By Mustapha Adamu
Imagine the situation where a mother would trek for over 20 kilometers from village to a Primary Healthcare Centre in the urban area just to collect a Ready-to-Use Therapeutic Food, popularly known as RUTF in order to save the life of her baby that suffers Severe Acute Malnutrition (SAM). She would also trek back home if she received the RUTF.
Also, imagine the trauma and devastation when a mother would piggyback her malnourished baby and covere 40 kilometers by trekking to a PHC, only to find that the RUTF has finished.
This is the situation that is currently happening in Kano State, a state that is experiencing complete stock-out of RUTF for over 8 months, despite the fact that it records the highest number, out of the 1.4 stunted children in northern Nigeria.
PRIME TIME NEWS reports that the devastating impacts of malnutrition in Kano, according to International Society of Media in Public Health (ISMPH) and Civil Society Legislative Advocacy Centre (CISLAC), led to the scale -up of Community Management of Acute Malnutrition (CMAM) programme from 6 out of 13 Local Government areas with most disturbing cases among children under-5 and pregnant mothers.
However, checks by PRIME TIME NEWS indicated that all CMAM facilities across the 44 Local Government Areas of Kano State, have not received a single RUTF from the state government.
Our reporter visited some facilities within the Kano metropolis and found that parents of the affected children, who had been coming to the centres to collect the RUTF have stopped turning up after realising that the government had not been supplying the therapy.
At Unguwar Gini Primary Health Care in Municipal Local Government, our reporter observed that parents of the children suffering from malnutrition have not been turning up as a result of the absence of RUTF.
Our reporter also gathered that the parents come on Tuesdays and Thursdays- the designated days for treatment of the disease and collection of the RUTF.
An officer in the CMAM facility, who pleaded for anonymity, said a lot of children are suffering as a result of stock-out of the RUTF.
According to the officer, some children reportedly died as a result of severe condition, exacerbates by absence of the RUTF, situation that prompted the health workers to embark on sensitizing the parents on hygiene, which according to her, would help in suppressing the condition.
“They have been coming to collect the RUTF but we have only told them to exercise patients as we are still expecting it from the government. The government has not been supplying the RUTF for almost 7 months, this made the parents to stop coming after realising that the therapy may not come soon,” she said
The health worker added that absence of the RUTF had prompted the hospital staff to intensify on sensitizing the parents, especially who come from rural areas on hygiene, which according to her, helps a lot in reducing the risk of contracting and exacerbating the diseases.
She noted that lack of hygiene is the major cause of malnutrition among children, especially in the rural areas where children are exposed to so many health risks.
“We have to resort to intensifying sensitization to the parents and pregnant women, especially who come from rural areas on hygiene. Let me tell you that lack of hygiene is the major cause of this disease, followed by lack of diet nutritious food.
” Even the RUTF will not be effective in the body of a baby without medication and hygienic foods. Nowadays, most of the parents are neglect to their hygiene. They don’t clean their environment. They don’t even treat their underwear, especially brassier. A mother has to wash her breast before breastfeeding her baby because of the bacteria that cover the breast as a result of wearing brassier.
“They don’t even eat nutritious food due to poverty. So, we counsel them to embrace proper medication in the absence of the RUTF. Since it is believe that malnutrition starts from diarrhoea, the fever, we therefore counsel the parents on hygiene and proper medication. Thank God, our advises have proved successful,”
She disclosed that about 50% of the patients that had been brought to the hospital had been recovered through the counselling, especially from the rural areas where, according to her, they constituted 98% of the malnourished children that are brought to the facility.
“98% of our patients are from rural areas. They need to imbibe the culture of hygiene and cleanliness. They need to eat well. Eat diet and nutritious food. We advise them to live a hygienic life and many of them have seen positive results. We will continue doing this until the RUTF is supplied by the government,” she said
Our reporter also visited Tudun Fulani Primary Health Care, located in Ungoggo Local Government area of Kano State and observed that no malnourished child brought to the centre on the designated day for collection of RUTF.
An officer in the PHC, who also preferred not to be named, said the RUTF has proven to be effective in curing malnutrition among under-5 children.
According to her, when the RUTF was available, most of the children suffering from malnutrition that were being brought to the centre for medication developed signs of recovery.
But, with the absence of the RUTF, the health condition of the children became deteriorated.
She said over 1,500 women besieged the PHC on the designated days for collection of the RUTF to collect the therapy.
“They spend the whole day here until they make sure they collect the RUTF. Let me tell you that some women trek from some villages for the RUTF at the center because they don’t have the transport money. After collecting the RUTF, they would therefore start complaining of not having the transport money,or even food to eat.
” Most of the time it is the management of this PHC that would help them with the transport money. Some women even attempted to beat us of they did not get the RUTF. Especially when the government had stopped supplying the RUTF. A woman would trek for over 20 kilometers and didn’t get the RUTF, what do you expect? She must be angry,” she said
The officer also attributed malnutrition to poverty, because, according to her, the parents lack diet and nutritious food to eat and that would not provide adequate breast milk to feed her baby with.
She also advocated for hygienic lifestyle, especially to women in the rural areas, saying; “even an egg is enough to keep a child healthy. Since there is no RUTF at the moment, parent should provide dietary foods for their children as they will serve as the replacement of RUTF. RUTF contians all the diet and nutrients found in food. That is why it cures malnutrition and keep the malnourished children energetic,” she said
When contacted for comment, Hajiya Halima Yakasai, Nutrition Officer, Kano State Ministry of Health said the state government has released the some of N200 million for supply of 4 quarters of RUTF.
According to her, the state government was collaborating with UNICEF for the supply of the RUTF, but the donors have withdrawn their partnership, leaving the state government alone with the burden of importing the therapy.
She added that the government is trying its best to ensure availability of the RUTF in its hospitals, assuring that the consignment, which is imported from overseas, is expected to arrive Nigeria in 3 months time.
“Kano State government is spending billions of naira in providing this RUTF. It is not an easy task. Each carton of the RUTF is supplied at N22, 000. There was partnership with UNICEF but the donors are no longer collaborating, leaving the state government to supply it alone.
“Again, you need to understand that this RUTF is supplied from different countries overseas and as at now, the state government has ordered for the supply of 4 quarters of the therapy at the cost of N200 million.
” Let me use this opportunity to appeal to the parents of our children suffering from malnutrition to be calm and exercise patients that the consignment is arriving soon,”she assured
PRIME TIME NEWS recalls that ISMPH, at a joint press conference with CISLAC, on July 9, called on Kano State government to declare state of emergency on malnutrition to accord appropriate priority to and avert persistent death of children from preventable long stock-out of RUTF across CMAM facilities in the state.