Hopeful Again. The Story of Baby Areola

The case of Areola, a 10 months old baby born in Kibera Slums in Kenya is perhaps one of the strongest indications of how important Community-based Health and Nutrition Interventions can be especially within the marginalized communities and informal settlements.

She is the 2nd and last born in this small family of three headed by a single mother. The first born is my 22 years old sister. Areola was identified by our Community Health Promoter during our regular active case finding with a Middle Upper Arm Circumference (MUAC) of 10 cm indicating a case of severe acute malnutrition. 

She was referred to a link facility for further management where underlying medical conditions were ruled out. Management for malnutrition was however not possible at the facility due to stock outs for requisite nutrition commodities prompting us to enroll her back in our community-based management.

Her mother who was the sole provider for the family developed serious arthritis when her baby was three months and could not continue with her livelihood related activities. The situation meant that this burden shifted to the sister who now has to balance between school and providing for the entire family with all the challenges involved. Household food insecurity worsened during this period from the time Areola was 3 months old.

Our Assessment

We established that lactation and breastfeeding was seriously affected hence the onset of malnutrition in baby Areola as the mother also resorted to mixed feeding. Additionally, there was poor adherence to child welfare clinics since the mother is unable to move while the sister has to prioritize providing for the family.

Other assessment during admission into the program;

• Visible wasting (wrinkled skin around the abdomen and arms).
• Restlessness and the baby crying a lot
• The baby was weak and unable to sit or support her head without support.
• Static weight at 5kgs and stunted with a length of 60cm.

Intervention

Upon being enrolled into our program, nutrition counseling was a priority to the mother and the sister on maternal infant and young child nutrition and its importance during the critical first 1000 days of life. Our counseling also extended on adherence to child welfare clinics with nutrition services.

Our nutrition interventions covered three critical areas;

• Nutrition supplementation using corn soy blend and MAMA micronutrient powder provided by MAMA project.
• Home-based dietary modifications using the available foods that the family can afford and improved hygiene and sanitation.
• Close monitoring through house visits by our team for psycho social support and continuous guidance on implementation of our interventions.

Outcomes

We are glad to report that we have recorded tremendous improvement and success so far. The caregivers report that they can now make a balanced nutritious meal that is inexpensive from the nutrition education they received. Besides, the baby is now jovial, able to sit and is breastfeeding on demand. Anthropometrics have also improved with a current MUAC of 12cm up from 10cm, weight of 6.2kgs and a height of 66cm. Sustainable livelihood support for this family remains to be a work in progress. “We are grateful and only wish the MAMA project is able to reach out and help more similar cases,” the mother says. Areola is now 10 months old and the family is hopeful she’ll fully recover and grow to her full potential.

Conclusion

Areola represents several cases in the marginalized communities and informal settlements whose rights to healthcare and optimum nutrition remain a pipe dream unless more focus and support is directed towards community-based health and nutrition interventions like this supported by MAMA project and Community Connect for Communities. More support for this program will go a long way in ensuring a healthy, resilient, responsible and empowered community even as we look to scale our activities to reach more needy cases.