As several concurrent crises plague the eastern Democratic Republic of Congo, like years of warfare, frequent pregnancies, and the separation of families, malnutrition is a persistent, deadly threat for Congolese children.
Family dynamics play a huge role in the region’s malnutrition problems. Many fathers are leaving their homes and farms to work in more profitable jobs like gold mining, leaving families without their main source of staple crops. As a result, many mothers are left caring for children without the ability to work the fields.
CHSC Pediatrician Dr. Lindsey Cooper sees the end result of food insecurity issues when working with Nyankunde Hospital‘s re-feeding program, which provides emergency care for people with severe cases of malnutrition and nutritional planning for their families so they can prevent malnutrition at the home.
The program mostly serves children under the age of five, but in the case of Shekina, severe malnutrition can persist for years, with dire consequences.
Lindsey met Shekina when she was hospitalized for malnutrition at five years old. Shekina lives with often uncontrolled diabetes due to her family’s lack of access to insulin, as well as an inability to properly store insulin whenever they do have it.
Her body can’t sufficiently absorb calories without insulin, and although Nyankunde keeps plenty in stock, her family lives 10 kilometers away from the hospital.
“She had no fat in her cheeks. She had no muscle tone in her face – nothing,” Lindsey said. “You could see even her glands. She was like a walking skeleton. She didn’t really have the strength to sit. Her mom would take her in this little chair onto our indoor Children’s Garden playground area. She watched the kids play, but she had no energy to do anything.”
Shekina would receive therapeutic re-feeding at Nyankunde, but only for so long. She would have to return home after several weeks, back into a situation that continually deprived her of lifesaving medication and proper nutrition. She would be hospitalized in Nyankunde two more times, with the last visit occurring this past March.
When Shekina last saw Lindsey, she weighed 8 kilos at eight years old – as much as a healthy newborn.
“She was with us for two months. She gained almost half of her body weight again and began controlling her diabetes to the point where she could go back home,” Lindsey said.
Despite the success of Nyankunde’s efforts, the hospital cannot fully address the structural disparities that prevent kids like Shekina from accessing insulin or healthy food. In addition to being far away from a place to buy the medication, her family lacks a refrigerator to store insulin, opting instead to keep it in a clay pot of water.
Lindsey and her colleagues can counsel families on strategies to keep their children fed, whether that means addressing what foods they can find, prepare and serve, or how to best to keep diabetes under control through meal timing or avoiding sugary starches.
This counseling ensures families at least have more information on how to prevent or cope with malnutrition, which can save lives even while kids like Shekina can’t make it to the hospital.