ISHOLA MICHAEL reports the worsening cases of malnutrition of children in communities in Bauchi State occasioned by poverty, lack of adequate education and the winding down of support activities by the United Nations Children’s Fund (UNICEF) for ready-to-use therapeutic food in the treatment centres.
Please, come to the aid of our dying children. These are the ones referred to as to the leaders of tomorrow but are here allowed to be dying gradually due to lack of medical care and support. Government should act swiftly before the leaders of tomorrow go six feet below the earth.” Those were the lamentations of Muhammad Sani Rabo of Wabu community in Gamawa Local Government Area of Bauchi State, whose children are suffering from Severe Acute Malnutrition (SAM) caused by poor nutrition.
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Severe acute malnutrition has become a common incident in the community following the exhaustion of their stock of Ready to Use Therapeutic Food (RTUF) administered on children suffering from SAM in Bauchi State. Parents of the affected infants told Saturday Tribune that the formula had been out of stock in the area for about three months and had therefore sent a “Save Our Souls” to the Bauchi State government. They said the government must urgently intervene in the situation in order to save the lives of their children.
The affected parents cried out when they found out that all of the Community-Based Management of Acute Malnutrition (CMAM) centres in the state had been out-of-stock of RUTF. The situation has left the patients, who are mostly children between ages one and five, at the mercy of God. The parents said their continued visits had produced no positive results.
Rabo, whose twin children, Hassan and Hussein were at the Wabu healthcare facility, said one of the children, Hassan, was diagnosed with malnutrition at the facility, but lamented that the condition had persisted and was gradually killing his child.
“We have been receiving treatment at the facility without knowing the actual disease our child is suffering from. We have not been referred to another hospital from Wabu maternity for further treatment; and even if they refer us to another hospital, we cannot afford the treatment,” he said.
Rabo noted that the toddler was in need of urgent medical attention to save his life, but lamented that he was constrained by lack of money to pay the medical bills.
The mother of the child, Aisha, fondly addressed as Hajja, also said that their biggest concern was the inability of the health care facility to properly diagnose her child’s ailment. “We are blind as far as his sickness is concerned; we don’t know what ails him, so we cannot do anything now,” she said.
Reacting to the development, the health personnel in charge of Wabu facility identified simply as Hajiya Altine, expressed concern that even the mother of the sick baby herself lacked good nutrition to produce healthy milk to breast-feed the twins, especially the one suffering from SAM. According to her, since birth, the child has been battling with diarrhea, malaria and “a yet-to-be-identified disease.”
Hajiya Altine, who expressed concern over the health situation of the child, said that the poor financial status of the parents had also prevented them from taking the child to the hospital. “Whenever we ask them to go to the general hospital for further checks and treatment, their response has always been that they don’t have money to do that,” she explained.
She added: “We have made series of efforts to refer the child’s case to the Federal Medical Center, Azare, but the poor financial condition of the parents of the baby has been a hindrance as they have no access to some of the medications prescribed by the doctor.”
Saturday Tribune gathered that the non-availability of the RUTF, a known effective cure of SAM, being experienced in all the CMAM centers across the state may have led to the aggravation of little Hassan’s ailment.
The death of two children who suffered from SAM was reported in Kirfi Local Government Area and the mortality was blamed on the non-availability of RUTF and a CMAM centre in the area. The children were said to have died in the last three months. Following the situation, affected mothers begged Govenor Bala Mohammed Abdulkadir to quickly intervene and save the lives of other children. They said the governor must rise to the occasion and come to the aid of their dying children, describing the situation as “very serious.”
The distraught mothers, who are clients of the Kirfi CMAM center, said they were sending the SOS to the governor because the formula to save their children was no longer available.
The mothers had opened up when newsmen accompanied members of civil society organisations to the CMAM centre at the Kirfi Local Government Area healthcare facility. The visit afforded both the CSOs and the newsmen an opportunity of an on-the-spot assessment of the stock-out situation with some of the mothers lamenting that just as their children were getting better, they were told the RUTF was no longer available. The crying women said they knew that already the ailment was taking its toll on their children with most of them already stunted, a development that might lead to their death unless something urgent was done.
Zubaida Mohammed, who is nursing nine-month-old Adams Isa, an orphan who lost his mother at birth, said “for the past three weeks now, we have been battling to save him. We lack food replacement for the malnourished baby since there is no more RUTF.”
She lamented that breastfeeding a malnourished child was not an easy thing to do because she has to breastfeed two babies at the same time and one of them is malnourished. She added that since the ready-made food for the malnourished children ran out of stock, she had been battling to see how the child would survive.
According to her, “we cannot afford even the local food supplements such as groundnut and beans because they are expensive. We are trying to manage the situation in our own way. We are calling on the government to do something. Tthe RUTF is helping the children to get cured,” she said.
Also speaking, Zainab Adam, mother of 16-month-old Hamza Abubakar, who is also suffering from SAM, said the situation had left her family traumatised and the state government must immediately look into the plight of the dying children in the community.
Another mother, Maryam Musa, also at the facility with her 12-month-old Safiya Musa, lamented the non-availability of RUTF in the community, saying “when we were taking the supplement regularly, the child improved from the illness but now that it is no longer available, the baby is suffering severely. The government should do something urgently.”
