We spent the night in the Magama Hotel in Dogon Doutchi. The last time I stayed here was in August 2010 and its services are as rudimentary as I remember. It is a magical time in the Sahel as the start of the rainy season transforms the countryside. It rained last night and we were kept company throughout the evening by a chorus of breeding toads taking advantage of the fresh puddles. The omelets and bread across the street were a welcome start to the day, and almost made up for a less than comfortable night’s sleep.
After the grim visit to the nutrition rehabilitation ward yesterday, today’s visits were a joy. We went to two villages where HKI is supporting the Ministry of Public Health to implement the essential nutrition actions framework. Two key elements are timely initiation of breastfeeding (within one hour after giving birth) and exclusive breastfeeding for the first six months. In both villages we were greeted by mothers who were practicing exclusive breastfeeding and their glowing babies. The sense of pride is palpable and the mothers routinely report that their infants have fewer cases of diarrhea, grow better and play more.
HKI tries to make sure health workers’ knowledge is up-to-date and we reach out to traditional birth attendants to ensure they are properly educated about breastfeeding. The head nurse of the health center completed his formal training in 1982, and he told us that at that time he was taught that breastfeeding should be delayed, that water should be given whenever the infant was thirsty and fruit juices should be started at three months. He and his team have come a long way since then and are now strong advocates for exclusive breastfeeding.
Traditional birth attendants and other older women in the village are the custodians of infant and young child feeding practices and provide guidance to new mothers. As they too become convinced of the merits of optimal breastfeeding, they have also become powerful allies in preventing malnutrition.
Seeing babies bursting with health and mothers beaming with joy transforms the dry statistics about improved breastfeeding rates into a human reality. Breastfeeding is a truly miraculous intervention and one that doesn’t require any drugs, any surgery or any fancy equipment. It gives me hope that if the success we saw in these two villages could happen on a national scale, it would become rarer and rarer for children to need treatment for severe acute malnutrition. This would be truly transforming.
We rounded out the day by going back to the nutrition rehabilitation center we visited yesterday to interview more mothers. I wanted to check on the progress of Mariama, the little girl who had been admitted for acute malnutrition a few days back. It was heartening to see that she was now sitting upright and even playing with a toy. She started crying before I left and her mother put her to the breast. We left the clinic as Mariama lay sleeping peacefully in her mother’s lap, clutching her toy.