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Frontline community workers help battle malnutrition, encourage mothers to breastfeed children

While nutrition centres provide therapeutic food to treat malnutrition, mothers are counselled on the nutritional benefits of breastfeeding

By Robin Giri

Maluakon, South Sudan – The shy mother turns her head the other away when asked how often she breastfeeds her child. Her child lies limp on her arms, as she is prodded again by the nurse aid, and then responds in her native Dinka.

“Oh, that is not enough,” says Winnie Dieto, the nurse aid at the Maluakon Outpatient Therapeutic Programme centre in Aweil. “You need to breastfeed more often, along with the other foods.”

Winne points to the posters plastered around the wall of the nutrition centre, which have simple illustrations on the benefits of breastfeeding and on infant and young child feeding practices.

The shy mother is 20-year-old Abiyak Dut. She bites her lower lip and nods, her eyes bright with hope, as she holds 14-month-old Awar Aduil, now fast asleep.

Little Awar is Abiyak’s third child; she has two older children aged six and three at home. Four weeks ago, Awar was diagnosed with severe acute malnutrition and referred to this nutrition centre.

“She weighed only 6 kilos four weeks ago, and today when we weighed her, she was 7.2 kilos,” says Winnie.

For the last three weekly visits, Abiyak was provided each time with a supply of 14 sachets of highly fortified Ready to Eat Therapeutic Food which is used to treat children suffering from severe acute malnutrition.

Although Awar has gained some weight in the last four weeks, it is not enough. The nurse aid and the community nutrition workers at the Maluakon nutrition centre want Abiyak to feed little Awar more often.

Severe acute malnutrition is a very serious condition among children under five. If untreated it can lead to more health complications. It can kill a child as the body doesn’t have the strength and the immunity to fight simple illnesses such as diarrhoeal diseases and pneumonia.

Food insecurity and malnutrition are at the highest levels since South Sudan gained independence 10 years ago. Some 60 percent of the population is severely food insecure with families unable to feed themselves because of the compounded effects of conflict, displacement, massive flooding, the economic impact of COVID-19 and rising poverty.

In 2021, UNICEF estimates that 313,000 children under five years of age will be affected by sever acute malnutrition in South Sudan.

Additionally, even when food is available, many mothers like Abiyak, lack the knowledge about correct feeding practices and how to prepare nutritious foods, with existing food sources. Many of them are unschooled and become mothers at an early age, often in their early teens. They lack experience and are often unaware of basic health and nutrition measures, including breastfeeding, which they could easily implement at home.

Fortunately, severe acute malnutrition can be treated. UNICEF procures therapeutic foods and lifesaving medicines to treat common childhood illnesses and other medical supplies to 1145 centres nationwide.

At the nutrition centre, Abiyak is also counselled by Nyibol Awaya, who is the relapse nutrition worker.  Nyibol explains how to prepare nutritious foods with the available resources and most importantly, tells her to continue breastfeeding.

“Many times, the problem is not that there is not enough to eat. It is the lack of knowledge by young mothers on how often to feed and on the importance to continue breastfeeding,” says Ms. Nyibol.

The community nutrition workers are trained to detect malnutrition among children, and provide treatment referrals to nutrition centres, like the one in Maluakon. Additionally, they also provide messages on the importance of clean water, hygiene, and sanitation, which prevents diarrhoea and other communicable diseases that afflicts children and contributes to malnutrition.

“Today, I learned how to make healthy food for my children. I will feed the therapeutic food to Awar and continue to breastfeed her and come back next week so you can check on her,” says Abiyak, sounding a little more confident.

While treatment is key to fighting acute malnutrition, UNICEF and the Ministry of Health are focussing on preventing malnutrition in the first place. The nutrition programme supports the training of community nutrition workers, who are the actual warriors in this campaign. They counsel mothers and caregivers on proper feeding and on increased breastfeeding, which will help to prevent malnutrition in the first place.

To commemorate Global Breastfeeding Week, the Ministry of Health and UNICEF have joined hands with many partners and have called upon mothers, fathers and policy makers  to work as one to promote exclusive breastfeeding of children up to six months, and continued breastfeeding until the child turns two. 

UNICEF thanks donors such as the European Union, European Humanitarian Aid (ECHO), UK Aid, USAID and the Government of Canada for their support to the WASH programme in South Sudan.

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