Samfya struggling with malnutrition

Children in Samfya in Kasuba community

DOREEN NAWA, Samfya
DESPITE being one of the best tourist attractions Zambia has, Samfya district probably has one of the highest malnutrition statistics in the country.
It only takes a trip to one of the villages to discover the dire situation that many children are living under as parents struggle to ensure they provide the much needed nutrients for the healthy growth of their infants.
According to nutritionists, children need about 40 nutrients to maintain normal health for without nutrients children become malnourished.
Civil Society Organisations Scaling up Nutrition Alliance (CSO-SUN) estimates that about 300 children succumb and die due to malnutrition annually in Samfya district alone.
Sad as it may be, this is a reality as it is a legitimate part of the story of food insecurity in rural areas in Zambia.
Chief Mwansakombe of Chifunabuli constituency says, “I have seen first-hand the consequences of malnutrition in our communities. Every year, nearly 300 deaths of children can be traced to malnutrition in Samfya District. These are children who should grow up to be the leaders of tomorrow.”
Chief Mwansakombe says communities lack knowledge on issues to do with nutrition.
“Our people are unaware of the problem of malnutrition and its solutions. We need to change the mind-set of our people in order to improve nutrition. Our women need to have basic knowledge about exclusive breastfeeding for six months after giving birth, the importance of varying diets and adequate water and sanitation practices.  This knowledge will empower the community to demand for better nutrition,” he said.
The traditional leader has since urged Government to maximise coverage and access of nutrition programmes in order to benefit the rural populace.
Malnutrition is depriving families of the chance to get out of poverty. Young women, who are malnourished, grow up to have malnourished children thereby continuing this vicious cycle.
For Chief Mwansakombe, the solution requires combined efforts from the community.
“Some people feel that the responsibility of child nutrition is for the mother. This perception is ancient and redundant; and anyone with such attitude should be ex-communicated from our local communities. Fathers, who are responsible and love their children, should take keen interest in the nutrition of their children at all times,” he said.
The traditional leader said parents should work to ensure their children are well fed on a daily basis.
With an estimated 87 percent of the population in Samfya being rural farmers, implementing practical and sustainable rural empowerment initiatives like knowledge sharing should be an urgent point in finding the answer to ending malnutrition.
While policy can have a positive influence, there is need to support practical and sustainable rural empowerment initiatives like knowledge sharing as the first step on the long road to establishing sustainable nutrition in Samfya district and other parts of the country.
For CSO-SUN country coordinator William Chilufya two salient efforts that can be used to sustainably address the above nutrition challenges are an approach that empowers families and communities to sustainably improve nutrition and make prevention and treatment of malnutrition possible within the community.
“We need the togetherness kind of approach in order to address malnutrition in various rural areas countrywide. We need to put up initiatives that will empower communities to learn to recognise malnutrition cases and treat them with supervised supplemental feedings of locally available, nutrient-dense foods,” Mr Chilufya said.
For Mr Chilufya, this approach strengthens the delivery of quality nutrition services to children below five years, pregnant and lactating women by promoting their use at both facility and community levels.
It increases support to prevention, case-finding, treatment and rehabilitation of malnutrition among women of reproductive age and their children at community and facility levels. This contributes to a reduction in maternal, child malnutrition and mortality.
And Esnart Mutale, a resident in Kasuba community in Chief Mwansakombe’s area and also a mother of five says a community involvement approach to addressing malnutrition is appropriate in Samfya since most health facilities are not adequately equipped with supplies and trained staff to treat malnutrition.
Mrs Mutale says with limited facilities to provide nutrition services and inadequate referral systems, parents with malnourished children have to trek longer distances to receive services.
“Most families lack means to support numerous trips to a health centres, nor can we afford the costs of being away from our home for the long periods of time required to treat malnutrition in a health centre,” Mrs Mutale said.
Nutrition education in Zambia is low. While the Ministry of Health tries to inform and educate mothers on good nutrition, this seems to be restricted to pregnant women who attend antenatal clinics.
Time allocated for nutrition education when women go for antenatal is too limited to provide adequate information to the women.
Compounding the problem further is the fact some pregnant women with low formal education cannot comprehend nutritional technical issues as they affect the child’s physical and mental growth.
Those with low formal education levels also tend to ignore formal and technical information they are provided with at such forums.
If mothers are to benefit from the nutrition knowledge offered in health facilities there’s need for more time and use of simple, local language. They also need nutrition education campaigns not only when they are pregnant but also at any time in their lives.
Nutrition education can include information on optimal infant and child-feeding and care practices, advice on hygiene and sanitation, and the prevention of illness, and psycho-social support.

