“Acute malnutrition may cause other health conditions like low blood sugar, anaemia and diarrhoea, which may cause severe dehydration, skin and visual problems because of lack nutrients,” she says.

One-and-a-half-year-old Tom cannot sit or crawl. He has to be carried or left to lie down. Tom has silky hair and his body is too small for his age.

He looks like a six-month-old. Like Tom, many children in Uganda are malnourished.

According to Hanifa Namusoke, a senior nutritionist at Mwanamugimu Nutrition Unit, Mulago Hospital, malnutrition results from an unbalanced diet, where certain nutrients are; either lacking, in excess, or are in the wrong proportions.

Dr. Elizabeth Kiboneka, the head of the Mwanamugimu Nutrition Unit, says cases of malnutrition in children under the age of five have reportedly increased in the last four years.

“The peak period is usually in the months of June, July and August, with national emergencies declared in Namutumba (2011) and Rwamwanja in Kamwenge district (2012) as a result of the Congolese refugee influx,” she says.

Kiboneka adds that a recent study done at Mulago Hospital’s assessment centre indicates that the cases of children with acute malnutrition stands at 14.5%.

According to the Uganda Demographic Health Survey (2011), 33% of children under the age of five are stunted, an indicator of chronic malnutrition.

Causes

The factors making acute malnutrition persistent in Uganda are basic, with the major ones being inadequate food and lack of food.

“Children are not getting enough food and sometimes when they do, mothers do not know what foods to give them and how to prepare the food,” Namusoke explains.

She adds that food must be cleaned and prepared appropriately so that the nutrients are retained.

Additionally, when a mother is malnourished, the chances of her giving birth to a malnourished baby are high.

Children are also susceptible to malnutrition if they are not breastfed adequately and given enough complementary feeds.

Proper nutrition should start before conception, continue during pregnancy, after birth and throughout breastfeeding alongside complementary feeding.

Namusoke says many Ugandans in rural areas lack safe drinking water, or live in poor sanitary conditions. These lead to infectious diseases like diarrhoea, which may result in severe malnutrition.

She says HIV/AIDS has also contributed to malnutrition. About 15% of children aged below five years admitted to Mwanamugimu have HIV/AIDS.

Complications

Kiboneka says malnutrition has immediate and long-term consequences. The immediate impact is death.

Malnutrition contributes about 50-60% deaths in Ugandan children below five years.

“Acute malnutrition may cause other health conditions like low blood sugar, anaemia and diarrhoea, which may cause severe dehydration, skin and visual problems because of lack nutrients,” she says.

A child may become sickly and suffer other micro-nutrient deficiency complications like lack of iron, resulting in anaemia and eventually death.

“lron is important for proper functioning of the heart and an anaemic heart may not be able to able pump blood,” Kiboneka explains.

She says stunting, which is a long-term effect of malnutrition, slows down the learning process since the child’s brain is fully developed by the age of two years.

Namusoke says children suffering from malnutrition have a compromised immune system, and are 10 times more likely to die of treatable conditions like colds or diarrhoea.

Kiboneka blames malnutrition on the high fertility rate, where mothers bear more children than they can afford to look after.

She encourages exclusive ­breastfeeding for the first six months and good nutrition thereafter where a child is given a variety of solid foods alongside breast milk.

The story was first published on April 22, 2013