This report was written by Self-Help International Board Member and nutritional advisor, The Rev. Dr. Mary Jane Oakland, following a trip to Ghana in November 2019. Dr. Mary Jane Oakland is an emeritus professor of Food Science and Human Nutrition at Iowa State University. She has served on the Self-Help International Board of Directors since 2006.
Self-Help International’s Growing Healthy Food, Growing Healthy Children program is improving the health and nutritional status of pregnant and lactating women and their babies. The program provides nutrition and health education along with teaching the mothers and their families to grow ingredients for a nutritional weaning food and to participate in income generation strategies.
Today was my last day with moms and babies in the villages of Beposo and Kukubuso, Ghana. I saw two little toddlers who are growing and thriving despite being separated from their mothers during the all-important breastfeeding period. Without this program of intensive nutrition support, they well may not have made it to toddlerhood.
I have the privilege of working with two fine Ghanaian nutritionists in this program, as well as agriculture specialists and program leaders for empowering women and girls. This whole team is changing the trajectory of the lives of women and children in a village where most scrape together an existence as share-cropping cocoa farmers.
For women who join the program during pregnancy, all of them have been able to successfully exclusively breastfeed their babies with excellent growth patterns during the first six months. Weaning from breast milk is a challenge because of the low nutritional value of the family diets, but we are seeing women willing to feed their babies according to the new information they learned who are having positive results. Last year, the moms and babies lost weight during the cocoa harvest, so this year all the women haven taken a pledge not to let that happen again. The women brainstormed ways in which they can work in the fields and still feed their babies and themselves.
There is still much work to be done - until enough food is grown and income generated so these villages are no longer perpetually hungry. The response of the moms and their children has shown us that the stunting rates that impacted the development of the children have been dramatically improved.
Today, I looked into bright eyes of two active toddlers. Last year, I feared we were not going to be able to turn them toward healthy growth and development. Thank you to all of our dedicated staff and to you, our supporters, who are helping Self-Help International make a difference in the lives of moms and babies.
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Jamilatu moved from her home near the Ivory Coast to Kumasi at just ten years old. She was staying with an aunt who had promised to pay her school fees and support her while she was in Kumasi, but her aunt did not follow through on her promise. To support herself, Jamilatu sold water on the streets, often in very dangerous road conditions. She met her husband through this work and moved to Beposo, a small village outside of Kumasi.
Life in Beposo has been challenging. Her husband rents land to farm and making a profit off this rented land is often difficult. Jamilatu tries to supplement their income with growing and harvesting peppers, okra, and small eggplants found in West Africa known as “garden eggs.”
When Jamilatu was five months pregnant, she was no longer able to work on her farm. She started attending Growing Healthy Food, Growing Healthy Children (GHFGHC) nutrition education sessions. She told Self-Help International nutritionists that she was not planning to receive antenatal care during her pregnancy because she already had two children and was familiar with being pregnant. Self-Help staff spent extra time counseling Jamilatu on the importance of doctors’ visits and medical care during her pregnancy, and she quickly realized how vital those visits would be. After visiting the doctor, Jamilatu learned that she was expecting twins! She was so grateful to have visited the health center.
Jamilatu had a new onset of questions after finding out that she’d be having twins soon.
Getting Support to Have Two Healthy Babies
“Although I have two children already and I know some of the challenges that come with raising kids, I was afraid of having twins because of breastfeeding and the general care twins need,” Jamilatu shared with Self-Help nutritionists.
Again, the Self-Help team spent extra time with Jamilatu to help ease some of her fears and equip her with the knowledge she needed to raise two healthy babies at the same time. They counseled Jamilatu through to the healthy delivery of her new babies and provided direction on breastfeeding and healthy eating for her as a new mother.
“It took the magic of Self-Help’s staff to show me how to breastfeed children who will not open their mouth to eat,” Jamilatu said. “With my previous pregnancies, I depended on my mother to travel to Beposo to take care of me.”
Self-Help Trainings Benefit the Whole Family
In fact, Self-Help trainings have benefited Jamilatu’s whole family.
“My husband came with me to the first financial management training organized by Self-Help to help me take care of the children, and he became an unexpected beneficiary of the training,” Jamilatu said.
Self-Help staff were discussing good financial management practices during the training. Her husband had not been sharing the family’s income with Jamilatu and had not been saving enough for the family’s supplies and necessities. After the training, he told Jamilatu that he had been listening attentively and understood that he should not be keeping money for himself.
