Malnutrition threatens Kenyan children

KNH admits more than 20 children a week for in-patient care solely to deal with malnutrition. Photo/FILE
KNH admits more than 20 children a week for in-patient care solely to deal with malnutrition. Photo/FILE 

At the Kenyatta National Hospital in-patient children’s ward Grace Ouma from Huruma estate holds her son Elvis.

At nine months he weighs only 3.8 kilograms.

Elvis is severely malnourished and has Marasmus, in a pattern than is blighting thousands of Kenyan children — now across all classes — through eating foods empty of nutritional value.

At nine months, according to the nurse observing Elvis, his weight is equivalent to that of a healthy newborn baby.

His mom has been feeding him with porridge, milk and avocado.

In another section of the hospital, a mother Beatrice Anyango, watches her malnourished daughter Beryl , who at three years weighs 5.7 kilograms.

Like Elvis, her mother has been feeding her on porridge, potatoes and bananas.

The child has severe malnutrition and is now being fed in the hospital on vitamin supplemented milk and Resomal rehydration solution, given to children with vitamin and nutrient deficiencies.

The problem for both children is the porridge, which fills the stomach but is almost devoid of nutritional value, and is contributing to a Kenya-wide Vitamin A Deficiency (VAD), which weakens the immune system in much the same way as AIDS, and stops the absorption of nutrients.

Across Africa, the WHO estimates VAD is now killing 600,000 children a year.

In Kenya, NGOs report the nation has one of the highest levels of VAD in the world, causing blindness, impaired immune systems, and, later, heart failure, kidney disease and cancer.

The World Health Organisation, World Bank, UNICEF and USAID all report the problem has now reached an all-time peak in Kenya, with 85 per cent of children in the country affected by VAD as a result of a departure from traditional foods that delivered the vitamin naturally.

The deficiency, which some studies suggest affects children’s abilities to digest any food, is now the leading cause of child blindness, skin conditions and weakened immunity, according to research by UNICEF and NGO Micro Nutrient Initiative.

Back at the outpatient wing at Kenyatta Hospital, one paediatrician clinical nurse says she personally handles at least four cases a day of children with VAD.

Other Nairobi hospitals, such as Mater, report that the majority of children admitted with serious illnesses arrive also suffering from VAD, which is usually the root cause.

However, some get so weak with VAD alone they need treatment for it before other conditions are dealt with.

Kenyatta Hospital admits more than 20 children a week for in-patient care solely to deal with malnutrition.

All the city’s hospitals report that most children arriving with VAD come from low social class areas, such as Kibera, Kawangware and Huruma slums, but more recently they are coming in from working class, well-educated families too, who are feeding children too few vitamin-A rich foods, leading to cases of wealthy, malnourished kids.

VAD increases the risk of malaria infections, turns minor colds and flu into pneumonia, and ups the levels of diarrhoea deaths.

One study in Burkina Faso by Boston University Public Health School found children from 6 months to 3 years old who took Vitamin A and Zinc supplements were 34 per cent less likely to contract malaria.

According to the United Nations, the Vitamin A deficit in Kenya is also more severe than in other developing countries because the country is receiving lower levels of vitamin A supplements – typically running at 62 per cent in other developing nations, but at just 15 per cent in Kenya as a result of diminishing funds.

Research by health economists at the Copenhagen Consensus in May 2008 showed funds spent on Vitamin A and Zinc supplements were the single most effective way of delivering development benefits, with every $1 spent on the supplements delivering $17 of benefits to the economy - through cutting the costs of illness, disability and deaths and increasing output and productivity.

When VAD does strike, one of the first symptoms is night blindness. This can then move on to become full blindness.

VAD can also develop as a condition of suppressed immunity, almost as dangerous to overall health as HIV/Aids.

The deficiency is the world’s leading cause of preventable blindness among children.

Half of the children with VAD-induced blindness die within 12 months, according to World Health Organisation (WHO) statistics.Yet VAD can be reversed with treatment.

“It requires supplemented Vitamin A taken as a drug, but not in foods,” said Professor Nimrod Bwibo a Paediatrician and Lecturer at Nairobi University Medical School.

However, long before children get to the point of needing supplements, medics advise feeding growing children with red vegetables, such as carrots, tomatoes, red onions, orange sweet potatoes and beets.

“These are rich in carotene, which is a rich source of Vitamin A,” said Professor Bwibo.

Medics say a higher intake of vitamin A is particularly critical during the last trimester of pregnancy, as both mother and baby need it more then.

Weaning prematurely also increases the chances of VAD.

“Breast milk is the best natural source of Vitamin A for babies and should not be substituted,” said Professor Bwibo: a view corroborated by Mater Hospital’s paediatric department.

Currently, the most recent NGO estimates suggest some 15 per cent of Kenyan children are already in the acute stages of the condition, with more than another 40 per cent moving towards acute VAD.

However, in most children, the root cause of their ailments is never spotted, and the deaths that follow are ascribed to diarrhoea, pneumonia, and malaria.

nutritionists Say even moving children from eating ugali, which has virtually zero nutritional value to sweet potato, githeri and red vegetables can stem the problem, most especially in young children.

Studies in western Kenya have shown the orange-fleshed sweet potatoes are one of the best foods available anywhere in the world for supplying Vitamin A.

The potatoes offer up to eight times the level of carotene necessary for making vitamin A in the body than other vitamin A foods.

African Laughter