Apr 2, 2018

Report 4: 'Stop Malnutrition..." - Tikondane

one girls weight going towards average
one girls weight going towards average

Statistics

Average age of 229 children is 30.6 months

Average age of 109 grandmothers is 53.2 years

Average age of 229 mothers is 27.1 years

Average age of 120 fathers is 29.7 years

Years of schooling Grandmothers 2.7 years; Mothers 6.6 years; Fathers 5.1 years

Status Married 151, divorced 20, single 41, status unknown 17

Child’s place in family: First-born 64, in-between 38, last-born 121, position in family not recorded 6

Average age difference between siblings: just under 2 years (nationwide 3)

Children per family: 3.3

Eating together: 5.9 people

Sources of Income: farming 118, business 58, piece work 62, charcoal burning 4

Produce per family: maize 100 %, soya 46 %, cassava 11%, pigeons 10 % (about half of the grandmothers had been members of a Tiko women’s club)

Owners of cellphones: 100 out of 223, talktime per week 7.5 kwacha or 0.75 dollar or 75 cents

Children seen: 229 children were seen the first time, 146 a second time and 156 a third time. The second and third interviews questions were asked about food for the child with malnutrition.

Results from the third interview with 156 families:

For breakfast, lunch and dinner Porridge 134, Nsima 327, vegetable 194, protein 72, beans & groundnuts 103

Between meals Snacks including sweet potato or biscuits 25, breastfeeding 35. Those indicating nothing either verbally or nonverbally 65

Nutrition in detail:

For the families with 156 children who were on the road to malnutrition, there was no trace of a balanced diet: 461 x maize,( i.e. 3 times a day starch with just a little protein). Zambians prefer white maize meal which has very little protein. Tiko is introducing ‘brown’ maize, which is even cheaper to grind, mixed with 50 % cassavaflour. People are stuck on maize, so half cassava is a real important step forward. Cassava is cheap to grow, is drought resistant avoids he debts that go with hybrid maize seed and artificial fertilizer buying, even if subsidized.

For the 156 children there were 72 servings with protein, i.e. less than half of the family got any protein during the day, kapenta (dried fish) and eggs , some soya products (commercial) and beef. Note that the best servings go to the man of the family, if there is one, especially the fish (5) and chicken (2). Most received one and a quarter portions of vegetable, mainly rape (90), dried pumpkin leaves (65), okra (18), cabbage (8) and cowpea leaves (7). Two thirds got some legume once a day and only 35 families get one ‘in-between’snack, namely sweet potato (12), rice (6), banana (5) and one orange.

From observations and reports it is clear that meals are prepared for the entire family and only the father is favoured. It is unlikely that the mother took special care of the child with malnutrition. The malnourished child is not given special care and in fact the interviewers found the ONENEPA was being shared by all the children. This makes sense to the Director of Tiko. When years ago Tiko was distributing food to community schools, there were always some children described as especially in need. These were given extra bags of maize by World Food Programme, but most villages did not agree and divided that maize between all of the households.

Compared to a Mediterranean diet, out of 20 portions a day with fruit, vegetable, grain, and protein, these families get 18 portions out of 20 from maize. Considering that maize is being planted by almost all rural people in Zambia and is a disappointment every year for subsistence farmers, then there is not only the wrong food being produced , but also not enough of the wrong food!

Moreover, half of the children in one group and a third in the other had had diarrhea in the week before the interview. These findings are shocking and well explain why there is so much malnutrition in Katete.

Report from the fourth and last visit

With the rains having started early and then stopped, the first half of the harvest was lost. When the rains restarted, the farmers went to the fields with double zeal and there was no way we could hope to see the mothers and children together at all. So, only the under-five cards were collected.

Results: out of 164 children we had seen on the third visit, 30 had not been to see the clinic for being weighed in 2018, which left 134. Out of these, six or 4.5% went further down towards malnutrition, 28 ie 21% kept their direction from before, 10 or 6 % improved in the beginning and went down at the end or the other way round, but did improve overall and 90 or 69% did clearly change direction away from malnutrition.

Conclusion

Stop malnutrition in 200 underfives in Zambia was our goal. We saw 239 children at the first visit, and out of them 156 on the third visit. 100 of these had changed towards a better weight after 3 weeks with ONENEPA and 3 weeks without. That is half.