There is life after a fistula

Jessy after fistula

Jessy being attended to at the hospital

DOREEN NAWA, Lusaka
FOR most Zambia’s rural populace, marrying off an adolescent girl is looked at in terms of monetary gains or indeed it being good riddance from the responsibility of looking after the girl.
For Jessy Chirwa, 19, because of extreme poverty in her community, she engaged herself into a relationship at 14 years.
Jessy was just 14 when she got pregnant. A community leader and father of two lured her into his room and impregnated her after giving her money. It was Jessy’s first sexual experience.
The man took responsibility of the pregnancy and accepted to marry her.
In a small village in Mumbwa, west side of Lusaka, Jessy, an orphan since the age of six, was left in the custody of her grandmother after the death of her parents.
In most rural areas countrywide, medical care is hard to come by, she carried her baby to full term.
When the time came for her to give birth, Jessy was at home by herself. Just several kilometres away was a medical centre but she was unable to reach it.
“My labour started around 03:00 hours. Because I was the younger wife, I could not walk from my house to go and wake up my husband who was sleeping at his senior wife’s house. It was after 10:00 hours that he showed up and I told him how I was feeling. He then took me to the nearest health centre.
“I didn’t have the bus fare to get to the nearest health care facility so we used an oxcart. When I got there, I was left unattended to for several hours too because the medical staff had gone to Lusaka to get their salaries,” Jessy said.
She was then rushed to Lusaka’s University Teaching Hospital where she underwent caesarean section just to remove the dead baby so as to save her life. She gave birth to a stillborn baby boy.
Such an intense labour, without medical assistance, placed strain on both her and the unborn baby.
Four days later, Jessy realised she was no longer able to control her bodily functions.
She couldn’t control her urine whenever she sat, walk or lying in bed. Her urine just leaked uncontrollably. She was later treated and went back to her village. Unfortunately, her husband divorced her because she could not give him a son.
The stigma attached to having fistula means women stand to lose a lot more than just their careers – partners and families often disown them because of the perception of uncleanliness, and the mistaken assumption that they’re suffering from venereal disease.
The condition is called obstetric fistula, a severe medical condition suffered by many African women, Zambia inclusive.
A study by World Bank has shown that in Zambia, girls aged between 15 to 19 who are sexually active, increased their chances of having fistula by more than 75 percent.
Obstetric fistula is both preventable and treatable, yet it still plagues the lives of many women living in poverty in developing countries.
With little reproductive health education or access to medical support, this relatively unknown and taboo condition regularly goes untreated, as women believe the symptoms are normal after giving birth.
It is now widely accepted that keeping girls in schools, especially, ensuring that they complete at least primary education, contributes to women empowerment, curtails harmful traditional practices such as child marriage, promotes gender equality and reduces incidences of maternal morbidity and mortality, including obstetric fistula.
In the past, the taboo nature of the condition prevented many sufferers from receiving the treatment they needed. But this is changing following commitment from Governments and various cooperating partners.
Minister of Gender and Child Development Nkandu Luo says poverty has contributed to the high number of adolescents getting pregnant, dropping out of school and early marriages.
Prof Luo said because of such vulnerability, adolescent girls aged between 10 and 19 have fallen prey to having sex early.
“Poverty has a female face and it’s worse among adolescent girls. The levels of poverty have led to these girls engaging in early sex resulting into not only dropping from school but also complications like fistula,” she said.
Prof Luo said child marriage can have devastating consequences for a girl’s health.
“Child marriage encourages the initiation of sexual activity at an age when girls’ bodies are still developing and when they know little about their sexual and reproductive health. Neither physically or emotionally ready to give birth, child brides face higher risks of death in childbirth and are particularly vulnerable to pregnancy-related injuries such as obstetric fistula,” Prof Luo said.
And World Bank country director Kundhavi Kadiresan said delaying early sexual debuts and reducing early marriages among adolescents will reduce and prevent chances of girls having Fistula.
Dr Kadiresan says it is extremely difficult for child brides to assert their wishes and needs to their usually older husbands, particularly when it comes to negotiating safe sexual practices and the use of family planning methods.
“When a girl marries as a child, the health of her children suffers too. The children of child brides are at substantially greater risk of perinatal infant mortality and morbidity, and stillbirths and newborn deaths are 50 percent higher in mothers younger than 20 years than in women who give birth later. There is little doubt that reducing child marriage will help to ensure more children survive into adulthood,” Dr Kadiresan said.
Dr Kadiresan said educating and providing employment opportunities to girls will reduce poverty among them.
“If girls attain high levels of education, this reduces or indeed delays their chances of getting married early. Opportunities to engage young women should be optimally utilised to enable mainstreaming of obstetric fistula messages into routine services such as antenatal and postnatal care services,” Dr Kadiresan said.
Dr Kadiresan said successful integration of family planning messages needs to be implemented with community based maternal health services such as antenatal and postnatal counselling services in rural areas countrywide.
Improving the health and wellbeing of adolescent girls and enabling them to avoid early marriage is a transformative way to improve maternal health around the world.
THIS STORY WAS PUBLISHED IN THE ZAMBIA DAILY MAIL ON MAY 10, 2015.

