Malnutrition grips Qacha’s Nek

QACHA’S NEK – WHEN ’Matšepo* went to South Africa to check on her nephews, a local hospital was one her first stop.

Her nephews, 19-months-old and seven-years-old, were swollen from malnourishment that she immediately took them to a nearby clinic. They were referred to Machabeng Hospital “because their situation was critical,” said ’Matšepo.

The boys’ mother allegedly abandoned them when she fell-out with her husband where they were staying in South Africa.

’Matšepo said the boys were diagnosed with malnutrition, a condition common among vulnerable toddlers.

Children aged between seven and 18-months-old are said to be most susceptible to acute malnutrition and waterborne illnesses, which makes them most vulnerable to rapid dehydration, infections and death.

“The second-born’s condition only got worse. His belly made some sounds and it swelled. When he was hungry, there was no way to stop him while crying. We did not know why he would cry and we did not know it was an illness until it was spotted and diagnosed. The second day at the hospital, the youngest succumbed to malnutrition,” ’Matšepo said.

The two boys stayed with their parents in South Africa before the fallout earlier last month.

“Just after their fallout, my sister-in-law brought them (already sick) to stay with my parents together with their 13 and seven-years-old cousins,” she said, adding that the seven-months-old who later died was still breastfeeding when his mother abandoned them.

“There was no milk to feed him,” she said.

“My parents already struggled to make ends meet as my mother sometimes brews fermented beer to put food on the table,” ’Matšepo said, adding that it was their ninth day at the hospital and “my (remaining) nephew is recovering well”.

“He is better than how he was when I first brought him here as the swelling is slowing down. I am happy I went to see them as soon as my mother told me about their state.”

The Machabeng Hospital nutritionist, ’Mapoulo ’Moso, expressed worry about the escalating cases of malnutrition in the district that are making stunting the dominant symptom.

She said malnutrition is caused by inadequate food intake, poor quality of diet and when the body is not able to use the consumed food.

She said people vulnerable to malnutrition are people living with HIV/TB, people who diet the wrong way and children under two years old because in the first six months they are expected to be breast-fed.

“Often that is the challenge and at that age, children are already being given a variety of food not just breast milk and they end up malnourished,” ’Moso said.

“Even when they are supposed to eat after six months, their diet is poor leading to malnutrition due to lack of nutrients they need to grow,” she said.

She said symptoms of malnutrition include short stature (stunting), getting ill often and taking a long time to recover and poor concentration in class among others.

She said as nutritionists, they give children under two years supplementary food to curb malnutrition.

Also, when a child is diagnosed with malnutrition, she said they are given a ready-to-use therapeutic food specifically formulated for the nutritional rehabilitation of children “although we currently do not have such commodities”.

She said on a monthly basis, children are weighed by Village Health Workers (VHW) to monitor their growth and once they are seen to be malnourished, they are referred to the nearest health centre.

The Qacha’s Nek District Medical Officer, Dr Thapelo Ramatseka, said malnutrition is proving to be a daunting challenge in the district and at times the children’s ward gets full with such patients.

“It is saddening because the said food is only provided at the hospital until one is released,” Dr Ramatseka said, adding: “It is a temporary solution because permanent treatment is found at home where the challenge is lack of food.”

He said stunting can be prevented in the first 1,000 days of a child’s life.

“It is our responsibility to solve that,” he said.

Dr Ramatseka said Qacha’s Nek, Mokhotlong, Mohale’s Hoek and Thaba-Tseka are the most affected districts.

Reports show that two in every five children under five-years-old are malnourished in Lesotho. Meanwhile, King Letsie III who is the African Union Nutrition Champion and also serves as the African Leader for Nutrition (ALN) Champion, said Lesotho takes seriously its goal of ending malnutrition.

He was speaking at a High-Level Forum on Nutrition Financing event held in Maseru in late March where he hosted leaders from across the continent

“Lesotho takes seriously the continental decisions to prioritise nutrition in their economic and social development programmes. She will ensure that nutrition programmes and activities get sufficient attention in the planning and budgeting processes of the ministry,” the King said.

He said Lesotho is embarking on the establishment and revival of nutrition plans at the community level.

“Extension workers conduct training for nutrition clubs through nutrition, education and demonstrations on production, storage, processing and preparation of food,” he said.
Speaking at the same event, Prime Minister Sam Matekane said nutrition is core to health, well-being and economic development of this continent.

“We can all agree that we can no longer look at nutrition as an issue of food production, yet it involves every sector within the cycle of food systems, that is, from farm to fork,” Matekane said.

Matekane said in an effort to contribute to the continental efforts, Lesotho decided to keep the nutrition coordinating body, the Food and Nutrition Coordination Office in the Office of the Prime Minister to track food and nutrition programmes carried out by implementing agencies.

He said the Senate took a decisive step to form a Health and Nutrition Portfolio Committee, while in the Lower House all portfolio committees are dedicated to supporting food and nutrition initiatives.

“The government is engaged in various food and nutrition initiatives that are meant to address malnutrition at grassroots level,” he said.

“Most food and nutrition initiatives in this country are undertaken with the support of development partners, donors and civil society organisations.”

He said he will ensure that the private sector takes its rightful spot in the fight against malnutrition.

“Let us join hands as governments, legislature and the private sector in combating the effects of malnutrition across the African continent,” Matekane said.

“Let us also remember that coordination, collaboration and multi-sectoral approach are key in achieving better results for all Africans.”

The United Nations Resident Coordinator, Amanda Khozi Mukwashi, said the Covid-19 pandemic has reminded them that without health, there is no future and no life.

“The consequences of the frequency and intensity of shocks caused by climate change are being experienced in our lifetime, leading to loss of life, displacements, damage to crops and livestock and causing food insecurity for those already vulnerable and marginalised,” she said.

She said current estimates indicate that most countries will not achieve internationally agreed nutrition targets by 2025 either.

“These challenges are plenty and find Africa in an already weakened state of development.”

Following the endorsement of the Abidjan Declaration to “Accelerate investment, implementation and coordination to improve nutrition and food security in Africa”, she said the gathering “is crucial to capitalize on the growing political momentum on nutrition and to develop evidence-based policies and supportive financial instruments that provide impetus for more sustainable food systems (nutrition included) and healthier diets.”

Achieving and sustaining nutrition progress in the continent requires investments, policy coherence and coordinated action among multiple stakeholders (including leveraging our communities, knowledge and traditions of healthy food practices) and across multiple sectors, including health, agriculture, social protection, education, and WASH to mention but a few.”

She added: “Not tackling the issue of nutrition and food systems will impact on productivity, delay economic growth, increase financial burden on the health systems and impede education for many children. Whatever the decision/choice, let us be clear that there will be a cost.”

’Mapule Motsopa