ADDIS ABABA – A Catholic hospital in southern Ethiopia is making giant strides in the fight against starvation in children. One of 24 feeding stations in the drought-stricken country, Bushulo Major Health Center, operated by the Franciscan Missionaries of Mary, has inaugurated a program that treats starvation as a disease affecting the entire body – heart, liver and kidneys.
In Ethiopia, where one out of every five children dies before age 5, the mortality rate of children treated at Bushulo is less than 3 percent. The Ethiopian Ministry of Health and international health organizations have lauded the program, developed by UNICEF, the United Nations Children’s Fund.
The children who come to the health center are all suffering from severe malnutrition, said Franciscan Sister Isabel Arbide, a pediatrician at the center. They suffer from low body weight and many have stopped growing; they are smaller than other children their age, she added. “Some of the children can hardly walk when they come to us. Others are too weak to cry.”
“The families are often too embarrassed to get help for their starving children,” she said. Their condition is usually identified by government health care workers in local villages.
In their fight against famine, the government has set up supplementary feeding centers throughout the country. Aside from distributing food and water to the victims of drought and famine, special attention is given to infants and children. Workers screen the children and many receive supplementary nourishment in their villages.
“The worst cases in the surrounding area,” reported Sister Isabel, “are brought to us.” Bushulo is designated a “therapeutic” center, she explained, rather than a “supplementary” center. “The children we treat need intensive care rather than the assistance available at their local stations,” she said.
“When the children come here, each is accompanied by a care giver,” said Sister Isabel. “Mother, father or guardian, that person will be responsible for feeding the child,” she added.
“All the children receive a special milk formula fortified with vitamins and minerals,” Sister Isabel said. “The gravely ill also receive intravenous feedings,” she stated. The program is intensive. “The care giver must see that the child takes the formula every three hours, 24 hours a day.
“We also look after the parent or guardian. We feed them too,” she said. “But we insist they do not give their food to the child; only the special milk. Many children find the drink distasteful and refuse it. Eventually they will accept it,” she said. Under no circumstances are they allowed food other than their formula, she stressed. As the children improve their formula is adjusted accordingly.
The hospital staff warns the guardians that their children will lose weight in the early stages of treatment. This is because their bodies have retained water and the weight they are losing is water, Sister Isabel explained. At the same time, their young bodies are absorbing the nutrients from the special formulas.
The children along with their guardians are housed in a large communal room, Sister Isabel said. “Nutrition is not our only concern here,” she said. “We keep the living quarters as clean as possible. Spread of infectious diseases is always a problem. Cholera, dysentery and tuberculosis are particularly virulent here.”
Sister Isabel described the center’s routine: “The children are weighed and measured every day. A record is kept for each child. We have a staff of five nurses who monitor the children and a doctor who supervises the entire program. Every improvement is noted.
“But the nurses and I have a better way of gauging the children’s progress. When they first arrive, the children are too weak to walk or even cry. As they gain strength, they begin to act like healthy children. They cry, run about, play with the others.”
The current program at Bushulo has been in operation since 24 April, Sister Isabel said. During that time it has treated more than 200 children; eight have died but many have returned to their families. Some will be released shortly.
“The average stay is about 18 days. Children with kwashiorkor [severe malnutrition marked by edema, anemia, potbellies, loss of hair] might stay an extra day or two,” Sister Isabel said.
“We also see our job as educating the children’s guardians,” Sister Isabel declared. After all, he or she will be responsible for maintaining the program when the child is discharged.
“Most of the families live near a supplementary health center, and the program for the child continues there,” the Spanish-born nun said. They will visit the local center once a week where they will be weighed and measured – as they were at our center. They will continue to receive food supplements. At the same time, their families will take home food packages.”
Sister Isabel is quick to comment on the change in the children from their arrival to their departure. In little less than three weeks, children who were carried in near death from malnutrition are running about with newfound friends.
“The children receive a fine going-away present,” Sister Isabel said laughing. “Many of them arrive in rags, some even naked. Their guardians are scarcely better clothed. We appealed to Catholic Near East Welfare Association for assistance. They helped us buy T-shirts for the children and grownups. When the children are sent home they and their guardians are given brightly colored shirts. The children respond to the vivid reds, yellows and greens. It seems a little thing, but the colors stimulate them.
“They look better and certainly feel better, and the staff shares their joy,” Sister Isabel said.
“There are so many, though, who need our help. We can only treat 100 children, maximum, at a time. Next week, more children will arrive and once again we will work our miracles,” she said.