A mere drop in the ocean ...

Often the health problems are because of kwashiorkor and marasmic kwash both due to lack of protein leading to swelling, diarrhoea, enlarged liver and detachment of the skin. If mothers take their children to the local health centres they are only given some peanuts and are sent home again. This is no real help so the mothers eventually come with their children to the Kolonyi Health Centre at SALEM-Uganda, not far from Mbale in Eastern Uganda. Here they are supplied with build foods like soy milk or porridge made from maize, milllet and soy.

Just one year ago the SALEM Nutrition ward in the health centre was deserted, whereas now it is bursting at the seams. Presently 25 children are staying there, most of them coming from Bukedea which is situated a little further north of Mbale. To add to the problem, these weak children often get malaria, severe coughs or pneumonia.

SALEM-Uganda is facing a huge challenge both in terms of the available staff and, of course, financially. About 9,000 UGS (Uganda Shillings) are spent per child each week – a total of about 200,000 UGS per week (about £45 or US$75), which is a big sum in this country. This does not include costs for medical treatment.

To make the situation even worse the price of food has risen sharply due to shortages resulting from poor harvests. Just one month ago a kilogramme of cornflour (a main component of nutrition in this area) cost 800 UGS on average, now the price is at 2,500 UGS, millet now costs 3,000 UGS for one kilogramme instead of 1,000 UGS. As the nutrition ward mixes up maize or millet with soy to porridge to give it to the children you can begin to understand that costs quickly mount up. This year’s first harvest is still due and it looks like it will be very poor.

The main causes of this dreadful situation are:

• The partitioning of the area of arable land among several family members which means that each member has hardly enough to survive during bad times
• High population density or birth rate, due of lacking family planning
• General poverty as, due to the climate conditions, the harvests have been poor for three years now
• Inadequate availability of food at the local markets, resulting in rising prices which cannot be paid on an average income of US$1 per day
• Malnutrition of pregnant women and babies being weaned too early because of further pregnancies
• General climate change, i. e. heavy rain falls with storms and floods that have devastated newly planted fields followed by extreme droughts with late rainy season. This means that farmers do not know when to sow new crops as they are dependent on the rain.

Which measures does SALEM-Uganda take to improve the situation (as well as aid for acute cases)?

• The health workers of SALEM work closely together with local health workers and try to make people – particularly local elders – aware of nutritional issues
• SALEM extends its mobile health service by propagating and focusing on good nutrition, vaccinations and family planning
• The leaders of the local health workers with their teams are taught to keep an eye on malnutrition in their areas and to report cases so that they can be assisted in time
• Follow-up programs are carried out, i. e. if a child is released from hospital after about two weeks it is still looked after and the families are taught the necessity but also the possibility of healthy food (e. g. by planting vegetables on their land).

It would be very helpful for the SALEM health workers to have a motorbike for this work (costs about £650 £ or US$1,000) in order to be able to make these journeys more quickly as communities are spread far apart.

The motto of SALEM is that prevention is better than cure.

We hope that you can see that SALEM is able to help a lot in this situation, but we need financial support to do so. The people in Eastern Uganda would be so grateful for your help.

Siegfried Kunz
from SALEM-Uganda in August 2011

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