Friday, August 17, 2012

the culture of motherhood: fat babies

Culture of motherhood: Fat babies
Every month, mothers take their babies to a growth monitoring clinic. The Ministry of Health in Zambia, in conjunction with the World Health Organization, recognizes that malnutrition in children under the age of five is a serious problem, and that if you can get a child past her fifth birthday, her survival rate greatly improves. So all kids under five are weighed every month in the hopes of helping the clinic staff identify underweight children before the problem becomes too severe.
Unfortunately, many children slip through the cracks. I had a mother come find me a while back who wanted me to tell her what was wrong with her sick child. This two year old had never spoken, hardly ever cried, could not sit up on his own and was generally lifeless. Exhibiting all of the signs of Kwashiorkor and Marasmus, two common malnutrition conditions characterized by spindly arms and legs, distended bellies and reddish hair, I asked the mother what the baby was eating. She explained that all they had planted was cassava, so the child, for two years, had only ever eaten cassava nshima and cassava leaves. I gently, but truthfully explained that the child was dying of malnutrition and that it was up to the mother and father to make a plan for how to nourish, and thereby heal, the child. He had not been witched, or cursed or unlucky.  He was starving to death. We added the boy to our Home Based Care client list making him eligible for nutrition supplements from our farm in the form of vegetables and eggs. Despite the improvement of diet, the little boy, unfortunately, still died a few weeks later.

Its kids like this that growth monitoring is supposed to save. Every child is given a card that has a graph on it. The different lines indicate various standard deviations above and below the mean. (whether that's an international or zambia specific mean, I'm not sure)

Its rather technical, actually, but all a mother need know is that the little dots charting her child’s weight should continue in an upward trajectory and stay above the lower red line.  Flat-lining, sloping down for more than two consecutive months, or dropping below that lower red line indicates a serious problem. I’ve helped with these clinics for years, being the weigher, the grapher and the one who makes babies cry by putting them in that terrifying, dangling swing.

We have a scale of our own at home and have no reason really to take Bronwyn to these clinics. They are long, hot and full of wailing. But we know how many babies suffer from parental neglect, and we want to set a good example. So, monthly, we too march our way up to the clinic and stand in line, waiting for our turn to put Bronwyn in the hanging scale. Last week she weighed 7.1kg and I was so proud. Look at my little chunk.

I think I told everyone between the clinic and home how fat she is. Everyone cheered. Big babies = healthy babies and healthy babies are what we all want. We sincerely pray that our concern for the health of our child will challenge and encourage others think the same towards their little bundles of joy.

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