Parwan province of Afghanistan
By Omid Rahman Fazel
Parwan, Afghanistan, 20 February 2019 - Helal Ahmad is two months old, he is from Parwan, central province of Afghanistan. Helal Ahmad’s mother is worried about the health condition of her child. “we eat a loaf of bread with a cup of boiled water at dinner” says Wahida mother of Helal Ahmad.
Undernutrition at an early age has serious effects on the physical and mental development of children. In Afghanistan around 600,000 children below the age of five years suffer from Severe Acute Malnutrition (SAM) – a condition in which a child has very low weight for his/her height and severe muscle wasting. Some of the main causes of severe acute malnutrition in Afghanistan is disease, conflict, and low purchasing power of families.
Helal Ahmad is from Chenaki Payan village, Parwan province approximately 114 Kilometers from the Afghanistan capital, Kabul. “Helal Ahmad has been vomiting and crying continuously for last three days” his mother Wahida explained. When I brought my son to the hospital, the doctors diagnosed him as suffering from severe acute malnutrition (SAM). Wahida 29, is a mother of three babies. Her elder son is 5 years old, her daughter is 4 years old and her youngest Helal Ahmad, is two months old.
Wahida’s husband is a laborer who carries construction material and earns just 200-300 Afghani per day which is equivalent to less than $4 USD. As such, the family cannot afford varieties of food such as vegetables and fruits which are essential for mothers to consume in order to produce milk for breastfeeding their infants, in this case Wahida is breastfeeding Helal.
Not having access to diverse foods for mothers and children, proper hygiene and safe drinking water, as well as to health services are some of the reasons why the children get malnourished. During the harsh winter the business goes down and Wahida’s husband is not able to even earn the minimal 200Afs (2 USD). They live in a rented house and pay 5000 Afghani ($ 65 USD) per month. The room requirements like mattresses and pillows are provided by their relatives.
Wahida, says: “Sometimes my children sleep without having dinner. We barely make it from one day to the next.
Mah Gul, 23 and her brother Ahmad Jan, 22 are volunteer community health workers. Both brother and sister visit each house once a week in Todom Dara village to provide basic health awareness and health counseling for mothers and their children. “With the right information and support, most breastfeeding mothers will produce plenty of breast milk and their babies will be well-nourished” says Mah Gul. Part of Mah Gul’s task is to refer the critical cases to the closest health centers. Thanks to the community health workers (CHW) Wahida was initially referred to the nearest health center to check on Helal’s condition, and then to the hospital. Infants less than six months and diagnosed with severe acute malnutrition must be followed up in the hospital as they still need to be exclusively breastfed. In the hospital setting, support will be provided to ensure that the mother continues to breastfeed and produce milk while the child is recovering from the condition.
Mah Gul, 23 with her brother Ahmad Jan,22 both work as a Community Health Worker (CHW) at Todom Dara village, Parwan, central province of Afghanistan.
Wahida referred to Charikar Central Hospital in Parwan province by Community Health Workers (CHWs). Doctors check Helal Ahmad’s his growth standards (including height and weight) and diagnosed him with severe acute malnutrition. At two months Helal Ahmad only weighs 2.5 kilogram. At the hospital, he is provided with diluted therapeutic milk in order for his body weight to increase with his still developing body. This is done following specific schedule under observation of medical personnel. Wahida was also supported to ensure she continues providing only breastmilk to the infant as this is the recommended global practice for the first six months of a child. Even when receiving the therapeutic milk breastfeeding must continue. Helal Ahmad gained 600 g after 7 days in hospital. Wahida, is happy from the hospital management team and doctors who care her son and provide her nutrition products on time.
UNICEF Afghanistan supports logistics of therapeutic supplies specific to treatment of severe acute malnutrition including F-75, F100, RUTF.
UNICEF Afghanistan provides and supports nutrition supplements such as: therapeutic milk (F75, F100) and Ready-to-Use Therapeutic Food (RUTF) for treatment of severely malnourished children under 5-year-old. This service is provided in the seventeen health centers of Parwan province.
In 2018, the Ministry of Public Health with support of UNICEF Afghanistan cured 2,956 cases of severe acute malnutrition (SAM) in Parwan province alone, with over 277000 children being admitted for treatment country wide. UNICEF Afghanistan works with Afghanistan government and partners, to accelerate equitable progress in scaling up nutrition services for mothers, caregivers, and their children especially in remote districts of Afghanistan.
Like Helal Ahmad, there are hundreds of thousands of children who suffer from severe acute malnutrition in Afghanistan.
Thanks to the continued support of our donor partners, UNICEF reaffirms its commitment to sustainably improve maternal and child nutrition, which is critical to the survival of every child, and ensuring well-nourished children in Afghanistan.