Treating malnutrition in Kenya: two very different journeys

I feel anxious and a little weary as we leave Maralal, the capital of Samburu county in Kenya, in a three-vehicle convoy, one of which has armed soldiers inside. My weariness is due to hours already spent in the car over the past couple of days. To reach Samburu, 400 kilometres north of Nairobi, has taken eight hours, half of which was on dirt road. The road ahead is worse.

My feeling of anxiety is because I have been told that security on the road is unpredictable. Some pastoralists on this route may be armed with guns to protect themselves from cattle rustling. Traditionally, cattle rustling was heralded as a demonstration of bravery and it was carried out with spears. Today cattle rustlers use guns and people get killed, including children.

The guns used illegally for protection have also occasionally been used to hold up vehicles. Fortunately, the rocky, narrow, dirt tracks that wind their way across the hills and deep escarpments distract me.

Ngewa feeds her baby with Plumpy‘Nut.
©UNICEF Kenya/2015/Ruth AyisiNgewa feeds her baby with Plumpy‘Nut.

We eventually reach the health centre in Barsaloi, a rural location. Also arriving at the health centre is Ngewa Lempate, 30, carrying her 15-month-old baby, Loilashu. By contrast Ngewa has made the journey on foot. It took her three hours across rocky hills. And she made the journey on an empty stomach.

She is given a packet of Plumpy’Nut, a peanut paste fortified by micronutrients, for her baby, Loilashu, to suck. He does so hungrily. Plumpy’Nut is supplied by UNICEF to health centres and is an effective treatment for severe acute malnutrition. Ngewa will be able to take stock back to give to Loilashu four times each day for about 16 weeks. She will have to bring him back to the health centre each week to be monitored though. Severe acute malnutrition can be life threatening if left untreated.

Ngewa looks serene despite the trek. She is dressed in an immaculate sky-blue cloth and wears white bead bracelets up her arms and a huge brightly-coloured beaded necklace. There is no trace of weariness from her hike, nor self- pity.

Ngewa, who has never attended school, is mother to five children, all of whom have been treated for severe acute malnutrition at some point. She explains that recurrent droughts have killed their 20 cows. Now they only have five goats and she survives by cutting and selling aloe vera.

Her family only eats once a day – and that is just a bowl of porridge and vegetables. There is no piped water nearby so they collect from a stream; and they have no latrine so they just use the bush. Only when she talks about her late husband does her voice waver and sadness seems to envelop her. “He died,” she says.

Ngewa’s story is not unique. Her poverty is not only typical of many living in the arid county of Samburu, but is also common in other parts of Kenya. Classified as a middle-income country, Kenya’s economic growth over the past 20 years has not trickled down to many sectors of society. Malnutrition is a serious nationwide public health problem, contributing to 45 per cent of all child deaths in Kenya. An estimated one third of Kenyan children under the age of 5 are stunted.

Hopefully other women like Ngewa will reap the benefit of a €19 million, four-year maternal and child nutrition programme funded by the European Union. It is part of a larger resilience-building programme covering the Horn of Africa. The goal of the programme, which is supported by UNICEF, is to reduce the impact of recurrent food shortages in Kenya’s semi-arid and arid lands, like Samburu, by strengthening health systems, advocating for stakeholders to invest more in the nutrition of women and children and building up the resilience of communities to withstand drought and other shocks.

After Loilashu has finished his packet of Plumpy ‘Nut, Ngewa starts her journey home. We do too. Our return trip is tricky as this time we have some steep climbs and threatening dark clouds hover above. To the pastoralists the rains will be welcome as it has not rained for four months in this area. I hope we get home before the clouds burst.

To my alarm, at one point the vehicle leading the convoy starts rolling back just as we almost reach a peak and are navigating a cliffhanger bend. The UNICEF driver skilfully reverses around the bend down the hill until the driver in front manages to gain control of his vehicle. Baboons jump out, agilely climbing up the rocks.

When we are on level ground, I think of Ngewa again, trekking on an empty stomach with her baby in the rain – her efforts have probably saved Loilashu’s life.

 

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