up to two years.”
Soon it’s time for the meal, and mothers and children dig in. Within minutes, there are a dozen messy faces.
“Today, we prepared a rich porridge — rice, peanuts, smoked fish, beans and oil,” Saly explains later. “We teach the mothers the importance of each ingredient, the helpful vitamins in each. This meal helps the child to have much more energy, and to grow.” The mothers love their children, she adds, but they don’t have good feeding practices; traditionally, the smallest children are allowed only the rice from the family bowl.
One mother stands at the edge of the group, blowing raspberries into her little boy’s neck. His eyes light up, and his laughter sounds like bells.
Kumba Diop, another relais, tells his story. “Ndiaga suddenly lost a lot of weight, got very sick and was hospitalized,” she says, and explains that the 11-month-old had picked up an intestinal parasite that disrupted nutrient absorption to the point that he became severely malnourished. “He was in such a desperate situation that it’s hard to believe Ndiaga is still with us today.” That was just 10 days ago.
Ndiaga’s mother, Awa, knew only that he was sick, not that it was a problem of nutrition, says Kumba. “After home visits and nutrition workshops from ChildFund, Ndiaga’s mom now knows what he needs to be healthy.”
Saly smiles at the end of another rewarding morning. “The more we work here in the community, the more the rate of malnourished children falls. It’s really encouraging.”
Christine Ennulat, ChildFund International, February, 2014