“He has now opened a savings account with a bank in a nearby community and has stopped spending on unnecessary items,” Jamilatu said.
Jamilatu is still involved in the program and is helping other mothers overcome any challenges they may encounter with breastfeeding.
“I listened attentively to Self-Help staff when they were educating us on caring for our babies,” Jamilatu said. “Self-Help has indeed made me an even better mother.”
All parents dream to see their children succeed academically or in other endeavors, but the ups and downs of life can often interfere with this dream. Diana, a 15-year-old mother from Kukubuso, a small village in the Ashanti region of Ghana, decided that she was going to overcome the challenges she was facing.
Diana’s father struggled to care for his nine children, so when Diana was in elementary school, he sent her to live with her aunt. For a few years, this was a very positive experience for Diana. Diana’s aunt provided for all of Diana’s basic needs and paid her school fees; however, things changed when Diana started junior high school. Her aunt stopped supporting her and no longer provided food or school fees. Diana didn’t know what to do.
As Diana was beginning her second year of junior high school, she found out she was pregnant. Diana could no longer stay with her aunt, and she returned to Kukubuso to live with her parents once again.
“The father denied responsibility for the baby, so I had to rely on my parents for food and other necessities, which I know has never been easy for them”, Diana shared.
Diana was not getting enough to eat, she was losing weight, and after giving birth, she was having difficulty providing adequate breast milk for her baby.
When Diana joined the Growing Healthy Food, Growing Healthy Children program, Self-Help International staff nutritionists completed assessments on her and her baby. Diana’s baby was stunted, an indicator of malnutrition, and Diana herself was malnourished as well. Babies who experience sustained malnutrition early in life are unable to reach full cognitive development, affecting their ability to learn and their productivity for the rest of their lives.
Self-Help nutritionists advised Diana on healthy eating and supplied her with a high protein porridge food supplement and an egg a day to address her immediate nutritional needs. Diana received counseling on breastfeeding and connected with a respectable and experienced mother in the community to provide ongoing support and lactation coaching.
Diana was always eager to listen to the lessons and advice given during Self-Help nutritional education sessions. Her punctuality and attentiveness at meetings was exceptional. As staff continued to monitor her and her baby, it became apparent she was putting all the lessons into practice. Her baby moved from the third percentile of stunting to the 50th percentile, putting him on track to achieve full physical and cognitive development.
“Although I am not independent now, I know I can do something better for myself and my son with the advice and help from Self-Help,” Diana said proudly.
She started a broom business in Kukubuso. In order to care for her baby, Diana accepted that she would need to move past her dream of returning to school and becoming a police officer - she needed to focus on her business and her baby. Self-Help staff talked with Diana and her parents about the importance of education for both Diana and her baby. Her parents have agreed to help Diana continue her education once the child matures.
Diana’s ability and commitment to improving the health status of her baby, as a teenage mother, is highly commendable. She is determined to continue raising a healthy son and pursue her dreams, and for the first time, feels that both are possible.
Elizabeth, a mother of two from the village of Beposo in southern Ghana, joined Self-Help's “Growing Healthy Food, Growing Healthy Children (GHFGHC)” maternal-child nutrition program when it first launched in 2018. Although she knew it was for children under the age of two and that her 18-month-old son, Derrick, would soon age out of the program, she was committed to learning as much as she could about proper nutrition to ensure a healthy diet for her children.
“I was very determined to improve both my life and the life of my kids,” Elizabeth shared, reflecting on the reason she became involved with the GHFGHC program.
By participating regularly in weekly training sessions, Elizabeth learned from Self-Help's trainers about the importance of Vitamin A in children’s diets, and during the minor rainy season, July - mid-October, she observed other mothers in the program growing orange-fleshed sweet potato (OFSP). The vines were in short supply, so she was among the second group to be able to access the vines to grow OFSP on her own farm.
Difficult First Steps
Elizabeth received her vines at the start of the dry season and was not be able to rely on rain water to grow her crops; instead, she had to transport water from a local river or stream by walking two-thirds of a mile each way from her farm to the river and carrying the heavy load of water back to her farm. Because of the difficulties transporting water, Elizabeth did not initially intend to plant any crops during the dry season; but after learning about the benefits of OFSP and receiving starter vines from Self-Help, she decided she would take on the challenge.
“Self-Help taught us mothers how to cultivate OFSP and supplied us with the vines to begin growing it. I was not sure this new crop was going to do well,” Elizabeth said. “We were told it needed water, especially during the first two weeks after cultivation. It was nearly the end of the rainy season when we learned this, and the rains had almost stopped coming in Beposo. I decided to give it a try anyway, and I dedicated time to watering my crop.”
