Proper nutrition is a critical component of care in people living with HIV/AIDS. In partnership with USAID, TASO implemented a therapeutic feeding program to support malnourished child clients. Each Tuesday and Thursday the clients gather in the children’s clinic and patiently wait to be seen by their counselors and physicians. While waiting, a nutrition technician gathers anthropometric measures suchs height, weight and mid arm circumference. These measures determine which children receive the high energy, fortified feeding packs called “Plumpy-Nut”. The supplement is basically 3/4 cup of peanut butter with added milk powder, sugar, soybean oil, and vitamins & minerals. Some children are prescribed up to five per day depending on their status.
In the past, all children who presented with moderate to severe malnutrition were given the supplements. However, a recent cut-back in funding has made the cut-off more stringent and TASO can only provide supplements to those who are categorized as “severly malnourished.”
One of our newly added participants receives the nutrition services at TASO. His name is Akoth – we met him at the Tororo workshop, he sat in the front row with his older sister. At first glance, I thought he was around 8 or 9 years old. His eyes are large, glassy and black, with a focused stare that seemed to look right through me. His shoulders were narrow and the sleeves of his tee shirt fell past the elbow, hiding his bony forearms. His chest would slowly rise with each inhale; labored breathing was apparent. He would place his hands on his somewhat misshapen head to either stay awake or fight back the pain of a headache. He seemed uncomfortable, so I quickly asked the counselor if there was anything we could do for the little boy. She shared with me that this small child was hungry, he didn’t feel well and he in fact, was not a child, but 17 years old. This was the first time that I’d seen such marked effects of undernutrition. Akoth is HIV positive, has stunted growth and is severely anemic.
Childhood stunting is a reduced growth rate caused by malnutrition in early childhood or malnutrition during fetal development due to a malnourished mother. Stunting and its effects are permanent. Children who experience this nutrition-related disorder, in most cases, do not regain the height and weight lost as a result. Overtime, the child will be faced with physical conditions that result in premature death because vital organs never fully develop. Children born with HIV are at a higher risk for stunted growth because of their increased nutrient needs and compromised immune systems.
While TASO provides the therapeutic feeding program, it’s never enough for some children. Due to extreme poverty, chronic illness and inadequate healthcare, some children will never get a chance at a normal childhood.
This post, and blog in general, is not a call for action from our readers. Rather, an opportunity for the reader to imagine the reality as it exists here in Uganda and much of the developing world.