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How ignorance fuels child malnutrition in Imo State

By Chioma Obinna

In her arms lay a tiny baby wrapped in an overall. Only  those standing close to her could see him. Intermittently, he screamed like a helpless puppy.  No one but the parents understood his pain. At eight months, Eme ka Ibe, of Ezinihite, Mbaise, Imo State, cannot sit or crawl. Unlike his peers that may have begun to stand and even take  their first steps, Emeka’s  skinny body and yellowish hair are indications that all is not well with him.   He is suffering from Severe Acute Malnutrition, SAM.

MALNUTRITION: Emeka and his mother Mrs. Juliet Ibe, a victim of malnutrition in Imo State.
MALNUTRITION: Emeka and his mother Mrs. Juliet Ibe, a victim of malnutrition in Imo State.

“He is my 5th child and eight months old but I don’t know what happened to him. I did what I was expected to do during pregnancy and took all the necessary drugs,” his mother, Juliet Ibe, stated. Emeka’s condition gives an insight into the plight of thousands of families across the length and breadth of the country even as UNICEF reports show that 2.5 million Nigerian children are severely malnourished.

Small from birth

“At birth, he was so small, and due to his low weight I thought breastfeeding would aid his growth, so I breastfed him for two months and introduced infant formula with water. Juliet confessed there have been times she felt like rejecting the baby, but couldn’t. “None of my children presented like this. My first daughter also weighed 2.5kg at birth, but my son does not take enough breast milk.  Right now, I am feeding him milk and pap.”

At birth, Juliet was urged to administer  Cod Liver Oil with Abidec Multivitamin syrup. She said Emeka had so far consumed three bottles in addition to a pack of Complan but his condition remained the same. “We do not have  money to  carry him about.  We went to the Federal Medical Centre, Owerri, but we were asked to pay for some laboratory tests. My husband is a civil servant but has not been paid. I need assistance because this baby has tied me down,” she lamented. The Ibes are not alone.

Next to Juliet and her baby  is  Uchechi Nnadi, with her one and a-half-year-old infant -Ikechukwu. Uchechi, a teenager and single mother, was delivered at Otuoha Primary Healthcare Centre, Ohaji Egbema LGA. Although Ikechukwu  initially started walking at eight months, he can no longer walk. he has become severely malnourished. Barely coping, even with the treatment, Uchechi’s baby is not improving. The specific treatment he requires isn’t even available at the  primary health centre.

Chinonso’s case is no different. His middle aged mother, sat dejectedly with him in her hands. The woman who hails from Ohaji –Egbema LGA had been told that her baby was suffering from Severe Acute Malnutrition, caused by her ignorance. Chinonso weighed 3.5kg at birth. At two months old, he was being fed pap with milk in addition to other complimentary foods.

“When he was four months old, I noticed he was becoming weak, was changing colour and his stomach began growing bigger. I thought it was what we call ‘mbo’ that affects babies. “We took him to a traditional healer but the problem continued. He throws up anything he is given. We have done everything we were asked to do.”

These instances are a tip of the iceberg. In Imo State,  malnutrition cases are commonplace. Investigations by Good Health Weekly revealed that essential remedies such as Ready-to Use-Therapeutic Foods, RUF, are unavailable in the state. Currently, there is no form of intervention programme in place throughout the State that could save ailing children like Daniel and others.

Health workers and  volunteers in some of the rural communities, note that the olive branch provided by UNICEF in some of the PHCs has been exhausted. Concerned parties are worried that they are mostly affected by hunger though statistics of the affected were not made available.

“In  some cases, a whole family is affected.  One thing common among these affected families is that they are all poor.  Sometimes, I use my resources to take care of them. The situation is so bad that they cannot afford to transport themselves to the centres even if treatment is made available free of charge,” a volunteer  nurse working in some of the communities said.

The burden

The Federal Ministry of Health report notes that Imo is one of the 12 states alongside Kogi, Kwara, Oyo, Osun, Ondo, Edo, Enugu, Anambra, Cross River, Rivers, Akwa Ibom and the Federal Capital Territory (FCT) that have medium burden of malnutrition.

Currently, Imo State is faced with triple burden of under-nutrition, micronutrient deficiency and over-nutrition which among other things equally lead to stunting, wasting, underweight and children not doing well in school.

A 2015 study published in the American Journal of Public Health Research by researchers from departments of Community Medicine, Imo State University, Nnamdi Azikiwe University, Nnewi Campus and Imo State University Teaching Hospital, Orlu, on the “Prevalence and Sociodemographic Determinants of Malnutrition among Under-Five Children in Rural Communities in Imo State”, confirmed high prevalence of malnutrition among under-five children in the state.

The study  revealed that most  causes were preventable with the proportion of underweight children being 28.6 percent  in comparison with the national figure of 29.0 percent  according to the 2013 Nigeria Demographic and Health Survey (NDHS).

The proportion of stunted children was 28.1 percent (national figure 37.0 percent) for stunted under-fives. It also revealed high proportion, wasted (too thin for their height) children with 23.6 percent of under-five-year olds (18.0 percent, national).

More male children were under-weight, stunted and wasted when compared to females.   Majority of the underweight, stunted and wasted children were in the age group 13 – 24 months and a period when most children are weaned off breast milk and supplementary feeds introduced.

Corroborating their findings in a comparative analysis of malnutrition among under-five children in rural and urban communities in Owerri, by Merenu I.A and colleagues published in the International Journal of Public Health, it was also found that, overall, the observed malnutrition states were underweight, with 60.6 percent, overweight 26.9 percent and marasmus 12.6 percent.

Also, in a comparative analysis of malnutrition among under-five children in rural and urban communities in Owerri, the researchers found that in rural communities prevalence of malnutrition was 25.3 percent, though 26.7 percent in the urban against 23.5 percent in the rural participants. Comparatively, underweight was significantly more in the rural


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