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Esther smiles again after her one-year old baby is cured of severe acute malnutrition by UNICEF and partner

By Irene Nabisere, UNICEF Uganda

Esther Amony (20 years) and her family are part of over 150,000 South Sudanese refugees living in Bidibidi Refugee Settlement in Yumbe District, West Nile. Dressed in a coffee brown skirt with patterns of white, orange and brown and a black blouse, Amony is at her new home, preparing a meal for her family as she waits for the husband who enrolled in primary school with their two children to return. Esther has 3 children, her first born is 5 years delivered at 15 years. The second born is 4 years. Even after getting displaced by the war in South Sudan, she is happy her family is alive and healthy while in Uganda.

As the situation deteriorated in South Sudan in July, Esther and her family had to seek refuge and their destination was Uganda. Her last born, Lakot James aged one and half years suffered from severe acute malnutrition. “We walked for over eight hours from Serotenya to Madi Opei border in Lamwo District. We lacked food for several days and did not have enough breast milk for Lakot,” narrates Amony. At the screening point in Nyumanzi transit centre in Adjumani district, Lakot was found to have marasmus upon her arrival on 10 August, 2016 and was referred to a health post. He was given Vitamin A to boost his immunity and deworming to prevent worm infestation.

Due to congestion at the centre, Amony and the family were relocated to Bidibidi settlement in Yumbe district a day after their arrival. As soon as they reached Bidibidi reception centre, Lakot’s condition worsened. He was admitted to the UNICEF and Concern Worldwide Inpatient Therapeutic Feeding Centre (ITC) where he stayed for 8 days.

Lakot weighed 6.6kgs with with a mid-upper arm circumference (MUAC) of 10.9cm, suffered severe diarrhoea, vomiting and fever. He was given therapeutic milk, amoxicillin, rehydrated with RESOMAL (Rehydration salt for the malnourished and weighed daily). After two days, Lakot’s situation worsened. He lost appetite and stopped feeding. The clinicians and nutritionists introduced nasogastric tube (NGT) for nutritional feeding support with stronger antibiotics to ensure continued feeding; and to stop any other underlying infections. On the fifth day, Lakot started to recover. On the eighth day, Lakot was transferred to Out-Patient Therapeutic feeding centre (OTC) where he was given plumpy nut, antibiotics and the mother received counselling on infant and young child feeding. “I fed Lakot as was told by the nutritionist. I took my recommended food rations and was able to breast feed Lakot again in addition to the plumpy nut and antibiotics,” said Amony, Lakot’s mother. Within two months, Lakot was discharged from OTC through supplementary feeding program for monitoring. He was weighing 8.7kgs with a MUAC of 13.0cm.

Charlotte Nakate, a nutritionist with Concern Worldwide a UNICEF partner they were amazed at how fast Lakot responded to treatment. “It usually takes a child three months to recover but Lakot’s mother did everything as recommended hence the quick responsiveness to treatment,” Nakate says. At ITC, Mothers who had witnessed Lakot on admission were astonished by the quick recovery and requested for the NGT even those that did not need it. Mothers were sensitised on the ITC programmes.

Amony has a backyard garden where she planted beans, maize and potatoes in order to supplement food rations provided by other partners also to ensure nutritious food intake for her family. She is able to harvest the dark green leafy vegetables for a nutritious diet.

Wilson Kirabira, UNICEF Nutrition Officer, Gulu Zonal Office says that the UNICEF curative and preventive nutrition programmes help to have healthy children. The curative programme includes Children in ITC and OTC are able to respond quickly due to quality treatment, monitoring and follow up of cases to household level by UNICEF and its partners Concern Worldwide and District Health staff. Preventive programme includes maternal, infant and young child feeding counselling, micronutrient supplementation through vitamin A to boost immunity and deworming to avoid worm infestation and counselling mothers on proper feeding habits. Majority of the children enrolled are cured.

The nutrition situation among the South Sudanese children has seen improvements from 2014 when they first arrived in Uganda to date. In 2014 GAM (Global acute malnutrition) was at 19.5% with a SAM (Severe Acute Malnutrition) at 4.5 %. Based on the latest Food security ans Nutrition assessment in refugee settlements, GAM is now at 9.4% below the WHO emergency threshold. Thanks to support from UNICEF, WFP and other partners. In 2016 UNICEF was able to provide treatment to estimated 5600 children with SAM (about 90%) of the caseload. UNICEF provides technical, financial and material support to districts to support these nutrition interventions.

UNICEF supports refugee children in humanitarian action with WASH, Education, Health and Child Protection services as stipulated by the UNICEF core commitments for children in humanitarian action global framework that promotes predictable, effective and timely collective humanitarian action to fulfill the rights of children affected by humanitarian crisis.

UN Agencies in Uganda