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PARTNERS IN HEALTH: Toddlers Growing, Gaining with Help from Malawi Clinic

One-year-old Violet McDonald is one of 11 children enrolled in the malnutrition clinic at the PIH-supported Matope Health Center, which serves 11 villages in rural Neno District, Malawi. PIH supports malnutrition care for more than 11,500 children across Neno. Nearly 11,000 of them are younger than 5.

Violet’s mother Lydia, 20, had been bringing her to the Matope facility in Malawi since late June of 2018 for regular checkups through the program known as CMAM, or Community Management of Acute Malnutrition.

Violet’s weight had increased from 7 kilograms at her first visit to 7.9 kilograms in early October. That equates to growing from about 15 pounds to 17.4 pounds. It was a significant gain, but there was plenty of room to grow. CMAM facilitator Jessie Chizumo carefully recorded Violet’s health information in large paper files, and checked her weight on a chart that showed a corresponding amount of RUTF—ready-to-use therapeutic food, or nutritional meal supplements known locally as chiponde—that Violet would need for the week ahead.

September and October are Malawi’s hottest months, known colloquially as “hunger season.” Riverbeds are dry, fields are dustbowls, the harvest is weeks in the past and new rains have not yet arrived. Dry heat turns bent, picked-bare cornstalks into crinkly brown matchsticks. For Neno District’s population of about 170,000, it’s a time of food scarcity and corresponding high prices for corn and other staples—especially this year, when many people around Neno cited a weak harvest.

Robert Jackson, supervisor for Matope’s community health workers, said the 115 CHWs based at the health center do all they can to screen every child for malnutrition, and refer children and parents to the CMAM clinic. It’s a busy job. Just nearby Tchenga Village, where McDonald lives with Violet, has more than 600 households.

“By screening all children at the household level through visits by community health workers, our goal is to catch malnutrition earlier and refer children quickly to treatment, to avoid hospitalization or significant illness,” said Emilia Connolly, chief medical officer for PIH in Malawi. “This will improve the health of children and families overall, thanks to the invaluable work by the community health workers—our foot soldiers.”

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