Sitting on a straw mat in a hospital in southern Malawi, Weza Juga cradles her 20-month-old grandson in her arms, an emaciated baby weighing less than 6kg, unable to crawl, much less stand.
Prospects for a recovery are not good for little James Bungu, whose mother died of Aids four weeks ago and who may also be HIV-positive, says Eltrudes Ndasowa, head of the nutritional rehabilitation unit at Montfort hospital in Nchalo, a town in Malawi’s southern Chikwawa district.
”We are going to see more sick children,” says Ndasowa at the hospital where three of the eight children admitted in September died, having arrived too late for the staff to be able to nurse them back to health. ”There is nothing to eat.”
United Nations agencies are warning that five million of Malawi’s 12-million people are facing hunger after the worst drought in more than a decade drastically cut production of maize, the staple food in this Southern African country.
President Bingu wa Mutharika on Saturday declared the food crisis a national disaster in a bid to receive more international aid from donors.
The food crisis could erase years of work by health-care officials to combat high levels of child malnutrition and to start providing treatment for Aids.
About 48% of children under five in Malawi are stunted, a key indicator of chronic malnutrition, according to the health ministry. Forty percent of malnourished children have HIV.
”We have food shortages and the impact is going to be felt first on children,” says Health Minister Hetherwick Ntaba.
”There is no question that the hunger situation is going to impact on malnutrition in children and depressed immune systems due to HIV,” he said. ”It might well set us back.”
Malawi’s largest hospital, Queen Elizabeth central hospital in Blantyre, recorded a 30% increase in admissions for severe malnutrition in September, compared with the same time last year.
But British paediatrician James Bunn, who works at Queen Elizabeth, says the ward is bracing for greater numbers and more severe cases of malnutrition when the hunger season peaks between December and April.
”The problem is around the corner,” says Bunn.
Between 10% and 12% of children admitted for severe malnutrition do not survive and Bunn worries that overcrowding at the ward could place such a strain on hospital staff that mortality rates will rise.
Half of the 36 children being treated last week at Queen Elizabeth had HIV, and many were under the care of a grandmother or an aunt, with Aids having claimed the life of their mothers.
”The grandmothers, they can’t cope,” says nurse Jane Ndenguma. ”Sometimes they have six children to feed and getting food is a problem.”
Under the government’s programme of free anti-retroviral drugs launched last year, 15 children are put on ARV treatment per month at Queen Elizabeth, while others are treated with a simple antibiotic to prevent opportunistic infections from setting in.
At nutritional rehabilitation units across Malawi, children are given feedings of fortified milk followed by a high-energy cereal and a locally made supplement that is a sort of peanut butter.
”There is a little improvement,” says 32-year-old Regina Yussuf, whose 10-month-old son Dandaulo was admitted just more than a week ago at Zomba central hospital, suffering from diarrhoea and a fever.
Yussuf underwent HIV testing at the hospital and found out that both she and her son are HIV-positive. She plans to start taking anti-retrovirals.
About 900 000 children have been left orphaned by Aids in Malawi, with the HIV prevalence rate at 15%, according to UNAids. — Sapa-AFP