The Integrated Management of Malnutrition (IMAM) project in Hiran Region in South Central Somalia was started in April 2012 by Oxfam and Humanitarian Action for Relief and Development (HARDO) to treat malnourished children. So far, 2,184 children have been admitted in four treatment sites in Belet Weyne districts.
Initially, the sites would attend to about 60 new patients everyday but this changed because there were frequent gaps in the supply of Ready-to-use Therapeutic Food (RUTF) or plumpy’nut. This is a peanut-based paste in a plastic wrapper for treatment of severe acute malnutrition that can be administered at home. Children are currently being admitted after supply of plumpy’nut resumed in January 2013. Now only registered patients benefit from the programme.
A typical day begins with a meeting at seven in the morning in each of the four sites where the volunteers discuss the case findings, follow-ups and home visits that they conducted the day before. Part of their job is to visit different villages and towns to find and refer children that show signs of malnutrition to the nearest treatment sites. Lively stories are told and challenges and lessons learnt are shared.
Following this they discuss managing personal hygiene, proper feeding of children, how to prepare balanced meals using local foods and taking care of the environment. Following the group discussion, project staff report to their respective sites to start treating children referred to them by the volunteers. The children are between 6 and 59 months old. At this stage, both the mother and child undergo a series of medical tests to find out determine their health status and whether or not they meet the admission criteria for malnutrition treatment. It’s not uncommon to find that not only are some of the children malnourished, but they have other illnesses such as Acute Watery Diarrhea (AWD), measles, fever, skin and ear infections, among other things.
After screening, the child is classified as either severely or moderately malnourished and this determines what kind of treatment they will receive at the IMAM centre. It is important to have this information before any medication or treatment is carried out to ensure that the child receives appropriate and adequate support. If a child is found to be severely malnourished, their mother, father or care takers is given Ready-to-use Therapeutic Food (RUTF) to treat the illness for a specific period of time before they can return for further check-up and follow-up which is usually the following week . Severely malnourished are started on a Routine Systematic Treatment. However, if there are more complications; the child is referred to the Stabilization Centers or private clinics. In cases where a child has not been immunized, the nurses refer them to the nearest Maternal Child Health Clinic (MCH).
IMAM centres also perform deworming and appetite tests, issue aqua tabs to purify drinking water and offer cash relief for the most vulnerable families especially during severe food insecurity. Volunteers make follow up home visits every day to note progress of discharged patients. The IMAM centres operate until 5 pm every day except Fridays which is the day reserved for worship.
See more pictures here: Nutrition support in Hiraan
By Stella Madete