Monday, January 15, 2018

Skilled health workers helping mothers to tackle undernutrition in Timor-Leste

Joaquima Felisberta (30) is the Nutrition Coordinator at the Maliana Community Health Centre
is checking health of  Francisca’s baby.
She estimates of the 300 patients her team sees every week,
approximately 10 will present with malnutrition.  @UNICEF Timor-Leste/2017/bsoares
The baby cradled in Francisca Isabel Revio’s lap shifts and whimpers, waking from a nap in the sticky afternoon heat as her mother sits in the Maliana Community Health Center waiting room. Anticipating the baby’s cry moments before it happens, Francisca (41) calmly pulls up the hem of her shirt and begins to breastfeed the child without pausing her sentence.

“I don’t know why it’s this one that has the problem,” she’s saying, gesturing to the 13-month-old now suckling quietly. “None of the others ever got it.”

Francisca’s baby daughter is her youngest child and the first in her family who gets often sick and low weight. She is surprised, and she’s come to the health facility to seek treatment for the girl.

Mothers leading the way, considering every cause

“We wash our hands before we cook, we drink water only from the gallon, the baby drinks breastmilk,” Francisca continues, confidently reciting several factors may reasons that her child may get sick. “The other children eat rice, yam, cassava, corn, papaya leaves, other vegetable leaves … we’re farmers, so whatever we can grow.”

Like most of the population in Timor-Leste, Francisca and her husband are subsistence farmers, who eat whatever they can grow on their land, and live on a wage of around USD 1 per day. At 41, she’s strong and active, and despite the difficulty of growing food in drought-stricken Maliana, Francisca makes sure her family eats at least twice a day.

If you didn’t know, you’d assume Francisca to be the nurse, not the worried mother of a malnourished child. A subsistence farmer, pregnant at 20, she’s not the first person you’d guess to be examining paperwork, explaining nutrient profiles, questioning sanitation practises and conducting diagnoses.

But, of course, as a mother, she’s the best person for the job – and the resources, information and trustworthy consultancy provided by the Health Worker ensure she’s equipped with what she needs to do it well.

The baby’s diet is unlikely to be the problem, and Francisca knows it. Feeding practises, sanitation and diarrhoea and illness can all contribute to poor nutrition in children. While around a third of children in Timor-Leste are underweight, a lack of food isn’t necessarily the problem: according to the country’s 20013 National Nutrition Survey, it’s because nearly three-quarters of children aren’t getting an adequate diet, which comprises both the frequency of meals and the diversity of a child’s diet.