Zambia and IFAD sign deal

THE Republic of Zambia and the United Nations International Fund for Agricultural Development (IFAD) signed a US$14.23 million loan and $0.87 million grant agreement to finance the Enhanced Smallholder Livestock Investment Programme (E-SLIP).
The E-SLIP financing agreement was signed today in Rome by Pamela C. Kabamba, Permanent Secretary of Ministry of Finance of the Republic of Zambia, and by Kanayo F. Nwanze, President of IFAD.
In Zambia, livestock is an important sector, contributing to poverty reduction, household food security and nutrition, in particular by providing high-quality proteins. This makes livestock a useful tool to mitigate the effects of malnutrition and HIV/AIDS. In addition, the sector contributes greatly to the economic growth and exports incomes.
However, the sector is constrained by livestock diseases, lack of expertise in modern livestock husbandry practices and a limited genetic pool, Additional constraints include, limited access to knowledge and infrastructure for marketing value addition.
The E-SLIP is designed to address the critical gaps in Zambian livestock sector services and technologies. These include the control of key cattle diseases that are limiting smallholder herd growth, and forage production for improved livestock health and productivity. In addition, the programme will enlarge and enhance the Ministry of Agriculture and Livestock’s restocking programme for poor smallholder farmers, an important pathway to pull them out of poverty.
“This new programme will scale-up the closing IFAD-supported Smallholder Livestock Investment Project, which has provided valuable support to the Zambian livestock sector through strengthening the government capacity for animal diseases control and reducing the incidence of the east coast fever and contagious bovine pleuropneumonia, two of the main causes of cattle mortality for smallholder farmers in Zambia,” said Abla Benhammouche, IFAD Representative and Country Director for Zambia.
“It will also improve sustainably the production and productivity of key livestock systems of the targeted smallholder producers in the programme areas.”
With a total cost of $46.3 million, E-SLIP is cofinanced with a $10.6 million contribution from the Government of Zambia, an $8.6 million contribution from the beneficiaries themselves and a $12 million funding gap for which discussions are ongoing with potential cofinancers such as OPEC Fund for International Development.
It will be managed by the Ministry of Agriculture and Livestock of Zambia and will directly benefit 180,000 poor rural livestock households that are raising cattle, goats, pigs and poultry. It will particularly benefit women and young people headed households, improving their economic activities and livelihoods. In addition, about 900,000 farm households that raise livestock will benefit indirectly from the programme disease control and technology development.
Since 1981, IFAD has invested a total of $203.6 million in 14 programmes and projects in Zambia, amounting to $320.5 million when cofinancing is included. It is estimated nearly 960,000 Zambian rural households have benefitted from these efforts so far.