Born underweight and undernourished, Miracle Makwinja’s story highlights the challenge of malnutrition the African continent and Malawi, in particular, face to prevent poor child mental and physical development or, worse still, premature deaths.
According to the United Nations Children Fund (Unicef), early childhood, which spans the period up to eight years of age, is critical for cognitive, social, emotional and physical development. During these years, a child’s newly developing brain is highly plastic and responsive to change as billions of integrated neural circuits are established through the interaction of genetics, environment and experience.
“My child was at the crossroads of life and death; weighing 9 kgs at the age of four was very scaring for a divorced, poor and helpless mother of one. Moreover, she was very pale and weak, and complained of stomach pains,” recalls Maggie Makwinja, 27, mother of now five-year-old Miracle.
Doctors at Queen Elizabeth Central Hospital (Qech) diagnosed that Miracle did not have enough blood and was malnourished.
The Early Childhood Development (ECD) concept emphasises that poor nutrition in the first 1,000 days of a child’s life can also lead to stunted growth, which is irreversible and associated with impaired cognitive ability and reduced school and work performance.
At the age of four, Miracle had problems enrolling at any school because almost all reception schools she was taken to refused to enroll her because her health status gave her a fragile look which teachers feared.
“I feared for my child’s future because most of her age-mates were in school and I was not financially stable to support her with a balanced diet,” Makwinja says.
Born on January 19, 2011 in Thawani Village, Traditional Authority (T/A) Makuwira in the flood-prone district of Chikwawa, Miracle is just a single example among thousands of children in the country who are suffering from malnutrition.
However, it took a miracle for Miracle to survive as most malnourished children risk premature death or walking along a doomed path as their learning ability is limited and cannot be compared with that of children who are well-nourished and healthy.
Miraculously, Miracle was enrolled at United Methodist Church (UMC) Model Nursery School at the age of four in 2015 after being spotted in her community by volunteers of UMC Health Department who later tested and scanned her at their church clinic where she was discovered to be malnourished
Some disorders were also discovered in her left arm due to the same problem and the UMC Health Department immediately enlisted Miracle to start receiving free peanut paste and soya porridge flour among other nutritious foods – a programme called the Winning Programme.
“Upon being enrolled, I observed that Miracle was not as active as other children in class. She used to doze and sleep a lot in class and she was underperforming in class. One day she almost fainted at the morning School Assembly, she fell down and she could not respond very well to the immediate treatment we gave her until a few minutes later when we gave her some food to eat,” reflects Olga Mwembele, Miracle’s former nursery school teacher at UMC Model School.
According to Mwembele, Miracle seemed to be a bright child but was struggling with the learning process, a situation that was attributed to her poor early stages of development.
Women’s and ECD Coordinator at UMC country office Motera Mhone also attests to Miracle’s story, saying her name vindicates her story because a normal and healthy four-year-old child is supposed to weigh about 18 kilogrammes but with Miracle it was an alarming 9 kilogrammes.
“After putting her on the Winning Programme where she started receiving nutritious foods like peanut paste, soya porridge, rice, eggs, nsima and beans, Miracle started gaining weight, though the process was gradual. All of a sudden she started being active in class and she started performing well to the extent that this year she was among those who graduated to Standard One,” Mhone says.
Miracle passed very well with grade three which is second best to grade four and is currently enrolled in Standard One at Namasimba Primary School in Blantyre though still under the UMC Winning Programme where she is to be monitored until a later age.
Commenting on the same, Maggie Chiwaula, Nutrition Specialist in the Ministry of Health explains: “When children are malnourished, it means the caretakers will be busy taking them to hospitals for medical help. And when the child is sick, he or she cannot understand at school. And also parents cannot even have time to go out in the fields and maybe do business when the child is sick.”
Executive Director for Civil Society Education Coalition (Csec), Benedicto Kondowe concurs with Chiwaula, saying there is indeed a strong link between nutrition and the learning process among under-five children because in most cases the malnourished children are retarded and fail to grasp issues quickly.
“ECD is very important to children under the age of five. When the nutrition of children within this age is not good, their future becomes very unpromising because they miss out on the strongholds of the foundation of life and education,” he says.
Ministry of Education Spokesperson Lindiwe Chide says when the government invests much in ECD and nutrition, the country realises huge benefits as evident with the Mary’s Meals Programme that provides nutritious porridge to some primary schools across the country.
“Though it is not the primary mandate of the Ministry of Education to look into under-five nutrition and learning ability but with this project, we are really making strides into moulding future leaders of the country. Soon, the ministry will come up with a Department of School Health and Nutrition, an arm which will look into all issues to do with ECD and nutrition,” she says.
If left unattended, malnutrition can be retrogressive to a child’s entire future and to development at large. Thanks to UMC Health Department and Model School which rendered a quick remedy to the then dying and hopeless poor Miracle who is now enjoying robust health and excellent academic life at Namasimba Primary School as confirmed by her current Standard One teacher Mervis Ndaona including her Head teacher Lea Juta.
As Kondowe stipulates: “If we invest one dollar in under-five nutrition, we will yield back 10 dollars which will see this country achieving much towards economic, education and development.”
The story of Miracle could have been worse had it not been for the timely intervention of the UMC good Samaritans. Miracle could have been out of school or could have been in school but her performance could not have been promising. Even worse, she could have been among the numerous under-five deaths.
Malnutrition is devastating and the single biggest contributor to child deaths according to Unicef. In Malawi, there has unfortunately been no change in children’s nutritional status since 1992 and malnutrition rates remain unacceptably high.
Around 46 percent of children under-five are stunted, 21 percent are underweigh and four percent are wasted. Micronutrient deficiencies are common. The Ministry of Health’s 2001 Micronutrient Survey revealed that 60 percent of children under five had sub-clinical vitamin A deficiency.
According to Unicef Malawi Humanitarian Situation Report No.9 of September 2016, a smart nutrition survey conducted in May 2016 has shown an increase to 2.5 percent in malnutrition rates as compared to 1.1 percent registered in 2015 Smart survey results. The admissions in community management of acute malnutrition facilities have also been on the rise since the drought was declared in the country.
Moreover, Concern Worldwide is quoted to have said in its recent report on nutrition that there is need for local and international support to supply food like peanut paste and train local health staff how to implement the community-based Therapeutic Care Programme in order to prevent malnutrition in the first place. It says some of the major benefits of this programme are that families are not split up and the decentralised nature of treatment means that more children can benefit.
On March 15, 2011, the Republic of Malawi joined the Scaling Up Nutrition Movement comprising 57 countries. At the time, Malawi had established a National Nutrition Committee, chaired by the Secretary for Nutrition, HIV and Aids in the Office of the President whose main function was to mobilise resources and support the implementation of interventions in line with the country’s Food and Nutrition Security Policy (2005) and the National Nutrition Policy and Strategic Plan (2007 – 2015)
Moreover, in August 2016, the Ministry of Health in conjunction with Unicef rolled out a campaign where 3,158 children under five years suffering from Severe Acute Malnutrition were treated, representing a 59 percent increase in admissions compared to 1,989 during the same month in 2015.
Also, the 2016/17 mass screening and referral treatment of children between six and 59 months with malnutrition was rolled out in September across the country and is targeting approximately 1.8 million children over the next seven months.
Thanks to UMC and improved nutrition, now Miracle weighs 15.5 kilogrammes but fluctuates between 12.5 kilogrammes and 17 kilogrammes from time to time but as her name stipulates, she is indeed a Miracle currently testifying at Namasimba Primary School in Blantyre.
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