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Health News of Tuesday, 24 October 2017


‘My baby went to sleep and didn't wake up’: Young lives lost to Ghana's silent killer

malnutrition remains a silent killer that accounts for one-third of all child deaths in Ghana

There is no war or famine in Ghana, and the economy is growing, yet malnutrition remains a silent killer that accounts for one-third of all child deaths in the country.

Although mortality rates are slowly starting to come down across the west African country, Ghana is struggling with high levels of stunting, a condition caused by chronic lack of nutrition in pregnancy and early childhood that permanently affects a baby’s mental and physical development.

One in five babies born in Ghana are stunted, which has been calculated to cost the economy $2.6bn (£2bn) a year, about 6.4% of the country’s GDP.

In Bentum, Apprah and Nyanyano, rural communities in Ghana’s Central region, about an hour from Accra, more than 35% of children under five suffer from severe malnutrition.

Kate Afful (above, right), 40, at home with her mother in Nyanyano, tells the story of how one of her daughters died at the age of two. Anotherof her six children died during childbirth. She worked as a fishmonger for her husband up until his death, about 10 years ago. Since then, she’s struggled to find work and take care of her remaining four children. Her children are malnourished and often get sick – they only eat “banku”, a fermented corn and cassava dough. “God took my two-year old daughter,” she says. “She was not feeling well so I put her to bed. Later that evening, there was a bad storm. The sky was loud and angry. I heard an explosion in the clouds. When I went to check on my baby, she was dead. I believe the thunder killed my baby.”

Nana Agya Kwao (left), 76, the chief of the farming community of Bentum, has two wives and says he has 35 children. As chief, a position he has held for 35 years, he owns the land and has the right to sell or rent it out. Two years ago, he sold most of the farming land in Bentum to a developer. As a result, the majority of villagers lost their livelihoods and now struggle to feed their families. “I am very proud to be the chief. It’s not easy. No one will take my land. I know my people in Bentum cannot farm anymore. But whatever you do for food, is on you.”

Ama’s husband is a fisherman, and she sells fried food on the street in Nyanyano. Both her children are malnourished, and her oldest child has had an eye infection for two years without medical treatment. “A lot of children die in this village. People talk about my children being sick and malnourished, but I don’t care what they say. There is nothing I can do because I can’t afford to take my children to the hospital or to give them the food supplements the nurses recommend.”

At her home, Hannah Abekah (left), 23, is surrounded by the yellow buckets of rainwater she collected the night before. She has never attended school, and started working at a very early age as a fishmonger. She is married to a fisherman, and they have two young children. Her husband is often away for weeks. “My kitchen is empty. I have no food,” she says. “My children don’t even eat the little food I give them. I don’t know about malnutrition. I just pray my children become great people.”

Rebecca (above) has two children who are regularly ill. They receive medicine from the local store instead of professional healthcare at the hospital. Rebecca, 17, doesn’t receive much support from the children’s father. “He doesn’t take care of us as he should. He says he doesn’t have money, but I know he is not honest.” She feels she has nowhere to turn. “Women don’t support one another here, it’s not something we do.”

Rachel Edifile, 18, works as a fishmonger in Nyanyano but struggles to provide food for her children. Her youngest child is underweight, and she relies on the help of her grandmother to pay for medical costs. She cannot send her older child to school. “I am not happy,” she says. “I want to take better care of my children, send them to school and buy good food.”

Nevertheless, more children are attending school in the area as private schools have been springing up. Some of the schools provide feeding programmes, so pupils can expect to get at least one meal a day.

Beatrice Amponfi (right) and Joy Glii (left) are in charge of the childcare and malnutrition unit at Kasoa clinic. The clinic, the largest run by the government in the city of Kasoa, serves the people of Bentum, Apprah and Nyanyano, but it can involve a journey of up to three hours to get there. According to Amponfi, only 20% of malnourished children are taken to this clinic, mostly extreme cases. Fifteen nurses work at the clinic, serving a catchment area of about 100,000 people. There is also a nutrition officer in the district who visits the clinic four times a month.

“There is a stigma associated with having a malnourished child. So we mostly identify malnutrition cases by talking to neighbours. Besides, mothers of malnourished children are lonely and they don’t feel supported by their husbands. Our most important job is to provide a safe environment to counsel them about their children, so that they don’t feel embarrassed about bringing them here. But our effort is just a drop in the ocean.”

Charity Essel, 29, used to work on a farm in Bentum before all the farming land was sold to a developer by the local chief two years ago. The land is now surrounded by a 9ft wall, built by the villagers who have lost their farms, and food is scarce. Since birth, Charity’s daughter Tiffany has struggled with malnutrition but Charity says hospital staff never explained what was wrong with her daughter. The child only started to put on weight and improve once a local non-profit organisation diagnosed malnutrition and provided her with dietary supplements, she says. “My daughter used not take any food. When she lay down, I could see all her ribs. My child would have died without the help of this non-profit.”

Christy Ansah, 32, has also struggled since the farmland in Bentum was sold. As a result of the village chief selling all the farming land in the community to a local company, “no one here can access their farms”, she says. “I was able to feed my four children before, but there is no food any more and no jobs in this village. I struggle to earn a quarter of what I made before.”

Mary Essil, 27, at her home in the farming community of Bentum, holds the bottle of glucose that she gave her son when he was sick. She could not breastfeed her newborn, who was small at birth. Her baby died when he was two months old. “My baby went to sleep and did not wake up,” she says. Local tradition mandates that when a baby dies of malnutrition, the baby is taken away. Mary and her husband were not allowed to attend their son’s funeral.

NGOs in the area are supporting women like Charity, Mary and Christy. The Cheerful Hearts Foundation, in Kasoa, runs a nutrition programme in the area, conducting workshops in schools for children, and home visits for mothers, led by volunteers.

Nana, the chief of Nyanyano, at his palace. As a traditional leader, he is responsible for overseeing political and ethical issues in the fishing community. “Fishermen leave women pregnant and then they run away. Mothers are left to fend for themselves and support their children alone. My people are starving. Mothers are desperate … The government does nothing about it. So many people look to me for answers, but I am only one man. I wish I could help them, but I have no power.”

The land the chief sold to developers two years ago is now lying idle. There is some animosity towards him from the community for selling the land, but most people say they felt powerless to do anything to stop the sale. Since then, some families have moved away in search of new opportunities.