Sarah survived Malnutrition

December 03rd, 2017 Honiara - Sitting on her grandmother’s lap looking around with sad eyes, eighteen-month-old Sarah looked tired. Her abdomen was bloated and her arms and legs were thin, her straight, blond hair was brittle, her face was wrinkled and her skin was rough and thick with multiple scars all over her body. Sarah could not stand or walk. 

The World Vision Maternal Child Health and Nutrition (MNCHN) project team and village health volunteers (VHV) first met Sarah in the Reef Island, Temotu Province, Solomon Islands in July 2016.

The Reef Islands are beautiful but life is tough. Jobs are scarce, the cost of living has increased and it is challenging for families to support their children. Sarah’s mother left her in the care of her grandmother, Margaret, to travel to Western Province in search of employment.

The MNCHN project, supported by UNICEF and World Vision New Zealand, aims to improve the health of pregnant and lactating mothers and children aged up to five by providing nutrition information and access to health services. The project is implemented in selected communities on Santa Cruz Island and the Reef Islands.

Village health volunteers work alongside registered nurses at the community level to keep track of pregnant and lactating women and newborns in the community to ensure they are up-to-date with antenatal and postal care. Part of their responsibility is to help parents monitor their children’s health and raise awareness in regards to eating a healthy diet and living a healthy lifestyle.

World Vision staff who met Sarah during the first visit in July 2016 encouraged Margret to take Sarah to the nearest health centre, which is a two to three-hour walk from the community. They also gave advice on the types of food Sarah needs. The appointed village health volunteers, who were part of the first visit with Sarah, identified Sarah as malnourished based on her symptoms and overall health. 

A few weeks later, in early August 2016, a monitoring and evaluation team comprising of World Vision staff, village health volunteers and UNICEF staff visited the same community after the first infant young child feeding training session with the village health volunteers. They once again met Sarah. Sarah’s weighed 7.9 kilograms and mid-upper arm circumference measurement (MUAC) was 7.4 centimetre when she should be weighed 10.6 kilograms and MUAC at 12 centimetres. She was aged one year and seven months at that time.

The team provided food for Sarah, conducted counselling for her grandmother and delivered awareness and demonstration sessions on cooking and the importance of a balanced diet. Other mothers in the village also attended the session.

The visiting team encouraged Margret to take Sarah to the clinic and encouraged the village health committee and village health volunteers to provide ongoing support and guidance to Margaret so she could care for Sarah and provide her with balanced meals. 

The sessions have proved helpful. For Margret, she learned how to prepare balanced meals. 

“Before and after the first visit from the team, I didn’t realize Sarah’s health problems were severe. I knew she was not well but I thought she would be fine after a few days. I did not take her to the clinic because the clinic is too far, I am also weak. It was after the second visit that I realized Sarah could die because of her current health condition. Sarah eats but sometimes rejects the food I prepare for her. But she is improving.”

“I prepare cabbage, kumara, fish and pawpaw for Sarah,” said Margret.

Margret was happy to see Sarah’s health improve and now has more confidence in taking care of Sarah.

Sarah has grown strong and healthy.  She has recovered from her skin infections. She has been seen running, playing and swimming when World Vision and UNICEF staff have visited her village.

World Vision staff member, Alfred Niene, has followed up with Sarah and her grandmother to track Sarah’s progress. In November 2016, she weighed 8.6 kilograms, compared to 7.9 kilograms in August 2016.  In March 2017, Sarah weighed 10.3 kilograms. She looked brighter, her hair was shiny and she was walking, talking and playing with other children. By August 2017 her weight had increased by a further 0.3 kilograms and mid-upper arm circumference measurement was 15.5 centimetre.

World Vision Solomon Islands Health Technical Specialist, Everlyn Darcy, said, “Sarah is gaining weight and is getting stronger and more active. Sarah’s is no longer under-weight but in the normal range weight, her MUAC had increased and no longer wasted but she is still severely stunted for her current age and that should pick up after a year. She looks brighter than before and shows improvement each time, thanks to the help of the VHV, the Village Health Committee and the community members who support Margret in looking after Sarah. There is also a broader positive impact on many other children in this community.”