The faces of seriously malnourished children are the same the world over: large, sunken eyes, few smiles, a listless look. Never the boisterous, constant movements of a well child, but a quiet head, resting on the shoulder of a mother, aunt or even a slightly older sister. Arms and legs are thin, and dangle from a swollen middle. For the children of Africa, dark and strong hair becomes sparse, brittle and the color of copper.
I think: if this is how poorly nourished the body is, what about this 2 year-old brain? What about the learning she can’t do or the memories she can’t gather for the future? It is an emergency witnessed in slow motion.
Yet, we are today in a small community-based health center with our colleague from Valid Nutrition. It is a place trying to change this tragedy. I have seen this model of community outreach in 4 countries now, and help to support one in the Dominican Republic, and I am impressed. This center, in Nsaru, is clean, organized, and focused. Despite a waiting area crammed with women and small children, lines are formed and the small ones are processed through 5 stations.
At the first, children are weighed in a piece of colored cloth suspended from a hook in the ceiling. Next, a length is taken, then, the circumference of their mid-upper arms. The presence of edema is assessed. Edema is fluid that leaks from the blood vessels when there is not enough protein to ‘hold it in’, and gives the children a puffy appearance. For children who are in need of immediate nutritional help (but not so severely malnourished as to need hospitalization), the next stop is the Valid Nutrition trial station. Here, a spoonful of thick, super-nutritious peanut-based paste is offered. If the child accepts it (and one who is hungry and not otherwise ill with malaria or another serious condition usually does), it is theirs at the next station. A mother is asked to sign for a week’s worth of paste, assuring a visit in the next week and close follow-up by the staff of the center.
The message this effort sends is a good one: we care about and value your children. We have bothered to come where you live, and did not expect you to walk long distances to find us. We want the futures of your children to be brighter and healthier, starting today.