IDP children: Challenges of the first 1000 days
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