While answering questions from the team, the Nutrition Focal Person in Kirfi Local Government Area, Babani Mohammed, said for the past four weeks, RUTF had been out of stock in all the six out-patient therapeutic sites in the council area. Mohammed added: “Normally, the caregivers or the nursing mothers come to the sites every Friday to collect the ready-to-use therapeutic foods for their malnourished children. For now, the sites are out of stuck of the RUTF for the past four weeks. That is why we encouraged the parents to go for food supplements such as palm oil, soya beans and groundnut to make up.”
Mohammed said that CMAM services in the area commenced in 2014 and had been helping members of the community, especially those who have issues of malnutrition, particularly the children under the age of five. He noted that that the conditions of most of the children had greatly improved since then as the community members became aware of the importance of the service.
He explained that children with SAM are brought to the centre for monitoring and treatment for between eight and 16 months, but expressed dismay that the centre had not received supply now for four weeks just as he also regretted that some clients were not coming because of the economic situation.
The Kirfi Local Government Area Nutrition Focal Person disclosed that the centre has over 800 patients receiving treatment, out of which about 400 have been treated successfully and discharged. He lamented that a few, however, have defaulted, stressing that on a daily basis, there are about three to eight new cases while there is a shortage of trained CMAM manpower. He also regretted that the centre has run out of stock of the materials needed to teach the clients how to prepare local supplements now that the RUTF is not available, adding that other equipment required for treatment is also not available for now.
Findings by Saturday Tribune showed that all the 27 community-based management of acute malnutrition (CMAM) sites across the state have not received RUTF for over four months now because the development partners, UNICEF, that was supplying the life-saving food for the treatment of the children are in the process of winding down their interventions.
The mothers, therefore, want the Bauchi State government to, as a matter of urgency, come to their aid following the winding down of the intervention of UNICEF.
RUTF is a ready-made nutritional food with high protein that is used for the treatment and prevention of SAM in children under the age of five, who are most vulnerable to the disease.
The North-East has the highest burden of cases of SAM, and it is currently put at 8.7 per cent, according to a 2018 SMART Survey report.
The visit to the CMAM sites was part of a media/CSOs advocacy training organised by an NGO, International Society of Media in Public Health (ISMPH), in collaboration with Civil Society Legislative Advocacy Center (CISLAC), Network for Health Equity and Development (NHED) and the Aisha Buhari Foundation (ABF).
While giving an overview of the malnutrition situation in the country, CISLAC said nine northern states contribute over 50 per cent of stunted children in Nigeria with Kano having the highest number of stunted children of 1.4 million.
The other eight states, according to CISLAC, are Katsina with 0.9 million; Bauchi, 0.8 million; Kaduna, 0.7 million; Jigawa, 0.7 million, while Sokoto, Kebbi, Zamfara and Borno each has 0.5 million, according to a paper presented by its programme officer, Muhammed Murtala, at a roundtable held in Bauchi. At the meeting, it was revealed that 12 million children were stunted in 2018, thus ranking the country second after India on the number of stunted children globally.
He said “transporting CMAM commodities (RUTF and Routine Drugs) from the state drugs store to LGAs and OTP sites is faced with challenges resulting in periodic stock-outs.” However, he suggested that the state government should take up ownership and sustainability of CMAN programmes and the ministry of health to ensure budgetary allocation for the procurement of RUTF for 2019 and subsequent years.
Meanwhile, investigations have revealed that no fewer than 70 children suffering from SAM died in Bauchi State between January and July.
Saturday Tribune gathered that the death was caused by lack of RUTF. It was also gathered that during the period, a total of 14,020 children diagnosed with SAM were placed on admission, out of which 10,359 were cured while 249 are yet to recover and defaulters for clinical attendance were put at 589. It was also discovered that the state had been out of stock for RUTF for four months now during which period a total of 22 children died.
At some of the CMAM centres in the state, clients are being turned back due to non-availability of the RUTF.
Speaking on the development, the Chief Nutrition Officer, Hamza Sade, lamented that RUTF had been out of stock in the state for the past four months due to the withdrawal of the supply of the stuff by the international development partners. Sade lamented that most of the parents of the SAM victims do not have a stable means of livelihood thereby making it difficult for them to source for the local substances needed to replace the RUTF.
The Nutrition Officer said as a way of emergency management of the situation, his office would require the sum of N200 million to procure RUTF pending when actual budgetary allocation would be made in 2020 to take care of counterpart funding.
Sade gave the assurance that his office would soon brief the Executive Secretary of the State Primary Healthcare Development Agency, Dr Muhammad Rilwanu, in order to prepare a memo that is to be presented to Governor Abdulkadir for approval to enable the agency procure the RUTF.
When contacted, the Permanent Secretary of the state’s Ministry of Budget and Planning, Yahuza Adamu, disclosed that efforts were on to ensure that the problem was tackled. He said the ministry would meet with UNICEF “very soon” with the aim of finding a way out of the problem.
Findings by Saturday Tribune revealed that the situation is at a stage described as “red alert,” considering the fact that no hope of an immediate solution is in sight, which may translate to more deaths of the children.
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