Rwanda

In Rwanda, Combating Malnutrition Begins with Educating Parents

Malnutrition continues to be a problem for many Rwandan children, but the country is making some strides. Rwanda’s Ministry of Health, in collaboration with health centers and counselors, has launched a number of programs that teach parents how to grow and prepare vitamin-rich food.

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In Rwanda, Combating Malnutrition Begins with Educating Parents

Janviere Uwimana, GPJ Rwanda

Women gather with their children and listen to a health specialist discuss proper child nutrition at the Murara Health Center in Gisenyi, Rwanda.

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RUGERERO, RWANDA — When Vestine Umwanankundi learned her three children were suffering from malnutrition, she worried that she wouldn’t be able to afford the quantity of food necessary to ensure their health.

“I used to think that what was really important for my kids was to eat large quantities of food to such an extent that I could feed them sweet potatoes and beans every morning, noon and night,” she says.

Other mothers in her village near Gisenyi, the Rwandan town bordering the Democratic Republic of Congo, stepped in and taught her that nutrition means including a variety of healthy foods in the diet.

“I learned from fellow moms that contrary to my earlier belief, proper feeding has nothing to do with money, because I can even pick veggies, Sombe (cassava leaves), and spinach leaves from a garden at my home or my neighbors‘ home without having to buy them,” Umwanankundi says.

Her neighbors began to help when they noticed her 2-year-old showed signed of malnutrition after her husband had deserted the family.  “Sometimes, we could only afford to eat once a day with the help of our kind-hearted neighbors,” she says.

I learned from fellow moms that contrary to my earlier belief, proper feeding has nothing to do with money, because I can even pick veggies, Sombe (cassava leaves), and spinach leaves from a garden at my home or my neighbors‘ home without having to buy them.

“My son had just turned 2 when his cheeks and abdomen started becoming swollen. However, I thought there was nothing wrong with it until a neighbor told me that my kids were falling prey to kwashiorkor, ” she says, referring to the formal name of a life-threatening form of malnutrition caused by a lack of protein.

Malnutrition continues to be a problem for many Rwandan children, but the country is making some strides. Levels of malnutrition among children under 5 dropped to 36.7 percent in 2015, down from 43 percent in 2012, according to the Comprehensive Food Security and Vulnerability Analysis (CFSVA) report conducted by the Rwandan Ministry of Agriculture and the World Food Program.

While the problem is declining, the report noted that the rates of chronic malnutrition remain stubbornly high, especially in rural areas, and that such malnutrition permanently affects brain development. Contributing factors for young child malnutrition include poverty, lack of education and shortage of agricultural land.

To educate families, the Rwandan Ministry of Health, in collaboration with health centers and community health counselors, has launched a number of programs, including Igikoni cy’umudugudu (village kitchens), where women are taught to grow and prepare vitamin-rich food for their children. The kitchens are part of the “1,000 days” campaign, a government program aimed at ensuring that children get the nutrition necessary for healthy development in the first crucial 1,000 days of life.

During village kitchen sessions, community health counselor Alexia Murekatete says local women contribute food items, such as vegetables, potatoes, minnows, small dried sardine-like silver lake fish (known locally as ndagala) and fruits to help others.

“Mothers are brought together to learn together how to prepare and combine foods to make balanced diets to protect children against diseases caused by malnutrition,” she says. “We hope malnutrition will no longer prey upon our children because parents are beginning to realize that ensuring healthy eating for children doesn’t require parents to be ultra-wealthy.”

Madeleine Ndererimana, 33, helped Umwanankundi find low-cost solutions.

“Every time I saw her children suffering from kwashiorkor, I felt an infinite pity for them. So I decided to help their mother make a small vegetable garden at home, and it really helped them a lot,” she says.

Neighbor Diane Ingabire, a mother of four, shared her tip to include protein for combating malnutrition.

“If I hadn’t been more careful, my twin daughters would have already died,” she says. “I took small dried sardine-like silver lake fish (Ndagala), and crushed them into a powder for use as a nutritional additive to every meal. As a result, the signs of malnutrition went away in a few days.”

We hope malnutrition will no longer prey upon our children because parents are beginning to realize that ensuring healthy eating for children doesn’t require parents to be ultra-wealthy.

Blisse Kampire, a community health officer at nearby Murara Health Center, says she meets with mothers at vaccination sites every month and teaches them how to keep their kids healthy as part of the “1,000 days” program.

“I avail myself of the immunization days to teach them how to care for their children, especially telling them that eating well doesn’t mean spending the big bucks,” Kampire says.

Each family goes home with a package containing vitamin A, vitamin C, vitamin D3, vitamin E, vitamin B1, vitamin B2, niacinamide, pyridoxine (vitamin B6), vitamin B12, folic acid, iron, zinc, iodine and selenium. The vitamin powder is mixed with lukewarm food and it is given to a child three times a week, Kampire says.

Nicolas Mugisha, an officer in charge of environmental health in the Murara district, says the problem is that some parents blame other forces instead of malnutrition or disease.

“When the child starts showing signs of malnutrition, witchcraft is something that immediately springs to the parent’s mind, instead of taking the fight to the real problem,” Mugisha says. “In any case, this is definitely a big problem in our society.”

Vestine Umwanankundi is now an ambassador to other women in her community, and says she has come to realize that knowledge is the key to the door of a better life.

“I didn’t even have a clear idea of the meaning of word ‘vitamin’ before,” she says. “Today, however, I first make sure foods are rich in vitamins before feeding my children.”

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Janviere Uwimana, GPJ Rwanda

Children who come to the Murara Heath Center in Gisenyi, Rwanda, for vaccinations are weighed to check their health. Families are sent home with vitamin packs.