Luckily, Elizabeth’s tireless efforts paid off.
“My dedication was not in vain because I have reaped the fruits of my labour. The crop did very well, and I started harvesting late December 2018,” Elizabeth said.
The Importance of Education
Providing education to increase knowledge is central to all of the programs at Self-Help International. Self-Help is constantly seeking ways to equip clients and partners with accurate and relevant information to help them make sound decisions to improve their lives. It is vital that the new information is able to be integrated in to the daily lives of Self-Help participants.
“Self-Help also taught us some OFSP recipes as hands-on practical training, so I already knew how to use the tubers before the crop was even ready for harvest,” Elizabeth shared. “My family really loves all the dishes prepared from OFSP, and my little boy really loves the chips and the OFSP leaves sauce.”
Reaping the Benefits
Elizabeth’s vines have continued to grow and are even extending into neighboring farms. She plans to cut some of her vines and share them with other mothers in the program and community members so they can also grow OFSP. She is continuing to share the benefits of her education and the OFSP itself.
“I am not the only one enjoying this harvest,” Elizabeth said. “I have given some to the other mothers who are part of the GHFGHC program to cook for their families.”
“As the popular saying goes ‘sharing is caring,’ and I strongly believe this is the reason why Self-Help supporters are also sharing with us: to make it possible for us to live a life with dignity. A very big thank you to all of Self-Help’s supporters. Your gifts are really going a long way to help us and our children,” Elizabeth added.
Elizabeth is an exemplary leader, both as a farmer and as a mother concerned with her children's health. While her son, Derrick, has now aged out of the intensive first 1,000 days intervention, Elizabeth and Derrick still regularly attend training sessions, which are free to all of the community, so she can continue to learn about new ways to support her two children at home.
From April 8-12, GlobalGiving will match donations of up to $50 to Self-Help's projects at 50%! That means that by making a donation of $40 today, GlobalGiving will give an additional $20, so you can sponsor three months of nutrition intervention for a mother and her baby! Read complete terms and conditions here.
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It is often sad to see malnourished women and their children in our rural communities. The question that comes to mind is: why are these communities that produce food for people in the urban areas malnourished? Could this be attributed to inadequate knowledge about food preparation methods or food distribution in the households?
This is the situation in the village of Beposo, Ghana and Akosua, a 20-year-old mother of one, told Self-Help staff in Ghana how she’s starting to address this issue. Akosua joined the Growing Healthy Food, Growing Healthy Children (GHFGHC) program last year.
“I got pregnant again when Lapope, my daughter, was 12 months old, and this compelled me to stop breastfeeding her. I realized my daughter was losing weight, but I didn’t know what to do because accessing food had always been a challenge for my family,” Akosua said. “‘Diversified meal’ was not in our dictionary - the only food in our diet was akple, a dish made from corn flour and grinded pepper, and sometimes ayoyo, a green leafy vegetable soup. Any leftover akple would be mashed with sugar for breakfast and sometimes lunch.”
“My family depended on this for survival for many years until, one day, a friend told me about Self-Help International and its program,” Akosua said. “Although I registered with the program as an expectant mother, I attended meetings with my 19-month-old daughter. The moment the nutrition officer saw my girl, he noticed she was malnourished and registered her into the program as well.
“My girl and I were supplied with a food supplement called Tom Brown, which is a mixture of Quality Protein Maize (QPM), ground nuts, and water. Upon further nutritional analysis of my girl and me, we were given eggs to help improve both our macro and micro nutrient status”.
Lapope was further supplied with Ready to Use Therapeutic Foods (RUTF) by Self-Help to help her catch up with her growth, after she had been confirmed by a medical officer that she had no medical condition.
Akosua told Self-Help, “With these food supplements, my girl is now growing well and I can confidently say my unborn child will be born healthy. I cannot say my household is completely food secure, but one thing I know is: the headache of not knowing what to eat for breakfast is now a thing of the past. Many women from Beposo have benefited from this program - my family and I have been saved by this program”.
More importantly, Akosua and 69 other women from Beposo and surrounding areas have received the knowledge and skills to grow QPM, a vital component in the Tom Brown supplement. With the onset of rains in March 2019, they are going to receive fertilizers, seeds, and herbicides to grow their own QPM and other nutritious crops such as orange-fleshed sweet potato (OFSP) to feed their family and ensure a healthy community full of strong and energetic children to help realize the dreams of Ghana.
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