1,000 life-changing days
The first five years are crucial to lay the foundation for future health. In remote regions of Lesotho, many children are not given this opportunity to thrive. One such child is Siyabonga. He is now receiving support as part of a new SolidarMed project.
6.2 kilos: this is how much Siyabonga weighed when he was 18 months old. An average healthy toddler should weigh 11.5 kilos at this age. The circumference of his upper arm was only ten centimetres, although it should be at least three centimetres more. His delayed development was due to malnourishment caused by food insecurity and poverty. This delayed development can have far-reaching and lifelong consequences. Because the first 1,000 days of early childhood development are crucial, and it is often impossible to catch up on the missed growth.
Siyabonga’s family live in Mapholaneng in the Mokhotlong District in northeastern Lesotho at over 2,000 metres altitude. The barren landscape surrounding the family home is unfertile and they have to travel long distances to fetch drinking water. The village is so remote that people have to travel many kilometres on foot or horseback to reach the nearest healthcare facility. People here have to contend with several difficulties. The unemployment rate in the small country of around 2 million inhabitants is 25%. Self-sufficiency is not an alternative for most people as only 12% of land can be farmed – that’s three times less than in Switzerland.
Loving care is crucial
Public health is also a challenge. According to official statistics, 2,500 children suffer from the consequences of malnutrition every year, 500 of whom are severely malnourished. One in three children has delayed growth. The region also faces high mortality in under-fives, with one in every nine children dying before they reach their fifth birthday. Food scarcity in Lesotho is not conducive to the health of infants and toddlers either. The number of children under five suffering from anaemia and stunting is soaring. On top of that, 40% of infants under six months are no longer breastfed for various reasons, and only one in ten children eats enough to support healthy growth.
Childcare – which is key to development – is often hard to organise, as for example a quarter of adults are living with HIV – the second-highest HIV prevalence rate in the world. The disease often affects the economically productive age group, which means many children are orphaned. Of the 100,000 HIV orphans in Lesotho, 18,000 live in the mountains.
Siyabonga is not an orphan. His mother Nolast is 39. She has five children with Siyabonga’s father but the family doesn’t live together. The eldest daughter is already married and lives with her husband. The two teenaged sons live with Nolast’s sister where they attend school. Only Boniswa and little Siyabonga live with Nolast in the modest family hut. Nolast also lost another four children. “The children’s father doesn’t live with us. He works in South Africa, where he looks after farmers‘ cattle,” explains Nolast.
But he doesn’t earn enough to feed the family. “I sold home-brewed beer to earn a bit extra. But even that wasn’t enough,” says Nolast, who therefore left her children with her sister to take a job in South Africa. Many parents in this region have to leave their children with relatives or older siblings to be able to go and work in neighbouring South Africa. This often results in the children not receiving sufficient pre-school support and care.
Frühkindliche Entwicklung in Lesotho
Am Donnerstag, 5. Dezember, können Sie ab 17 Uhr am Webinar «Frühkindliche Entwicklung in Lesotho» (in Deutsch) unter anderem von Pauline Grimm, Programmverantwortliche Lesotho, erfahren, was SolidarMed im kleinen Bergstaat unternimmt, um die frühkindliche Entwicklung
zu fördern. Denn was verpasst wird, kann oft lebenslange Konsequenzen haben.
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After four months, Nolast was back. In the intervening period, Siyabonga’s health had deteriorated. “When he lived with me, his diet mostly consisted of eggs, dried beans, peas, and papa – a type of polenta. His health worsened when he was at my sister’s,” she explains. When the medicalprofessionals in the SolidarMed mobile clinic noticed Siyabonga’s severe, acute malnutrition, he was immediately referred to staff on the new SolidarMed ECD project. The project team took care of Siyabonga’s hospital admission. Describing Siyabonga’s state of health at the time, Sibongile Mpeka, Siyabonga’s nurse on the paediatric ward at Mokhotlong Hospital explains that he had swollen arms and legs, no appetite, and was very irritable.
Children like Siyabonga are usually given a special nutritional product to treat severe acute malnutrition. “It’s a formula rich in protein and calories that’s designed to help children regain weight and improve their general health,” explains Sibongile Mpeka, who also attended SolidarMed training sessions. This formula is usually administered in clinical settings under medical supervision, she explains. “During Siyabonga’s stay in hospital, we didn’t have any ready-to-use food available, but we were able to make our own,” she says.
Siyabonga has now returned home to his mother. “I’m really grateful for the support and care Siyabonga received from the medical professionals and organisations such as Touching Tiny Lives and SolidarMed. I’m going to keep following the nutritional advice I received from healthcare professionals to ensure that he stays healthy and strong. And I’m going to make sure I follow the recommendations on early childhood development to offer him a supportive environment to learn and grow,” says Nolast. Siyabonga seems to agree as he chats excitedly and laughs.
Whether Siyabonga can make up for his bumpy start in life remains to be seen. When he was discharged from hospital, he couldn’t run around like other children his age, only crawl. With the support of SolidarMed and TTL, he will receive community-based support with his development in the form of nutritional supplements until he reaches the age of five, if necessary. “This way we can be sure that he makes a full recovery, that he can start school, and that he doesn’t fall behind,” explains Laetitia Tanka, ECD coordinator at SolidarMed in Mokhotlong (see box for further TTL activities).
