Fighting malnutrition

Ruksar Khan, 3, weighed barely seven kg and was malnourished when she was spotted by SNEHA workers last year. Her family who lives in Mandala slum at Mankhurd believed that Ruksar was just a fussy eater (sirf doodh peeti thi) and she would “grow up on her own” (apne aap badi hogi), like her other three older siblings. Ruksar refused to eat home-cooked foods and was pacified only with a packet of fried snacks. After intervention by SNEHA workers, Ruksar and her mother overcame malnutrition and Ruksar now weighs over 10 kilos.

On December 31, 2013, Ruksar and her mother, Saibunissa were felicitated along with 16 other mother-child duos from the Mankhurd-Govandi area for recovering from malnutrition successfully for over six months. Ruksar excitedly accepted her tiffin box handed over by the SNEHA team, while Saibunissa was given a mother-daughter framed photograph. More than seventy children have been felicitated for recovering from malnutrition last year.

Three similar functions in different venues were held in the area and were attended by municipality staffers, Integrated Child Development Scheme (ICDS) functionaries and Anganwadi staff who are partners with SNEHA.

Every month, in association with ICDS workers, SNEHA staffers conduct anthropometry (measuring child’s height, and weight) of children under the age of five. This exercise, funded by CRY and Welcome Trust, takes place in 23 community centers in the Kurla, Govandi, Mankhurd, and Trombay areas. SNEHA has covered about 20,000 households with 7000 children so far.

SNEHA workers then urge the parents whose children are detected as malnourished to enroll them in the Doorstep Childcare Centres (DCCs). A medical examination is done to check if the child suffers any medical problems or complications. In case of severe complications, the child is sent to the hospital. About 20 children attend the centers daily.

Convincing parents that their child is malnourished is an uphill task. The health of women and children is low on the priority of residents in such vulnerable slums. Talking to the mothers, Digambar Gaikwad, the program officer who handles two centers in the Mankhurd area said, “It is great that you mothers accepted that your child was weak. Then you trusted us to care for your child at our center where we nourished the child. Now that these children are healthy, we are today celebrating this achievement and felicitating them and you as their mother.”

The enrolled malnourished children are fed medical nutrition therapy (MNT), a peanut-based mixture with all the essential micronutrients, provided under a community-based trial on the effectiveness of MNT by the Nutrition Research and Rehabilitation Centre of the pediatric department of Lokmanya Tilak Municipal General Hospital, Sion.

“We first get the mothers to come with their children and do an appetite test to check if they are willing to eat the MNT, as prescribed by our doctor. After a few days, the children can stay in the center where our workers/sakhis feed them MNT for eight weeks,” said Neena Shah More, program director for SNEHA centers. The aim is to ensure that the children attain normal nutritional status.

The change in the child’s diet is not possible without roping in the mothers. The mothers are counseled to ensure good eating practices among children. “Many mothers are overburdened with housework and do not make time to cook nutritious food and feed the child nor do they see the value of scheduled feeds. Our trained balsakhis feed them with a great deal of patience and eating in a group of children makes a big difference,” said Anjanatai, a community organizer.

The balsakhis also engage in games with children and try to inculcate good habits such as regular sleeping, and washing hands. Once out of the center, the community outreach workers follow up with the child and the mother by making frequent home visits and ensuring that the children do not get sick again because of a lack of adequate nutrition.

In the meanwhile, Ruksar, who refused to eat dal rice and vegetables now eats well. “Ruksar now does not throw a fuss and eats well. I am happy that she is healthy now,” said Saibunissa.

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