Whether these children will continue towards an average weight, in other words, whether we ‘stopped’ malnutrition in these 100 children is another question. Going by anecdotal evidence, namely the call from the mothers to please come back, we think we did achieve some change in awareness of the young child’s needs, but from the information we collected on the nutrition people get and the deep belief in sharing alike, not according to need, a more decisive change of mindset will have to be effected.

Just how unaware some people in the villages are as to the needs for healthy food you will find reported in Tiko’s newsletter from end of March. A new group we visited insisted they needed to start income-generating activities like chicken and did not take into account that not only did they themselves not have enough food, but that the pigs next door, the result of their last ‘income-generating activity’ had not had food for 5 days and no water for 3.

Not all of the money from the crowdfunding has been spent. We will go back to the villages with food demonstrations for snacks. When a mother is told that her toddler needs five meals a day, she will panick, because for her that means the need for five times cooking, which of course is impossible.

onenepa made a change
onenepa made a change
one boys weight went up, but no value for Jan/Feb
one boys weight went up, but no value for Jan/Feb

Links:

Jan 2, 2018

Report 3: 'Stop Malnutrition..." - Tikondane

Rozindabah and Miso are early for their trip
Rozindabah and Miso are early for their trip

Crowdfunding report 22nd December 2017

The last visit to the 229 children who are receiving food supplements should have been made at the beginning of December, but the rains came early so everyone in Katete district has been working in the fields since then. Tiko also gives the crew two days off to tend their own fields each week during this planting time. This meant that the facilitators were not consistently available and in any case,would not have found mothers and children for the meetings which take place in the open. February is the time for weeding, so that will be a better period for our visit and in the meantime, we hope that the children are still benefitting from the food supplement and their improved diet.

In fact, we started with what to most donors would seem to be a simple project, but in rural villages in Zambia this brought to light problems you would not have thought of!

At least three visits were made to each village and as well as some obvious progress, they showed up obvious cultural differences. Let’s admit that, by Western standards, many of the visits started pretty chaotically – the mothers are not there since often women take their children to visit relatives (any report of some relative not being well calls for a visit) and children from one village may be found in a different one; a funeral is taking place and everyone has to attend that as per tradition; some other village activity was planned, but not communicated to our facilitators – a myriad of reasons why appointments had to be changed or single families be found on other days.

When trying to find a mother and child again, there may be a problem with names. The mothers change their names the moment their babies are born; they become ‘mother of …” and, with a number of children, that becomes really difficult. Moreover, most people in Katete have Banda or Phiri as their surname. Using first names works very well within Tiko, but outside it is not easy to always identify people.

In the local culture verbal communication is limited. Although they love them dearly, adults do not talk to babies or toddlers. They believe that it is no use talking to somebody who cannot yet talk and the Western way of talking to babies (and dogs) seems totally mad to them. The result is that children’s language development is delayed and, as they rarely learn to speak clearly, the whole community basically mumbles. Girls in particular must avoid attracting attention and will not be able to speak up loudly other than with their peers. Add to this the fact that the Tiko facilitators have limited education themselves and their questions are not taken as seriously as one would wish. Moreover, if people don’t understand or don’t like a question they simply do not answer.

One also has to take into account that for the people here ‘food’ means ‘nsima’ or maizepap, - (now for some mixed with cassava) or porridge, which needs cooking. This usually takes two hours on an open fire for which wood first has to be collected. There are no ready-made meals or special foods for toddlers to make up five feeds per day. The idea of mashing fruit and vegetables for small children is new and in any case, this is difficult to do for women who are often without utensils that most people elsewhere would consider minimal basic equipment.

Tiko is working on this and hopes soon to be able to supply some nourishing foods that do not require cooking such as tasty vegetable or granola bars. But that won’t be easy: Even the crew at Tiko, who should be used to my funny ideas, were not impressed by the roasted sunflower and pumpkin seeds that are so popular in many parts of the world including Zambian towns. Remember that in a traditional society changing tastes is a multi-generational task!

