Malnutrition tightens its grip on Karamoja, Uganda

Motionless, she lays on her mother’s lap. She looks severely emaciated. The skin on her body is wrinkled, pale, and peeling off. And when she attempts to cry her voice can hardly be heard. When she was taken to the therapeutic feeding centre, 2-year-old Lucy Nasugai weighed only 3.2 kg.

Nasugai is one of the over 297,494 children in Karamoja, Uganda who have been hit by severe malnutrition; a condition that occurs when the body fails to get the right quantities and proportions of nutrients for it to maintain health and function properly.

Malnutrition kills, causes diseases and makes disease even more severe, according to a briefing note from Food and Nutrition Technical Assistance (FANTA2).

Cyclic drought in the region has aggravated the situation affecting both crops and livestock and causing food insecurity and severe malnutrition, especially in infants and children younger than five. Indeed, the child survival rate in Karamoja is among the worst in the world, according to UN agencies.

Both local and health officials in Nakapiripirit, Moroto and Napak paint a grim picture of the severe malnutrition situation in the three districts.

An estimated 39 out of 375 children who were being treated for malnutrition in Matany Hospital are known to have died in 2011, while 22 escaped from the feeding centre, according to Ngiro Martin, a health educator for Napak District who is attached to Matany Hospital.

“Our major challenge here is that people look at malnutrition not as a deficiency but as a curse or witchcraft as most people are illiterate and the latrine coverage is [also] low,” Ngiro said.

He pointed out that empty granaries are another major challenge to fighting against malnutrition in Karamoja.

“The year is just beginning and the situation is already out of hand and yet we expect it to worsen from March up to June,” Ngiro notes.

In Nakapiripirit, the district health officer Dr. John Anguzu said out of 1,397 malnutrition cases recorded, 448 were admitted to various health units in the district.

Dr. Anguzu added that in January alone they recoded 2,004 cases of severe malnutrition. The area’s non recovery rate currently stands at 16%.

Timothy Teko, a Nutrition Focal Person in charge of Napak and Moroto, pointed out that although malnutrition is high in Karamoja, it has not yet reached a critical level.

Alibino Lobong, the LC1 chairman of Nakapelem settlement, a suburb in Moroto town, said two out of 60 severely malnourished children in the village, mainly occupied by poverty stricken Karimojong, have died due to malnutrition.

“Most of these children you see here are living at the mercy of God. Their families can hardly afford to prepare a meal in a day. They mostly live on porridge which is always taken at lunch time.” Lobong made the comments during a public visit from Humanitarian Services Country Director for the Church of Jesus Christ of Latter Day Saints Elder Karl Beckle, who together with Sister Robin Beckle was in the area to handover nutritional food supplements.

The Church of Jesus Christ of the Latter Day Saints has given 100 bags of Atmit; nutritional food supplement, to Tokora health Centre in Nakapiripirit, Moroto Regional Referral Hospital in Moroto and Matany Hospital in Napak. Abim, Kotido,Kaabong and Lira are also expected to benefit.

“Crop harvests this year have been affected by the heavy rains. Otherwise we would be having some food here,” said Moses Chuna, an elder from Napak.

According to the UN Children’s Fund (UNICEF), Karamoja represents a developmental and humanitarian challenge to Uganda’s stability and poverty eradication efforts. Mortality and malnutrition levels routinely surpass recognized crisis thresholds in the area.

John Lorot, the LC5 Chairman for Nakapiripirit District, said malnutrition has been compounded by last year’s floods, which devastated the area and destroyed the food crops people were about to harvest.

“It’s now a double tragedy for us here; we lost our food crops to floods and also lost our cows to the cattle rustlers who frequent this area because the disarmament exercise has been largely a success here. We appeal to government and humanitarian organizations to rescue us. And also government should degazette [release from protection] the green belts here because all our fertile areas are under the game reserve for wildlife conservation,” Lorot said.

Due to its semi-arid nature villages in the area are far apart so families seeking treatment for their malnourished children have to trek many kilometres to reach hospitals, food distribution points, therapeutic feeding centres or nutrition services found in a few of the region’s health facilities.

Karamoja suffers from one the worst rates of malnutrition in the world. In 2010, 16% of children under the age of five suffered from acute malnutrition, and nearly 40% of children in this age group were underweight, according to FANTA2.

The mayor of Moroto Municipal council Alex Longona said malnutrition was equally prevalent in the urban area.

“Please consider us also in the urban centre for relief assistance. Some people think we people in town are well off. But as you can see we have many children here who are severely malnourished,” he said.

Over 60 children in Nakapelem settlement in Moroto municipality are severely malnourished, according to local leaders here.

The Minister of State for Mineral Development Peter Lokeris, who is also the MP for Chekwi County in Nakapiripirit District, warned the food situation in the whole of Karamoja may worsen in the coming few months.

”To make it worse even the food stores for UN World Food Programme in Nakapiripirit, where we would have relied for some relief assistance are empty,” he said.

Musa Ecweru, the Minister of sate for Disaster Preparedness and Relief who visited Karamoja to assess the situation, said: “As government, we pledge that we shall feed these people until they are able to harvest their own food. We shall also give them planting materials. But as a matter of urgency we are going to meet all the humanitarian agencies like UN World Food Programme, Food and Agricultural Organization and other stake holders to discuss how we are going to make a coordinated intervention in Karamoja.”

According to FANTA2, at household level malnutrition is linked to women having workloads so high they cannot provide quality childcare. Poor sanitation, hygiene, frequent pregnancies, and poverty caused by lack of livelihood alternatives in rural areas are also causes.

All these can be true of Karamoja where women are the major bread earners and are also responsible for child upbringing as men go for hunting and looking after cattle.

In September 2011, Karamoja had 301 malnutrition cases, 161 admissions and two deaths. In October there were 339 cases, 113 admissions and four deaths. In November, there were 366 cases reported, 115 admissions and one death and in December 2011 there were 331 malnutrition cases, 59 admissions and one death.