This post was written by Jessica Blankenship, Ph.D., Helen Keller International’s Regional Micronutrient Advisor.
It is only a two-hour flight to Lodwar in the Turkana District of Kenya from Nairobi; however the differences between the two cities are striking. Lodwar is the capital of the arid district of Turkana, and the only reliable method to reach the town is by air as the roads leading from Nairobi have been battered by seasonal rains and years of neglect. Despite being the largest district in Kenya, Turkana is sparsely populated; bordered by the countries of Uganda, South Sudan and Ethiopia, it is mostly populated by pastoralists who graze their goats and camels on the sandy soil.
It is plain to see, upon landing in Lodwar, that Turkana has been one of the worst affected in Kenya by the current drought. The landscape is full of vast stretches of sand and the riverbeds, which are used for watering livestock and human consumption, are dry and dusty in the winter sun. What I don’t see are many developed wells. Instead, families often have to walk long distances to gather water from pit wells dug into the riverbeds. The lack of water has had multiple deleterious effects in Turkana, but the most pressing is the loss of valuable livestock which comprises the income and savings of the majority of Turkana people. Without livestock, whole communities are unable to purchase enough of their staple food – corn meal – to meet their basic energy needs.
I flew into Lodwar to conduct the first of a series of trainings Helen Keller International (HKI) will implement along with Save the Children, the World Food Program and the Government of Kenya. These trainings are for the staff of NGOs and the Ministry of Health to help them deliver supplementary food to all children under the age of three years and to pregnant and breastfeeding women. The objective of the program, the Blanket Supplementary Feeding Program (BSFP), is to prevent the further deterioration of nutritional status of these targeted groups by providing a daily food ration to supplement their current diet. The ration consists of a highly nutritious dry porridge called CSB which is fortified with vitamins and minerals, as well as vegetable oil to be mixed with the porridge. Together, the CSB and oil supplement the current diet of corn meal porridge and provide the additional energy, protein, vitamins and minerals needed to prevent malnutrition.
I am training BSFP staff on the communication strategy we have developed to deliver key messages on nutrition and health to communities receiving the BSFP. Together, the participants and I demonstrate the preparation and storage of the CSB porridge. Cooking over a traditional fire pit, we discuss the importance of breastfeeding, of ensuring the young children consume small frequent meals, and the serious and permanent effects of malnutrition amongst children less than 3 years of age.
Later, after all participants sample the porridge, we break into groups and practice using the counseling cards developed by HKI to guide the Nurses and Community Health Workers in the delivery of routine health services to beneficiaries. As all young children less than 3 years and all pregnant and lactating women in Turkana will be eligible for the BSFP, the program is a fantastic opportunity to reach these young children and women with vital health services. Each group of participants practices with a flow chart of the National Protocol for Immunization, Vitamin A Supplementation, De-worming, Iron Folate Supplementation and Treatment of Diarrhea with Zinc to ensure that all beneficiaries receive these necessary services.
Later in the afternoon, we practice using a counseling card to deliver key messages to mothers for how to care for sick children and to notice danger signs so that they can take their children to the health center for urgent care. One of the key messages we discuss is the importance of breastfeeding. During emergencies like the current drought, it is vital to ensure that mothers are provided with supportive messaging to continue providing only breast milk to their babies less than 6 months of age and to continue breastfeeding their older babies until 2 years of age. Breastfeeding, a cheap and always available option, is a fundamental intervention to prevent babies and young children from becoming sick and to help them recover quickly.
After a full day of training, the BSFP staff is eager to start the delivery of the program and gather up their training manuals, counseling cards and posters to hang in the baraza or meeting place outside the homes of each village chief. I feel energized with the skill and the motivation of the participants in Turkana; their commitment to the health of children in their communities is palpable.
I will be traveling to five other districts in Kenya over the next few weeks to provide similar trainings for the BSFP and will be sharing my experiences on this blog.