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Turkana’s Children Race for Survival

By Maryanne Waweru-Wanyama

Among some mothers in Turkana, a newborn does not start breastfeeding until he responds to his name.

“After she gives birth, different names are called out and only when the newborn responds positively to a name will he begin breastfeeding,” says Nicholas Losike, a community health worker in Loima district, Turkana.

Losike says this traditional naming practice, which is still observed by some adherents, serves as one of the greatest challenges health workers face as they advocate for exclusive breastfeeding where the newborn is fed nothing else but the mother’s breastmilk for the first six months of life.

As a name is called out and the child shows no enthusiasm about it, it means he has rejected it, prompting more names to be called out. But when the child hears a particular name, opens his mouth and reaches out for his mother’s nipple, it means he has accepted the name and only then can his mother begin to breastfeed him.

“On average it takes about two days for the child to ‘respond’ to a name. Sometimes it can take even longer. In the meantime, the baby is fed on boiled goat or camel milk,” says Losike.

PASSIONATE: Nicholas Losike, a community health worker in Turkana. Photo/Maryanne Wanyama

Photo: Nicholas Losike, a community health worker

Even if the mother has delivered in a health facility, she will argue with the nurses about it and if they insist on her breastfeeding the newborn before he responds to a name, she will sneak out of the hospital, he adds.

Yet, the World Health Organization (WHO) recommends that mothers initiate breastfeeding within the first hour of birth. This is because of the immense benefits that breastmilk offers the infant.

According to Terry Wefwafwa, the head of nutrition and dietetics at the Ministry of Health, breast milk contains all the nutrients that an infant needs in the first six months of life. “Mothers should breastfeed as soon as possible after birth. This is because the first thick yellowish milk she produces called colostrum is filled with antibodies that give the newborn immunity from infection. It is actually the baby’s first immunisation,” she says.

Breastfeeding, according to Wefwafwa, is the single most effective prevention intervention for ensuring child survival and healthy development.

So when mothers such as those in Turkana discard this first milk due to long-held traditions, it gives the newborns a disadvantaged start to a healthy life as they miss out on the free and available first immunisation.

It is perhaps such cultural practices that contribute to a high infant mortality rate in Turkana, which stands at 60 in every 1,000. The health status of children in Turkana is wanting, with only 54 per cent of children aged 0-5 years being fully immunised, which is below the national average of 83 per cent.

This is partly attributable to the lack of quick access to health care services, forcing residents to trek long distances in the harsh, arid climate to reach health facilities.

“Many mothers take days to get to a dispensary or hospital, so they only come for services like immunisation when they are coming to seek other treatment services. We have women who bring in children for their first immunisation at 10 months,” says Susan Ilikwel, a 28-year-old mother of three in Namoruputh division.

Turkana has a population of 855,000, with only one doctor for every 52,434 people. This is against the universal recommendation of one doctor for 1,000 people.

The issue of child deaths in Turkana county is further compounded by the high maternal mortality rate, which stands at 1,500 deaths per 100,000 live births — which is three times the national average. Often, a mother’s death leaves devastating consequences for her family.

Findings from the study A Price too High to Bear released in March 2014 by Family Care International (FCI), the International Center for Research on Women (ICRW) and KEMRI/CDC demonstrated the great link between maternal deaths and neonatal mortality. Of the 59 maternal deaths in the study, only 15 babies survived the first 60 days of life. The deaths of mothers, most of who are in their productive years and engaged in different economic activities only deepens the poverty levels in the home. In some households in the study, surviving children had to be withdrawn from school because of economic disruptions. Often, the sudden death of a woman from pregnancy or childbirth-related causes begins a chain of losses that compromises her children’s health, education and future opportunities.

The WHO states that children from the poorest households are nearly twice as likely to die before their fifth birthday than children in the richest households. It is indeed a tough life for poor children as they struggle for food, health, education and other necessities that would enable them enjoy healthy mental, physical, emotional and spiritual lives.

With Turkana County ranked as the poorest county in Kenya, life for a child here is difficult, with the most pressing health problem being malnutrition. Malnutrition is marked by a deficiency of essential proteins, fats, vitamins and minerals in a diet. Without these nutrients, it becomes difficult for a child to achieve optimum health. Assessment reports indicate that the Global Acute Malnutrition level in Turkana is at 28 per cent, which is high considering the WHO threshold is 15 per cent.

Recurring droughts, increasing populations that have put pressure on the county’s resources, as well as insecurity characterised by clashes over water and grazing pastures as well as frequent cattle raids have compounded food insecurity issues for Turkana’s pastoralist population.

However, it is not all gloom for the county, as both the national and the country governments are putting in place measures aimed at bettering the lives of Turkana’s mothers and children.

In June 2013, the national government introduced free maternity services in all public health facilities. This move has seen an increase in the number of women accessing antenatal care services and subsequent delivery in hospitals.

With the cost barrier eliminated, the Turkana county government has put in place measures to ensure that pregnant women and children have better access to health services. “Because of the long distances women have to walk to access a health facility, we have now ensured that each ward in the county has at least one health centre. There will be additional 30 more health centres by the end of this year. With the assistance of partners, we have put up a model maternity section at the county’s referral hospital that will specifically take care of the health needs of mothers and children,” says Peter Ekai, Turkana’s deputy governor.

According to Ekai, the county has further committed 2.1 billion shillings to the health sector, a move that is expected to increase the positive health outcomes in the county.

“We also acknowledge the strategies that the Kenyan government has established at national and county levels with regard to mothers and children. One is the introduction of free maternity services which has seen more Turkana women access services in hospitals, and second is the introduction of free rotavirus and pneumococcal vaccines in public hospitals which will no doubt see more of our children surviving their childhood.”

Ekai was speaking at Lodwar Mixed Primary School during an event called ‘Race for Survival’ organised by the children’s rights organisation Save the Children on October 17 to mark the UN International Day for the Eradication of Poverty. On this day, children from across the world participated in a symbolic race aimed at highlighting the plight of children from the most difficult places in the world.

DISADVANTAGED: Children run in an event to mark the UN International Day for the Eradication of Poverty in Turkana on October 17. Photo/Maryanne Wanyama

Photo: Turkana children participate in the Race for Survival

In Kenya, the celebrations were marked in Turkana county where the focus was on malnutrition. Kenya loses 108,000 children each year from preventable diseases like diarrhoea, pneumonia, malaria and other neonatal causes. Malnutrition however remains a major threat to the survival, growth and development of children where it contributes to more than 3.5 million preventable deaths annually in Kenya.

Children who participated at the Race for Survival called on both the national and county governments to pay urgent attention to Turkana’s children. “We ask that our health and nutrition needs be given priority. We want our governments to ensure that every child has access to a nutritious diet as this will help us live longer,” said Elizabeth Sakasa, a 12-year-old girl from Lodwar Mixed Primary School.

Article courtesy: The Star.

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