Against All Odds: Baby Monday’s Story

5 August 2010 - Nurses at the Therapeutic Feeding Centre in the Kaabong Referral Hospital call him “the miracle baby.” In the hospital records his name is Monday; the staff name orphaned babies according to the day of the week they are born.

Baby Monday’s mother went into premature labour in Kathile, a tiny village in Karamoja, the arid and sparsely populated region of North Eastern Uganda bordering Sudan.

During childbirth, she had a retained placenta, an easily treatable condition where the placenta is left behind in a woman’s uterus. But because the family had no transportation to the nearest hospital—only 11 miles away—hours were lost while they tried to get help for the ailing mother and baby. Finally, a small truck was rented in Kaabong, but it broke down on the way to the hospital, and Baby Monday’s mother did not survive the journey.

The fact that the infant survived the journey in his grandmother’s arms over the rough and difficult terrain from Kathile to Kaabong is just one of the reasons that have earned him his unlikely nickname.

At birth Baby Monday weighed just three pounds. In the UK, a premature baby would be kept in an incubator for weeks, but there are no incubators at the Kaabong Referral Hospital, nor is there electricity to power a heating lamp that might keep his little body warm. So Baby Monday was wrapped in a bundle of wool blankets and kept in the sun whenever possible to keep his temperature up.

“This baby is a real fighter,” said Sam Mbuto, Action Against Hunger’s Clinical Officer who manages the hospital’s Therapeutic Feeding Centre. “After two weeks here he began to have vomiting and diarrhea, and we realised he had severe malaria. We put him on a quinine drip and gave him oxygen and, amazingly, he recovered from the malaria and began gaining weight.”

For over two months, Action Against Hunger and the local hospital staff monitored Baby Monday closely and fed him therapeutic milk formula every two hours without fail. Looking after him at all hours was his eight-year-old sister, Nakolong. Being the sole caregiver of a premature infant and waking up several times a night for the feedings would be enough to break most people, let alone an eight-year-old. But Nakalong said she didn’t mind at all.

“My mother died so there is no one else to take care of him,” she said matter-of-factly. “I nurse and feed him all day, give him baths and wash our clothes. When I have time I play with the other children at the hospital. Here we have medicine and food so we have to stay here until my brother is ok.”

In Karamoja, a region with some of the highest malnutrition rates in all of Uganda and where much of the population has little access to health care, Action Against Hunger manages two Therapeutic Feeding Centres. Located within local hospitals, the centres are dedicated to the treatment of the most severe cases of malnutrition in young children and women who are pregnant or nursing.

In addition to supplying therapeutic nutritional products and other essential medicines, ACF trains hospital staff to treat the condition so that they can eventually assume responsibility for managing the centres.

“The nurses here had some knowledge of malnutrition before Action Against Hunger, but not much,” says Hamis Basalirwa, the Clinical Officer at the feeding centre in the town of Moroto. “But now we are training the eight hospital nurses and nursing assistants on how to manage cases and nurse malnourished children back to health. Things are improving.” Kaabong Therapeutic Feeding Care for malnutrition begins at the community-level, and Action Against Hunger gives local health volunteers the skills and equipment to identify malnourished women and children and refer them for free treatment—either at outpatient feeding centres or at the inpatient feeding centres if their conditions have deteriorated to the point that they require special medical care.

“When ACF began the trainings, this was all new knowledge to us. We were provided with measuring tapes and referral forms, and went straight to work,” says Ayella Albino, coordinator of the village health teams in Kaabong.

“Personally, I look after 109 households with a total of 210 children under five, so I make sure I visit a certain number of households every day. I get reports from the mothers and examine the child, and because of the training I had from ACF, I now know the signs of conditions such as oedema [a swelling of body parts caused by severe acute malnutrition.]”

In Karamoja, malnutrition often stems from poor sanitation and hygiene practices. While children receive life-saving treatment, Action Against Hunger provides their caregivers with education on simple techniques like hand washing and hygienic food preparation to protect their families.

“It is so important for the mothers to receive health education. We could avoid a lot of diseases linked with malnutrition,” says Mbuto. “But it’s a gradual process and you have to deliver the messages over and over because it is all new to them. During their stay in the hospital their hygiene improves, and the good thing is that most of them maintain it when they go back home and even pass it on to other mothers in their villages.”

In this neglected region, where even the most basic health care is hard to come by, the programme is saving thousands of young lives—sometimes even despite the odds.

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