An Afghan woman holds her son during a visit to the children’s supplemental feeding center at the Farah City hospital, Dec. 22. The child was brought to the center for treatment after his mother lost another child to malnutrition and was made aware of the clinic by a relative. Provincial Reconstrution Team (PRT) Farah currently funds the program which has provided nourishment to over 350 children in need. (Photo by Lt. j.g. Matthew Stroup/released)
FARAH CITY, Afghanistan — Medical and civil affairs team members from Provincial Reconstruction Team (PRT) Farah recently visited the children’s supplemental feeding center at the Farah City hospital to meet with leadership and assess the center’s operations.
The children’s supplemental feeding program at the Farah City hospital is an outpatient therapeutic feeding program that is designed to provide much needed nourishment to children in Farah that are at risk of acute severe childhood malnutrition in order to reduce rates of infant and childhood mortality in Farah province. The program, which is currently funded by the PRT, has been in operation since August 2012 and is scheduled to run through November 2013. In order to serve the children in the program, the Farah provincial directorate of public health has provided three administrators to support Farah City hospital’s Director of Malnutrition, Abdul Ghani Mehrzad, who oversees the center’s operations, to process and track patients in the program.
The first step in a child’s enrollment into the program is a visit to the Farah City hospital. Once each week, old and new patients alike arrive at the center for processing. First, returning children are processed. Their height and weight are reviewed by staff and logged. Once they have recorded the child’s updated data, the mother’s of returning children are provided with an additional week’s supply of ready-to-use therapeutic food (RUTF) to take home for the week. RUTF is an essential part of the outpatient program that helps children to grow and return to a healthy weight.
According to a joint statement from the World Health Organization, World Food Programme, the UN Standing Committee on Nutrition and the UN Children’s Fund titled “Community-Based Management of Severe Acute Malnutrition,” RUTF is similar to other therapeutic diets used in hospital settings to treat malnutrition. However, RUTF are different than inpatient treatments as they are not water based. This means that bacteria cannot grow in them, making RUTF an optimal outpatient solution to malnutrition as they do not require refrigeration to stay safe for consumption.
Once returning patients are processed, new patients are processed. After providing basic information to caregivers, mother’s of children in the program are given an individual card that serves as a type of a ticket so they can receive RUTF, and helps administrators to track patient performance. After children are enrolled in the program, they are measured and weighed to determine their eligibility for the program. Once their measurements are charted and evaluated for eligibility, mother’s receive RUTF for the newly enrolled child.
In addition to receiving RUTF, mother’s whose children are in the program receive education. Education topics include general sanitation, hand washing before feeding, breast feeding and general health practices. These courses are intended to support long-term healthy growth of children in the program by not only providing food, but for providing skills that will keep them healthy as they grow.
According to Mehrzad, who leads the program at the hospital, approximately 180 children are enrolled in the supplemental feeding program. Even more encouraging is that approximately 90 children have been discharged from the program as they returned to a healthy weight. During their assessment of the feeding center, PRT team members took the opportunity to talk to some of the women who were bringing their children to the facility. They found that women traveled from distant districts such as Bala Boluk and Lash-e Juwayn to take part in the program. One mother even travelled from Helmand province, southeast of Farah, to take advantage of the program. Most women were notified of the program through a relative or friend who encouraged them to take advantage of the program. PRT members also learned that many families even relocate to Farah City to take advantage of the program for the benefit of their children.
One woman who spoke with U.S. Navy Lt. j.g. Laura Cook, physician assistant for PRT, shared a tragic story about the real-life consequences of malnutrition in children. Cook explained, “The woman shared with me that she lost a daughter because of malnutrition. After hearing about this program from a relative, she brought her son to get help so she didn’t lose him, too.”
In addition to treating malnutrition, the hospital also worked to provide oral polio vaccine to each of the children who visited the hospital.
“We are one of only 3 countries left in the world who have active polio cases,” said Dr. Abdul Jabar Shayeq, Farah provincial director of public health, “…We have had 33 cases of polio in all of Afghanistan this year and only one in Farah. We are working to rid Afghanistan of polio by 2013.”
Children who visited the children’s supplemental feeding center were provided a dose of oral polio vaccine, after which they had their hand marked with indelible ink to ensure that children did not received second dose during their visit. According to the World Health organization, polio mainly affects children under five years of age. Additionally, there is no cure for polio – it can only be prevented. Polio vaccine, given multiple times, can protect a child for life.
While the PRT funds the supplemental feeding program, the day-to-day operations of the supplemental feeding center are fully run by Mehrzad and his local staff. Their leadership and execution of this successful program are indicative of increasing Afghan capability and capacity to bring services to the people, provided that needed resources are available.
PRT Farah’s mission is to train, advise and assist Afghan government leaders at the municipal, district, and provincial levels in Farah province, Afghanistan. Their civil-military team is comprised of members of the U.S. Navy, U.S. Army, U.S. Air Force, the U.S. Department of State and the U.S. Agency for International Development (USAID). For more information about the PRT, visit their Facebook page at http://www.facebook.com/PRTFRH