A Letter from Larry and Inge Sthreshley, serving in Congo
Fall 2021
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Dear friends,
There are a lot of challenges with the nutrition work I do here in the Dem. Rep. of Congo, but it always gives me a lot of joy and encouragement when I receive a story of a family that has been helped by the programs we undertake. So, I want to share this story of Anastasie Awokana with you.
Anastasie was emaciated and had an arm circumference measurement of only 9 cm when she arrived at Mamu Wetu Health Center for evaluation and treatment on June 30, 2021. The community health volunteer, Mama Lyly (pronounced Lily), had discovered her condition during an intensive systematic screening of children under five years of age in her neighborhood in Katoka, a peri-urban area of Kananga. She immediately referred Anastasie and her mother to Mamu Wetu Health Center so that Anastasie could be evaluated by a nurse.
The head nurse, Jean Pierre, found that Anastasie had a fever, and she tested positive for malaria. She was treated for malaria and later given a de-worming treatment. He reviewed her records and noted that Anastasie was completely vaccinated. She had received Vitamin A and Mebendazole treatment in the last six months but had not been brought in regularly for quarterly preschool consultations at the health center and was not sleeping under a mosquito net.
Jean Pierre learned that Anastasie’s mother, Mama Ndolo, had recently undergone a surgical intervention. Mama Ndolo was a housewife with eight children to care for and her husband, Papy, was a day laborer. With limited means and a large family to care for, the surgery had destabilized their family. Anastasie had first fallen ill with a fever, followed by diarrhea that had contributed to her advanced state of malnutrition. Her parents had given up hope that she would recover as no therapeutic food (Plumpy Nut) was available at the health center. But the nurse, Jean Pierre, encouraged them to use local foods and accept the follow-up and counsel of a community health volunteer. He established a home visit form for Anastasie. He assigned Mama Lyly to visit Anastasie’s family to show them how to make an enriched porridge with local ingredients and share best nutrition and health practices.Mama Lyly visited Anastasie’s family five times over a two-month period to check on Anastasie. She measured and recorded her arm circumference at each visit and shared key nutrition messages with the family. She showed them how to enrich the child’s porridge using cornmeal, adding peanut or caterpillar powder for protein, and the nutrient-rich water from cooked greens and red palm oil to add vitamins and minerals. She gave Mama Ndolo a MUAC measuring tape and taught her how to use it to track Anastasie’s progress herself. Over the course of two months, Anastasie’s arm circumference readings went from 9 cm to 13.20 cm, and her weight increased from 6 kg to 13 kg.
Mama Dolo and her husband were extremely happy to see Anastasie regain her health. Mama Dolo is now in an infant and young child feeding support group. She has started sharing with other mothers in the community how to prevent malnutrition and feed malnourished children with local foods without having to wait for Plumpy Nut. She has asked for photos of Anastasie’s before and after pictures so she can share her story with other households.
Back at the health center, the nurse Jean Pierre talked about the advantages of the intensive systematic screening introduced by the Appui au Système de Santé en RDC (ASSR) project, which in English translates as Health Systems Support in DRC. This screening approach aims to screen every child between six and 59 months every quarter through community health workers (RECOs) and the infant young child feeding support groups they establish. “The advantage of the intensive systematic screening and the micro screening plans,” he said, “is that they involve 33 community groups, each with an active RECO and infant young child feeding support groups. It ensures coverage of the entire peri-urban health zone.”
Intensive systematic screening is also a “doorway into each household” to share nutrition messages targeted to the age of the children in the household and pregnant and nursing women. This approach has improved the proportion of children screened, the prevalence rate and the recovery rate. Over 96% of the children under five years of age have been screened in the Katoka health zone for the past three quarters. The prevalence rate for acute malnutrition in Mama Lyly’s neighborhood has dropped from 24% in January 2020 to 2.5% in June 2021.
Jean Pierre thanked the ASSR project for strengthening the capacity of the community health volunteers (RECOS), the members of the infant and young child feeding support groups, and the health care providers like himself through the ASSR nutrition component.
Isn’t that an encouraging story! I’m pleased to share that we are seeing significant reductions in acute malnutrition in all the 40 health zones supported by ASSR using this approach. Thank you for your financial support and prayers. I hope you will continue on this journey with Larry and me as we work within the framework of the national health system and help bring support to the numerous Protestant, Catholic, and government health centers that are a part of the health care system of the DRC, serving families like Anastasie’s.
God’s blessings,
Inge
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Dear partners in God’s mission,
I don’t know about you, but daily my heart grows heavier. News about the pandemic, wars, wildfires, gun violence, racism, earthquakes and hurricanes cloud my vision. It’s hard to see hope; our world is in a fog. Yet we trust that God’s light and love transcend the brokenness of this time.
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In the light of hope,
Sara P. Lisherness, Interim Director
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Presbyterian Mission Agency
Presbyterian Church (U.S.A.)
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Tags: Appui au Système de Santé en RDC (ASSR Project), childhood malnutrition, community health workers (RECOs), congo, Health Systems Support in DRC, infant young child feeding support groups, intensive systematic screening, Mamu Wetu health center, Matthew 25, MUAC measuring tape, Plumpy Nut
Tags: Larry and Inge Sthreshley