Enough of these problems. We are pleased that we can report that many mothers sent messages to tell us that their children were growing well and that they wanted more ONENEPA. Definitely, something good has started to happen and next time we will send some data. Thanking you all from the bottom of our hearts and wishing you a contented Christmas –

yours ever Elke and the Tiko crew

two of the many children who face a better future
two of the many children who face a better future

Links:

Oct 17, 2017

Report 2: 'Stop Malnutrition..." - Tikondane

A home in a village with latrine (l) and silos (r)
A home in a village with latrine (l) and silos (r)

Crowdfunding Project: Stopping Malnutrition in Children Under Five in Zambia  Report to Donors

 

Thanks to your donations we were able to start our project. For example, when after some delay the money reached our bank 80 km away, we were able to buy bicycles to get from Tikondane Community Centre to the villages and buy scales so that we could record the weights of the children. In the first two weeks we cycled to the first ten villages to distribute Onenepa. The third week we evaluated the data we had gathered.

The clinics issue record cards for the first 60 months for the under-fives, but many are inaccurate since many of the mothers are uneducated, birthdays and dates are not important in Chewa culture and the cards are sometimes inaccurately filled in by the staff of the clinics. We therefore had to determine which children were underweight and in need of food supplements. We included children whose weight was not dramatically under the average for their age, but was going down.

We also had to consider how the mothers could give the supplement to their children and what equipment they would need. We then decided what to teach about a balanced diet and the importance of healthy and regular nutrition.

In the villages most families lack the basic amenities and equipment that we take for granted, so we decided to give to every mother a spoon and a fork in order that they would be able to mix the supplement with water or add it to some mashed fruit, vegetables or porridge. To mix the powder with water they would need a plate or a bowl but as new kitchen tools would probably be shared with the whole family we started to produce our own small tins, using old soft drink cans. During this time enough Onenepa for distribution to 100 children for the first two weeks was produced at Tikondane. The supplement includes pounded soya beans, pounded maize, Moringa powder, milk powder, dark sugar and chocolate powder, thus the three food groups, plus abundant vitamins and minerals. This should also stimulate the appetites of the children.

When all preparations for visits to the villages had been made we informed the headmen about the days we would come. Each time our two teams made an early start to ride to two different villages. During the first week, even though a funeral interrupted our plans, we were able to visit ten villages. We returned to the same villages with the second supply for the week after. On arriving at our destination, we always had to wait for some time until everyone appeared at the meeting point. We could then introduce ourselves and the programme and teach the mothers how to give Onenepa to their children as well as the need for a balanced diet. As people here are not that used to adding vegetables to their meals we presented Moringa and explained different ways in which to use this plant which is richer in minerals and vitamins than any other vegetable. To stress the importance of enough vegetables being included in our feeding plan we also gave a moringa seedling to each mother.

We then weighed each child and interviewed the mothers and children to get information about the family and the health of their children and observed the behaviour of the child and its interaction with its mother.

At the end of the interview we distributed the first package of Onenepa, plus spoon, fork and tin to each mother.

For our second visit we prepared a different questionnaire and included a protocol about the food that the child had received the day before and the morning of our visit.

Of course, not all the mothers who were supposed to come showed up, while others who had heard about our project and wanted to take part, arrived. So we had to decide if each child was really underweight and if there were enough supplies to include it. We now plan to distribute Onenepa to all the children we treated during the first two weeks for a third time and to see the next group of children for the first time.

We really look forward to continuing the project and hope soon to see first changes in the weights of the children and the minds of the mothers.

Thanks again for your support - without your donation ‘Stopping Malnutrition in Katete District’ would not be possible!

 

Tikodane Community Centre, Katete, Zambia

Email: tikoeducation@gmail.com

Website: tikondane.org

Our team  ready for action!
Our team ready for action!
Gracious, her mother and moringa plant
Gracious, her mother and moringa plant
explaining to the mothers how to prepare onenega
explaining to the mothers how to prepare onenega
Ezara carefully weighing a child
Ezara carefully weighing a child
Mathilda  with her mother - first visit
Mathilda with her mother - first visit
Mathilda with her mother - second visit
Mathilda with her mother - second visit
Gibson with his mother - first visit
Gibson with his mother - first visit
Gibson with his mother - second visit
Gibson with his mother - second visit

Links:

 
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