16 Aug 2011 • Health and nutrition India

India: New Special Nutrition Unit opened in the Sundarbans of India

- Published by Darcissac, Marion

On the 11th of July, 4 little children below 2 years entered the newly set-up Special Nutrition Unit accompanied by their mothers. Questions were written large on the mother’s faces and they were unsure of what was in store for them and their babies. Two weeks later all of them returned to their communities with big smiles and promises of returning to visit and taking care of their babies.

The Special Nutrition Unit opened its doors on 11th of July, in the Sundarbans – the Ganges Delta in India. The Unit – set-up on the first floor of the Maternity Centre of Tdh’s partner organization Sundarban Social Development Centre (SSDC) and painted in bright colors – has an initial 10-bed capacity and is run by a team consisting of a head nurse, 4 assisting nurses, and a part time medical doctor. With the arrival of the 4 children the place came alive with bawling children and busy nurses who had to get used to preparing the formula feeds every 2 hours round the clock and encouraging the mothers to feed the children. Within a few days, the children showed a change, they were up and about and demanding larger feeds and they gradually made the transition to the next formula feed. Efforts were on with the mothers to educate them on hygiene practices and also provide them information on correct child care practices that they should follow once they were back home.

It was a poignant moment when one morning in the second week the Tdh team noticed a big smile on the face of the youngest mother – a tribal woman who barely spoke a word for the first few days – observing her child whose laughter was loud enough now to awaken others. The child had come to the unit very sick – with a swollen worm-filled belly, but it responded very quickly to the treatment.

Children and mothers returned home after 14 days with a take away ration of cereals, pulses and oil and also a set of clothes, a mosquito net and a blanket. They have been followed up closely at home with visits from the project team and will return soon for their first check up in the unit. Ideally it would be better to retain them for a longer period in the unit – at least another week – but it was not easy to convince the mothers to stay. Three of them had children back home whom they were anxious about. Persuading mothers to stay for the entire treatment period is a challenge the project will regularly face in the coming future.

It has been a challenging but exciting first experience for the Tdh team: “We recognize that there is a long way to go before we can send back every child who comes to us fully recovered but we have made a beginning. Our greatest reward in this first experience is the trust that we have earned in the community through a combination of the work in the community and in the clinical facility”. A sentence from the Community Mobiliser paraphrases the change: “I am now welcomed in the tribal hamlet with folded hands- earlier the men stood as if ready to grab my neck each time I visited their homes.”

The project which started in January 2011 intends to prevent 20’000 children under 5 years from malnutrition and provides community and institutional care for cases of moderate and severe acute malnutrition. The recently concluded baseline study reveals that 6.3% of children in our working area are severely and 12.5% are moderately acute malnourished. The project is the only one in the State of West Bengal with a population of 90 million inhabitants.

The National Rural Health Mission assisted technically by UNICEF has drawn up Guidelines for Integrated Management of Severe Acute Malnutrition (IMSAM) which is now being gradually introduced in a few districts across the state. We collaborate actively with the State and UNICEF and are being recognized as an agency with the technical capacity to work with malnourished children.

Further information on the Tdh intervention in India