IDP chil­dren: Chal­lenges of the first 1000 days

Sunday Trust - - SUNDAY MAGAZINE - By Adie Vanessa Of­fiong

Hauwau Gana, born pre­ma­turely on Oc­to­ber 7, 2016, lost her mother, Hadiza, to de­liv­ery com­pli­ca­tions. For two weeks she was in an in­cu­ba­tor at the Na­tional Hospi­tal, Abuja, un­til she was re­leased to her fa­ther, Baba, who signed an un­der­tak­ing to pay up her med­i­cal bill within a given pe­riod.

From the on­set, keep­ing up with her di­etary re­quire­ments was a prob­lem: he had three other chil­dren and made mea­gre in­come as a com­mer­cial mo­tor­cy­cle op­er­a­tor in Masaka, one of Abuja’s un­of­fi­cial IDP camps.

Hauwau died on March 5 due to ill health, prob­a­bly ac­cel­er­ated by com­pli­ca­tions from mal­nu­tri­tion. Her death was a rude shock to her fa­ther, who is still mourn­ing his wife.

The sit­u­a­tion is not very dif­fer­ent for other chil­dren in Abuja’s IDP camps, as was re­vealed dur­ing a visit to the New Kuchig­oro camp.

Upon en­ter­ing the camp, what im­me­di­ately caught one’s at­ten­tion were chil­dren eat­ing un­ripe cashew or hug­ging branded bot­tles of wa­ter con­tain­ing kunu (gruel made from guinea corn). They ei­ther sipped the con­tent of the bot­tles or their moth­ers fed them with it.

Ra­matu Ayuba, 23, from Gwoza, Borno State, gave birth to her son on Oc­to­ber 8, 2016. Un­like her two pre­vi­ous preg­nan­cies, where she nursed her chil­dren ex­clu­sively on breast milk, she said she was not pro­duc­ing enough. “That is why I give him kunu. I don’t know why the milk doesn’t flow. Back in my vil­lage, breast­feed­ing was one of the things we were en­cour­aged to do dur­ing an­te­na­tal, but not here,” she said.

Ra­matu knows noth­ing about ma­ter­nal or in­fant health. Her son has never been ill and has re­ceived the Bacil­lus Cal­met­teGuerin (BCG) in­oc­u­la­tion and po­lio im­mu­ni­sa­tion.

To en­hance her milk flow, the house­wife said, “In the morn­ing I ate kunu. I am mak­ing some beans and pasta for lunch and will have rice for din­ner. When I drink tea, I put some milk in it. Then my milk flows a lit­tle and I feed my son. He hasn’t yet started eat­ing solid foods. I mostly feed him kunu.”

Ra­matu said her son would have some kunu for din­ner, adding that there was no prob­lem with bowel move­ment.

Most of the of­fi­cial and iden­ti­fied un­of­fi­cial IDP camps are in states like Borno, Adamawa, Yobe, Taraba, Edo and the FCT, among oth­ers, where mea­sures are be­ing taken to curb mal­nu­tri­tion. But they are seem­ingly in­suf­fi­cient.

IDP data col­lected by non-gov­ern­men­tal or­gan­i­sa­tions and the United Na­tions Chil­dren’s Fund (UNICEF)-sup­ported teams in Yobe and Borno states stated that the pro­por­tion of chil­dren with global acute mal­nu­tri­tion [as iden­ti­fied by Mid-Upper Arm Cir­cum­fer­ence (MUAC) or oedema] is over 80 per cent. These ini­tial as­sess­ments pro­vide an in­di­ca­tion of in­creas­ing lev­els of acute mal­nu­tri­tion.

The United Na­tions Of­fice on the Co­or­di­na­tion of Hu­man­i­tar­ian Af­fairs es­ti­mates that 300,000 chil­dren in Borno State alone would suf­fer from se­vere mal­nu­tri­tion over the next 12 months and up to 450,000 in to­tal across Adamawa, Borno and Yobe, if ad­e­quate as­sis­tance is not re­ceived.

The sit­u­a­tion is dire for Maryam Amos, 25, who had her first child on March 8, 2016 in her room, as­sisted by a mid­wife on the camp. She con­sid­ers her­self for­tu­nate to have par­tic­i­pated when non-gov­ern­men­tal or­gan­i­sa­tions gave health talks and an­te­na­tal ser­vices.

“They ad­vised us to eat a lot of ba­nana, fish, or­anges, fruits and ground­nuts. When

I gave birth they ad­vised me to eat a lot of en­ergy-giv­ing foods, meat, veg­eta­bles and milk, among oth­ers, to help my breast milk. But I can’t af­ford some of them, so I make do with what I have,” Maryam re­called.

