15% of all children with disabilities registered with KCDC are severely malnourished, resulting in poor weight gain, delayed growth and development, lethargy, muscle weakness and a higher risk of other illnesses. If left untreated, malnutrition may lead to severe illness and, in some cases, death.
Both nutrition and disability matter for many reasons, not least because they are both key human rights issues. Children with disability are consistently reported to have a high incidence of malnutrition, stunting, and wasting. For example, children with cerebral palsy can be up to three times more likely to be underweight compared to non-disabled children.“Severe acute malnutrition has a 30% – 50% fatality rate if left untreated” (World Health Organisation (WHO)). The Uganda Demographic and Health Survey of 2018 indicated that the Toro sub-region where Kasese lies has the highest rates of malnutrition that subsequently leads to stunting among children at 40.6%, way above the national statistics at 29%. Additionally, according to the World Food Programme (WFP) Kasese district was one of the worst affected districts because of the negative impact of the COVID-19 lockdown, with crisis levels of food insecurity and 1 in 3 people struggled to find nutritious food on a regular basis.
For about two-thirds of the malnourished children we treat, it is due to a physical feeding difficulty such as a delayed swallow, or choking due to poor positioning or spasticity. These are difficulties that can be corrected with proper training and parental education from our speech and language therapists. KCDC’s nutrition programme sets out to improve the nutritional status of all the children with disabilities we work with. This is done through individual assessment and treatment to identify feeding difficulties and demonstrate specific techniques to manage them, and by educating parents on how to best use the food supply available at home to provide a nutritious diet for their children.
This programme provides access to emergency therapeutic foods for rapid reversal of severe acute malnutrition and prevents the effects of chronic malnutrition such as stunting and wasting, monitored by a registered nutritionist. For sustainability, we provide an educational gardening program that increases the capacity and knowledge for caregivers to grow a variety of nutritious foods improving health outcomes for the whole family.
“Derrick, now 2 years and 10 months presenting with cerebral palsy and seizures, was initially seen by KCDC team in March 2021. He was brought by his grandma who for the last 2 weeks took care of him after he had been abandoned by his mother who had already moved on to another marriage.
Derrick was found to be severely malnourished, weighing just 6.4kgs. He was very weak and passive and could not undergo physiotherapy due to the fact that all his energy was focused on survival. He also had significant feeding difficulties which could have contributed to the malnutrition. Feeding therapy was done and a referral was made to Fort-Portal regional referral hospital for further management of the malnutrition and seizures.
Generally, Derrick improved from severe acute malnutrition to mild malnutrition and controlled seizures within the first 2 months of treatment. He is now more active and responsive to stimulation and tries to explore his environment. He has also started physiotherapy and now makes attempts to sit and play with toys given to him.
Challenges are still faced with fluctuating progress due to household poverty and food insecurity. This is hampering the sustainability of therapy and progress, but we are working with the family to establish a more sustainable source of income and food through our Street Business School programme and the provision of seedling kits to start small kitchen gardens. Unfortunately, the Street Business School programme is currently on hold due to the ongoing movement restrictions. Derrick is still living with his grandmother and is improving weekly. We will continue to monitor him during the lockdown to ensure there is no regression in his condition.”
Charles Speech and language therapist