Malnutrition in Karamoja

MOTIONLESS, she lay on her mother's lap. She looked severely emaciated. The skin on her body is wrinkled, pale, and peeling off. And when she attempts to cry her voice can hardly be heard.  When she was taken to the therapeutic feeding centre, the 2 year old, Lucy Nasugai weighed only 3.2kg.

Nasugai is one of the over 29,7494 children in Karamoja who have been hit by severe malnutrition; a condition that occurs when the body fails to get the right quantities and proportions of nutrients for it to maintain health and proper function.

Malnutrition according to a briefing note from Food and Nutrition Technical Assistance (FANTA2) kills, causes diseases and makes disease even more severe.

Cyclic drought in the region has aggravated the situation, affecting both crops and livestock, causing food insecurity and severe malnutrition, especially in infants and children younger than five. Indeed, the child survival rate in Karamoja is among the worst in the world, according to UN agencies.

Both local and Health officials in Nakapiripirit,Moroto and Napak paint a grim picture of the severe  malnutrition situation in the three Districts.

An estimated 39 out of 375 children who were being treated for malnutrition in Matany Hospital are known to have died in 2011, while 22 escaped from the feeding centre, according to Ngiro Martin, a health educator for Napak District who is attached to Matany Hospital .

’Our major challenge here is that people look at malnutrition not as a deficiency but as a curse or withcraft,as most people are illiterate and the latrine coverage is low”,Ngiro said.

He pointed out that empty granaries are also a major challenge to the fight against malnutrition in Karamoja.

“The year is just beginning and the situation is already out of hand and yet we expect it to worsen from March upto June “,Ngiro notes.

In Nakapiripirit,the District Health officer,Dr.John Anguzu  said out of 1,397 cases recorded, 448 cases were admitted to various health units in the District.

“In September 2011, we had 301 malnutrition cases, 161 admissions and two deaths. In October we had 339 cases, 113 admissions and four deaths, in November we had 366 cases reported, 115 admissions and one death and in December 2011 we recorded 331 malnutrition cases, 59 admissions and one death. Our non recovery rate is at 16%”, Dr Anguzu said.

He adds that in January alone they recoded 2,004 cases of severe malnutrition.

Timothy Teko,a Nutrition Focal Person in charge of Napak and Moroto pointed out that though malnutrition was high in Karamoja it malnutrition has not yet reached a critical level.

According to the LC1 chairman of Nakapelem settlement, a suburb in Moroto town,Alibino Lobong,two out of 60 severely malnourished children in this village, mainly occupied by poverty stricken Karimojong have died due to malnutrition.

“Most of these children you see here are living at the mercy of God. Their families can hardly afford to prepare a meal in a day; they mostly live on porridge which is always taken at lunch time”, he told the visiting humanitarian services Country Director for The church of Jesus Christ of latter day Saints, Elder Karl Beckle who together with Sister Robin Beckle was in the area to handover nutritional food supplements on Saturday 4th and Sunday 5th.February 2012.

Church of Jesus Christ of the Latter Day Saints has given 100 bags of Atmit; nutritional food supplement for Tokora health Centre in Nakapiripirit, Moroto Regional Referral Hospital in Moroto and Matany Hospital in Napak.Abim,Kotido,Kaabong and Lira are also expected to benefit.

"Crop harvests this year have been affected by the heavy rains; otherwise we would be having some food here," said Moses Chuna , an elder from Napak.

According to the UN Children’s Fund (UNICEF), Karamoja represents a developmental and humanitarian challenge to Uganda 's stability and poverty eradication efforts. "Mortality and malnutrition levels routinely surpass recognized crisis thresholds," a UNICEF briefing note indicates.

John Lorot,the LC5 Chairman for Nakapiripirit District malnutrition has been compounded by last years floods which devastated the area and destroyed food crops which people were about to harvest.

“It’s now a double tragedy for us here, we lost our food crops to floods and also lost our cows to the cattle rustlers who frequent this area because the disarmament exercise has been largely a success here. We appeal to government and humanitarian organizations to rescue us. And also government should degazette the green belts here because all our fertile areas are under the game reserve for wild life conservation”, Lorot said.

Due to its semi-arid nature, villages are far apart and families seeking treatment for their malnourished children have to trek many kilometers to reach hospitals or food distribution points and the therapeutic feeding centres and nutrition services in a few of the region's health facilities.

“Karamoja suffers from one the worst rates of malnutrition in the world. In 2010, 16 per cent of children under the age of five suffered from acute malnutrition, and nearly 40 per cent of children in this age group were underweight” according to FANTA2 briefing notes.

The Mayor Moroto Municipal council, Alex Longona said malnutrition was equally prevalent in the urban area.

“Hon Minister, please consider us also in the urban centre for relief assistance. Some people think we people in town are well off. But as you can see we have many children here who are severely malnourished”, he said.

Over 60 children in Nakapelem settlement in Moroto Municipality are severely malnourished, according to local leaders here.

The Minister of State for Mineral Development,Peter Lokeris who is the MP for Chekwi County in Nakapiripirit District warned that the food situation in the whole of Karamoja may worsen in the coming few months.

”To make it worse even the food stores for UN World Food Programme in Nakapiripirit where we would have relied for some relief assistance are empty”, he said.

Musa Ecweru,the Minister of sate for Disaster Preparedness and Relief who visited Karamoja to assess the situation promised that government was going to feed the people of Karamoja upto to the rainy season.

“As government, we pledge that we shall feed these people until they are able to harvest their own food. We shall also give them planting materials. But as a matter of urgency, we are going to meet all the humanitarian agencies like UN World Food Porgramme,Food and Agricultural Organization and other stake holders to discuss how we are going to make a coordinated intervention in Karamoja”,he said.

According to the briefing note from Food and Nutrition Technical Assistance (FANTA2),  , at household level, the main causes of malnutrition are women having workloads so high that they cannot provide quality child care, poor sanitation, and hygiene, frequent pregnancies, and poverty caused by lack of livelihood alternatives in rural areas.

All these can be true of Karamoja where women are the major bread earners and are as well responsible for child upbringing as men go for hunting and looking after cattle.

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