Malnutrition: Tackling a major killer of under – 5s

Every year, about 20 million children under five years of age suffer severe acute malnutrition (SAM) and of these, about one million die annually in Africa. In this report, ALI GARBA Ali highlights the ordeal of malnourished children and the intervention of the state government and other agencies to curb unnecessary mortality



Wabu is a village in Gamawa Local Government Area of Bauchi State that has been ravaged in recent years by desertification, resulting in poor agricultural output by farmers, especially in crops and animal production needed for the growth of infants.

Moreover, due to the effects of desertification and drought, most residents in Wabu community lack access to arable farm lands that could boost the supply of food containing vital nutrients such as vegetables, fruits, beans, eggs, among  others, for the body system, especially for the growth  and development of children.

However, one-year-old Hassan Muhammed who has been suffering from yet to be diagnosed disease looked pale, highly dehydrated and malnourished such that one could easily count the bones in his ribs without missing any of them because of his highly deteriorating condition. You could see in his eyes pains and his struggle to breathe his last. My merely looking at him, you could see that he lacks basic nutrients in his body.

Beside dehydration, he looks two times younger than his age, stunted and he cannot walk nor talk as one that is his age mate because he has lost all his weight and strength.

In an interview with his parents, Mr and Mrs. Muhammud Sani Rabo to find out why and how Hassan’s sickness was different that of other children at the clinic, the father of the sick child said, “Hassan is a twin. We named them Hassan and Hussein. Hussein is at home right now but his condition is not critical like that of Hassan. Hassan’s ailment has persisted and is gradually killing him”.

Explaining further, he said: “I do not know the cause of my son illness.”

All doesn’t go well with Hassan’s parents who are peasant farmers as they are in dire need of help to assist their helpless two-year-old son that is dying slowly from acute malnutrition, which they cannot do anything about.

Rabo, 45, complained bitterly about lack of funds, poverty and other resources needed to take his son to a secondary health facility, saying they have no option than accessing care at the health facility close to them at Wabu.

The father of the ailing child, said, “My son has been suffering for quite a long time; we need help the Bauchi State Government, individuals and corporate bodies to enable us find a cure for him.”

The malnourished child who is likely to die any moment from the illness is in dire need of medical attention and by merely looking at the sign and symptoms he was presenting with, one could say that the boy was suffering from Severe Acute Malnutrition (SAM) .

“We has been receiving treatment and attending the maternity without the knowledge of the actual disease our child is suffering from. From the Wabu Health Center, we have been referred to another hospital for further treatment. Although, they refer us to another hospital, we cannot afford the bills,” he added.

Rabo said that his farm has not produced enough crops for the past two years because of desertification and pointed out that the toddler is in dire need of urgent medical attention to save him, adding that he was constrained by lack of money to pay the medical bills.

On her part, the mother of the ailing child, Aisha, fondly addressed as Hajia said , “My biggest concern is the inability of the health care facility to properly diagnose the disease that my son is suffering from and he is in critical situation, thereby battling for his life.”

“We are left in the dark as far as his sickness is concerned; we don’t know what his ailment is all about  and we cannot do anything about it now due to lack of fund.”

In her response, the personnel in-charge of Wabu Maternity Clinic, Hajiya Altine said that even the mother of the sick baby lacked balanced diet that can translate into healthy breast milk to feed the twins, especially the one that is hit by the SAM.

But, according to a data obtained from both Bauchi Primay Health Care Development Agency (BPHCDA) and ASH Foundation, from 2011 to date, a total number of 89,126 malnourished children under the age of five years have been treated free in Bauchi and Hassan was one of them.

Also, in a telephone phone conversation with Comfort Attah, founder of ASH Foundation, an NGO that works in nutrition and prevention of early girl child marriage, said, following media reports on the condition of Hassan he was transferred to the Federal Medical Centre Azare (FMC) where the facility offered free services on community based management of acute malnutrition (Cman) and out- patient therapy (OTP) of patients with malnutrition cases.

She said Hassan was diagnosed with SAM at FMC and he was currently responding to treatment.

On his part, Bauchi State Governor, Bala Mohammed has ordered the Secretary to the Bauchi State Government, Sabiu Baba to immediately find out the position of the Ready-To-Use Therapeutic Food (RUTF) with the state’s Primary Health Care Development Agency and proffer immediate solution for the supply of RUTF drugs in the existing 21 sites of Out-Patient Therapy Centres.

Also, a farmer in Wabu community Malam Yakubu Hassan said, as a community they have embarked on massive plantation of trees and special grass to combat desertification in their area, aimed  to facilitate the green project Nigeria to succeed.

The 2019 BPHCDA data, shows that more than 210 children are suffering from severe acute malnutrition in Gamawa LGA alone.

The data explained that, in 2019 the current statistic of children with malnutrition is 45.6, moderate solutions 29.3 and severe children stands at 16.3 in Bauchi.

Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 per cent of children under five. An estimated two million children in Nigeria suffer from severe acute malnutrition (SAM), but only two out of every 10 children affected is currently reached with treatment. Seven per cent of women of child-bearing age also suffer from acute malnutrition.

The states in northern Nigeria are the most affected by the two forms of malnutrition – stunting and wasting. High rates of malnutrition pose significant public health and development challenges for the country.

While in Gombe State that borders Bauchi State in the southern part, admitted 14,143 only 150 died, 13,060 were cured, according to data from the National Demographic Health Survey (NDHS) document on Gombe State.

On the way forward, she suggested that, “there is need to scale up numbers of OTP sites to each Local Government Area as well as scale up procurement of RUTF so there won’t be repeat of last year stock- out, leaving children to die while there is need for the release of necessary funds to meet the standing order activities,” Attah suggested.

“Our current challenges now include low coverage of community based management of acute malnutrition (Cman) services due to few out-patient therapy (OTP) site. There are only 21 sites in Bauchi State as compared to 66 in Yobe, 45 in Adamawa and 65 in Jigawa State,” Attah said further.

Other challenges include, poor release of standing order signed for leverage of funds for distribution of RUTF from state to LGAs and OTP sites, procurement of routine drugs, supportive monitoring and supervision and non regular payment of stipends for community volunteers in LGAs of Bauchi State. Also, the dilapidated facilities is another issue in most Cman centres, where they operate is discouraging while worst is the current stock-out of RUTF in Bauchi State.

She noted, “Every year, about 20 million children under five years of age suffer from SAM and of these, about one million die annually in Africa”

It would be recalled that in a fourth quarterly meeting to review malnutrition activities in Bauchi organised by International Society of Media in Public Health in collaboration with the Bauchi State Government and a consortia of CSOs working to fight SAM had revealed that government has not released money to fight malnutrition in the whole of 2019 but depended on donor agencies for assistance.

When our correspondent visited some CMAM centres where RUTF is provided for malnourished children, there are indications that the state could risk more cases of SAM amongst children due to inconsistency in supply of drugs.

Wabu village is one thousand three hundred and fifty  kilometer (1350km) away from Lagos State Nigeria and two hundred and fifty (280) kilometer from Bauchi State capital.

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