Carmel Lawry has been working with nurses at Holy Family Care Clinic in South Africa to address malnutrition. As this past week we recognised the International Day for the Eradication of Poverty and World Food Day, Carmel’s experience in this clinic demonstrates the multifaceted causes of poverty, and the importance of linking health, community, and nutrition services to ensure practical treatment plans are followed.
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By Carmel Lawry
In 2016, the South African Demographic Health Survey found that 27% of children under five were stunted. This is a sign of chronic malnutrition that compromises not only children’s growth but also their cognitive development, education and employment chances.
Holy Family Care Centre is admitting many children who have multiple health issues including HIV/Aids and tuberculosis. Currently, six of these children are also malnourished and stunted in their physical growth. Due to varying home situations, the children have “defaulted” multiple times from their medical treatment and have been extremely ill and hospitalised for many weeks, sometimes months. Two children now have chronic lung diseases associated with not receiving their medications and will never have the capacity to run around and play sports like the other children.
Growth-promoting activities need to extend beyond simply weighing a child and plotting their growth to ensuring that hungry or malnourished children are linked to food provision, community health services and social assistance. Holy Family Care Centre provides these links
Here at Holy Family Care Centre, I have been teaching our auxiliary nursing staff to read growth monitoring charts and to interpret where each child lies is on the malnutrition/stunting stage. With this understanding, together we have been able to design special diets and nutritional daily supplements to promote growth in the children who are compromised. We have the clinic set up so the nurses can cook and prepare special foods ensuring a well-balanced diet.
The children are so de-conditioned it can take years for weight and strength to increase.
We celebrate every little weight increase!
A real example is a little girl “Matamela” admitted to Holy Family in 2016. “Matamela’s” condition was high risk due to a cleft palate, cleft lip and oronasal fistula – the risk of aspiration was extremely high and she was also living with HIV/Aids. On admission, this 2-year-old weighed 6.7kg – 5 kg below the median weight expectation for her age. Two other Palms Volunteers- Clare Lourey and Jules Hanrahan were here during critical times of her surgery in 2017 and assisted to keep this little one moving forward. “Matemala” now 4 years old weighs a “whopping” 13.5kg (still a little underweight) but after two major surgeries she is thriving, playing, talking and learning.
Special diets and nutritional supplement regimes have been so important in managing Matamela’s growth. Never underestimate the value of peanut butter, bananas and age-appropriate powder supplements along with specially prepared meals to promote weight gain – slowly but surely. It is also important that her meals are culturally appropriate and to make use of available seasonal foods.
The nurses are receptive and value the teaching I am providing. The results are evident in the practical application of their learning. Resources have been made available and Holy Family is fortunate to receive donations to help purchase special supplements.
Above all else, Holy Family Care Centre through the staff’s care and love can help these sick, malnourished children and see them eventually grow, play and even begin or return to school.