William recovers from malnutrition

NUTRITION

AT Turiboiru Health Centre in Buin District of South Bougainville, William was diagnosed with severe acute malnutrition (Sam).
The health workers there gave parents Lawrence and Stella the grave news that he had a 50 per cent chance of survival if he did not gain weight fast. Deeply distraught, William’s parents became even more determined to do everything to help their son.
Much smaller in stature than your average two-year-old, we met William and his father Lawrence outside their family home in Pariro village. A couple of months shy of his third birthday, you would not think anything wrong with this bright-eyed little boy.
From behind his very long dark lashes, William’s inquisitive eyes examined us with trepidation and quiet excitement. “William is not usually so shy and quiet, this is his first encounter with outsiders (other than Bougainvillean’s) so he is overwhelmed to see more than one new face,” Lawrence Anis, William’s father explains. “William usually cannot keep still, he is quite noisy and likes to play with his siblings.”
His mother Stella had travelled to their family garden almost a day’s walk away from their village. The people of Buin and surrounding villages in South Bougainville are farmers and till the land for their living. Their markets bustle and overflow abundantly with fresh vegetables and fruits whilst the protein is supplemented by wallaby and smoked fish traded with nearby Solomon Islanders only a 15-minute boat ride away who come to Buin to sell their catch.
Roselyn, a village health volunteer (VHV) with World Vision’s Caring for Nutrition Project recalls, “Before William’s birth, my sister Bernadine, also a VHV with World Vision, and I were conducting Time Targeted Counselling (TTC) at Pariro village in the Lugakei Community Government. I noticed that each time we came around to counsel pregnant mothers during antenatal checks, William’s mother Stella was always absent.”
“It was not until later that I found out she was always at the garden and never properly ate or rested during her pregnancy. This worried me a lot as TTC for expectant mothers is very important in that we counsel the mothers to nourish both themselves and their unborn children pre and postnatal to ensure both babies and mothers are healthy”.
Roselyn and her sister Bernadine are VHVs in the CFN project and oversee eight of the 13 villages in the CFN project footprint covering the Lule Constituency comprising of the Lenoke and Lugakei Community government of Buin, South Bougainville.
With Covid-19 restrictions, it was not until March last year during a routine check that Benedine and Roselyn identified William as being severely undernourished. At one-year-old, he was not normal compared to an average toddler his age. He was not feeding well, severely underweight, he was not talking or making audible sounds, and could not move.

“ Mother-child nutrition both pre and postnatal is very important for a healthy life, family and community.”

Roselyn quickly notified World Vision Caring for Nutrition Project officer Mary and colleague Vasthie who took Williams’s necessary data including his mid-upper arm circumference (Muac) which was on the red mark at 10cm while his weight was 5kg. Upon further review of William’s health clinic book, Mary realised that William was born small and since then had trouble gaining weight.
Mary and Vasthie knew then it was a race against time to save William and referred him to Turiboiru Health Centre. Maternal and child survival and under-nutrition remain significant public health issues in Papua New Guinea. According to Unicef, in 2018, PNG had an infant mortality rate of 57 per 1000 live births, an estimated 15,400 children or one in 13 children, die each year in PNG, mostly from preventable diseases. The country has a maternal mortality ratio of 215 per 100,000 live birth, an estimated 580 mother’s die each year, the lifetime risk of maternal death is eight times higher in PNG than in East Asia and the Pacific region on average.
Low access to health services, high disease burden, very low access to safe water and improved sanitation, improper infant and young child feeding and care practices, insufficient dietary diversity, and vulnerability to shocks contribute to the prevalence of these issues.
At Turiboiru Health Centre William was diagnosed with SAM. Lawrence and Stella initially shocked were relieved when the health centre gave them a special peanut butter paste supplement packed with micronutrients to complement his meals to help with the quick weight gain. Coupled with nutritional guidance from Mary and the World Vision CFN project team in Buin and cooking demonstrations conducted in Pariro, by August the same year, William steadily began to gain weight. William’s journey to recovery had finally begun.
In recollection, WV programme officer Mary Diou said, “It has taken a lot of constant upkeep and monitoring but as William is a special case. We have continued to monitor his health which I am delighted to say has seen a 100 per cent improvement with our CFN intervention. William has truly beaten the odds. Today he is a happy, healthy two-year-old just months shy of his third birthday,”
“I am very grateful for World Vision and the Caring for Nutrition programme’s intervention. I would like to acquire more knowledge on nurturing to help William and his siblings and ensure my children are healthy as I now know the significance of nutrition in toddlers,” said Lawrence as he held William in his lap.
“When I review photos of William from almost 12 months ago, it’s been an amazing transformation. William is just one of the many cases World Vision through its Caring For Nutrition programme has supported and nurtured back to health through our time targeted counselling for children under two (CU2). William is a special case though so although TTC usually targets children under two years of age, we had to ensure he was in the healthy range so now that he is almost three, we will only call in to see how is progressing,” Vasthie said.
Vasthie, who would soon become a first-time mother herself encouraged pregnant mothers and expectant fathers to attend the World Vision CFN TTC awareness sessions, cooking demonstrations and seek our VHV assistance if they need counselling for CU2.
“Mother-child nutrition both pre and postnatal is very important for a healthy life, family and community.”
As we were leaving, we sighted an enthusiastic, energetic, and very mobile William break into a sprint across the lush neatly trimmed green grass of Pariro village to join his older siblings in play.

• Story and picture from World Vision PNG.