Journey to better health: Childhood malnutrition in Rwanda

by Maggie Andresen
Thursday, 29 November 2018 02:00 GMT

Maggie Andresen is the winner in the Multimedia Unpublished category of the 2018 Food Sustainability Media Award, and initiative by Thomson Reuters Foundation and Barilla Center for Food and Nutrition.

In Rwanda, 38 percent of children under five are chronically malnourished and at high risk of stunting, according to data from the United Nation’s children’s agency UNICEF. This has prompted the government to make ending childhood malnutrition a national priority, although it can be difficult to intervene in hard-to-reach rural areas. While stunting rates have declined from about 50 percent in 2005 to 38 percent in 2014/15, they still remain stubbornly high with the government working towards a target for all districts to reach a 19 percent stunting rate by 2024.

Nyirantungane Claudine, a 21-year-old mother of twin daughters Uwiduhaye Divine and Muhawenimana Kevine, is one such case. At the time of this photo essay, Claudine's daughters were suffering from severe acute malnutrition, a serious condition found most frequently in countries suffering from conflict-induced food shortages. Claudine's family also had no secure housing, which is a large contributor to childhood and generational malnutrition. 

In January 2018, Claudine enrolled in a three-month programme through her local health centre with a local non-profit, Gardens for Health International (GHI). GHI combines nutrition and agriculture training to create a sustainable solution to childhood malnutrition in Rwanda. Although the training Claudine attended addressed the various causes of malnutrition, her daughters  did not increase in weight during the three month programme. This was in large part due to the family's housing insecurity, a critically under-discussed contributor to both childhood and generational malnutrition. The family lived a 45-minute walk from their local health centre, in a one-room shack made from banana leaves and timber, which was on the property of her in-laws. When it rained, the roof leaked and Claudine’s children would fall ill. As the twins were not enrolled in government health insurance, all of the family's income was spent on treatment for the girls  who never fully recovered from an illness before falling sick again due to their malnourished state.

With advocacy from GHI and cooperation with local leaders in her community, GHI supported the construction of a new house for Claudine’s family during an Umuganda day, a monthly Saturday spent in obligatory public service. Following the construction of their home, two months after graduating the GHI program, Kevine and Devine gained 4 kgs (8.8 lbs) each - and today are officially out of the red and yellow zones of malnutrition. Once the family had a stable home, Claudine could concentrate fully on the needs of her daughters. 

Claudine’s family still faces many challenges; their income remains inconsistent and their garden did not produce as many vegetables as they had hoped due to last season’s heavy rains. But the security of their home will continue to support their livelihood as they aim for economic stability. Stories like Claudine's show the integrated causes of childhood malnutrition, and the need for innovative solutions that address the various contributing factors.

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