The Borno State in­di­gene added: “I was ad­vised to breast­feed my baby and on what kind of foods to eat to help my breast milk. I breast­fed him ex­clu­sively for 11 months and in­tro­duced ar­ti­fi­cial foods as he ap­proached 12 months. He had re­jected kunu, but to­day, he takes it. He often suf­fers stom­ach ache and I’ve had to take him to the camp’s in­fir­mary, where he was given med­i­ca­tion. The ill­ness isn’t com­pletely cured yet.”

Maryam, who con­sid­ers her son to be healthy but for the stom­ach ache, wants him to be­come a teacher. “I would like him to teach oth­ers the way of life,” she said.

Mal­nu­tri­tion among IDPs has been news and de­spite gov­ern­ment’s claims to be on top of the sit­u­a­tion, the statis­tics are still high. The Borno Emer­gency Man­age­ment Agency (BEMA) re­ported mal­nu­tri­tion­re­lated deaths of about 450 chil­dren from ages one to five in 28 IDP camps.

BEMA said, “About 6,444 se­vere cases of mal­nu­tri­tion were recorded in the camps; 25,511 had mild to mod­er­ate symp­toms.”

Ac­cord­ing to UNICEF, the 2017 nutrition re­quire­ment for IDPs is $40, 217 105. In 2016, it said 97,777 chil­dren un­der 5 years re­ceived mi­cronu­tri­ent sup­ple­men­ta­tion.

The sig­nif­i­cance of a child’s first 1,000 days is a phe­nom­e­non many are un­fa­mil­iar with. Shed­ding light on the is­sue, Dr. Bamidele Omo­tola, a nutrition spe­cial­ist in UNICEF, Abuja, said, “The first 1,000 days of life start from con­cep­tion within the first one day of the preg­nancy un­til the child is two years old. The preg­nancy nor­mally lasts for nine months, which is 270 days, and the two years at an av­er­age of 365 days per year, mul­ti­plied by two, which is 730, plus the 270 days. This gives the 1, 000 days we re­fer to.

“When a woman re­alises she’s preg­nant, the first thing is to go to the clinic, reg­is­ter for an­te­na­tal ser­vices, and from there, her health will be man­aged. She will be given reg­u­lar pills for blood be­cause in preg­nancy she needs to feed for her­self and the baby in­side her. She must take what we re­fer to as ad­e­quate diet. She must take at least three meals daily and en­cour­age her­self to eat.”

He de­scribed the com­po­nents of an ad­e­quate diet as hav­ing an­i­mal source, which is what a lot of peo­ple call pro­tein, beans, ce­re­als, maize, rice, mil­let, sorghum roots and tu­bers like yams, cas­sava, coco yam, plan­tain, veg­eta­bles, fruits and oil.

On when this re­lates to women in Ra­matu’s sit­u­a­tion, he said, “Ideally, the fact that you are a dis­placed per­son does not mean that your diet should be com­pro­mised. Also, know­ing their cir­cum­stances fully well, and that they The first 1,000 days of life start from con­cep­tion within the first one day of the preg­nancy un­til the child is two years old. The preg­nancy nor­mally lasts for nine months, which is 270 days, and the two years at an av­er­age of 365 days per year, mul­ti­plied by two, which is 730, plus the 270 days. This gives the 1, 000 days we re­fer to de­pend on what­ever they can get, who­ever is mak­ing such do­na­tions must be aware of the need of such women.”

Speak­ing on what kunu por­tends for chil­dren in their first 1,000 days, he said, “A child who is less than six months must be com­pletely breast­fed. The mother should be sup­ported to ad­e­quately breast­feed. Af­ter six months, that child would re­quire other foods in ad­di­tion to breast milk. Those other foods must come from var­ied sources. But noth­ing stops a mother from mix­ing the gruel with ground­nut paste or soya beans and oil to en­rich it. When there is no such mix­ture, these chil­dren are the ones who even­tu­ally be­come ema­ci­ated and may be­come se­verely mal­nour­ished be­cause they won’t grow well and their men­tal for­ma­tion is com­pro­mised, which has im­pli­ca­tions for such a child later in life. By the time a child is two years, 90 per cent of his brain for­ma­tion is at­tained.”

Mal­nu­tri­tion is a plague be­dev­illing chil­dren across Nige­ria. And the sit­u­a­tion is twice as bad with in­ter­nally dis­placed chil­dren. The cause of stunted growth in chil­dren has, in sev­eral cases, been traced to poor nutrition in their first 1, 000 days Ideally, the fact that you are a dis­placed per­son does not mean that your diet should be com­pro­mised. Also, know­ing their cir­cum­stances full well, and that they de­pend on what­ever they can get, who­ever is mak­ing such do­na­tions must be aware of the need of such women

Ra­matu in a jolly mood with her son and preg­nant friend, Christy Solomon

Baby Amos with a bot­tle of kunu Adie Vanessa Of­fiong

Nutrition alone takes 27.4% of UNICEF’s $146,867,901 re­quire­ment for six pro­ject ar­eas Map: unicef.org

A child eat­ing un­ripe cashew

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