Monday, 31 October 2016

Seeking every opportunity to find children in need of urgent medical care

Marthen recovered from severe acute malnutrition.
©UNICEF Indonesia/2016/Ha’i Raga Lawa

When health workers found little Marthen lying in a dark room at his grandparent’s home, they knew he needed urgent medical attention. Listless, miserable and painfully thin, his life and health was at serious risk.

Marthen was under the care of his grandmother in Poto village in eastern Indonesia. His mother had just given birth to another baby boy, and his father was earning money to feed and care for his family.

Marthen’s troubles began six months earlier, when he had just turned one year old. He fell sick with a fever and cough at his parent’s home. Believing that magical powers had caused his illness, the grandparents insisted that his young parents turn to “praying teams”, and not health professionals, to heal him.

Over the next six months, and several visits to different praying teams, his condition steadily worsened. He lost his appetite and a lot of weight, and became weak and extremely lethargic.
In desperation, his father sought the most powerful “praying team” in the neighbouring sub-district, and on their advice, moved Marthen to live with the grandparents.

Here, Marthen’s misfortune took a turn for the better.

The following week, Marthen was found by Ibu Christine, a midwife from the nearby community health centre (Puskesmas), who was making home visits to vaccinate children. Ibu Christine immediately recognized that Marthen was suffering from a severe and deadly form of acute malnutrition known as marasmic kwashiorkor. An extreme lack of nutrition had caused his feet and legs to swell, as well as inflammation and depigmentation of his skin.

Supported by UNICEF and the NGO Action Contre La Faim, midwives and community health workers in Kupang District, in East Nusa Tenggara (NTT) are trained in checking the nutrition status of children in the households they visit as part of an outreach programme. The learn how to screen children’s nutritional status with a tape that measures the circumference of their upper arm. This enables them to find children with acute malnutrition before life-threatening medical complications set in. Through the programme, UNICEF and the NGO Action Contre la Faim aim to help the government ensure that every child with severe acute malnutrition is found and given the best possible treatment for swift recovery.

“I now know what to do when I find children with severe acute malnutrition. We have a clear guideline”, explains Ibu Christine.

Marthen was referred to the nearest hospital, where he was admitted to an inpatient ward to treat his medical complications and help him gaining weight again. Marthen’s extended family rallied around to support his parents and ensure that they were able to stay with him in the hospital.

After discharge from the hospital, he continued his treatment as an outpatient at the Puskesmas in Poto. Just two months later, Marthen was a different boy - stronger, visibly alert and now interested in his surroundings.

Ibu Christine knows how important it is to seek every opportunity to find children with severe acute malnutrition. Many very thin children are not taken to health facilities because their parents do not recognize the seriousness of their condition, or do not know that effective treatment is available. Some are also too ashamed to come forward.

“I now encourage village governments to allocate some of their budget so that community-health workers can make monthly home visits to seek out every child with severe acute malnutrition”, says Ibu Christine.

Marthen’s parents say that they have learned much from their experience. They now recognize the importance of seeking medical care when their children become sick.