The Therapeutic Feeding Centre

The Therapeutic Feeding Centre

I’ve been working in the therapeutic feeding centre (TFC) for a few weeks now. This is where the children are admitted when “the body dry” or “don” (they are malnourished). Most children in SL are slimmer than their counterparts in the UK anyway and to be admitted here they have to be <70% of their expected weight for height AND have a complication such as severe infection or associated swelling. Malnutrition is associated with a very high mortality rate, with children dying from simple and preventable things like low blood sugar levels, hypothermia, infections, anaemia and electrolyte disturbances.

The nurses have all been specially trained in the treatment of malnourished children. They tell me which feeds, and which extra supplements and vitamins the child should get. There are great WHO guidelines/protocols/whatever you want to call them for the investigation and treatment of malnourished children. It’s great that the nurses can follow these guidelines and see the children getting better because of the work they are doing. As a bonus they also get given their prescribed medicines at least most of the time!

There are specially made formula feeds for malnourished children because of the electrolyte disturbances they can get. Unicef (United Nations Children’s Fund) are supposed to provide these feeds. Unfortunately they have stopped supplying our TFC. We have had no therapeutic feeds for about a month. I’m not quite sure why Unicef have run out….

Thankfully the children don’t come to hospital only to starve to death. Another NGO has been providing feeds in the meantime, as a stop gap until Unicef sorts itself out.

Most of the children in TFC have TB. A few are also HIV positive. The official rate of HIV prevalence here is supposed to be about 1-2%. It’s probably a bit higher in reality but still far less than Eastern Africa. We are very lucky in that the Global Fund pay for all TB and HIV treatment (although there are supply problems with these too, but not quite as drastic as the food shortage). We have a great nurse who gives out the TB treatment to the children. To ensure compliance, the treatment is directly observed by the nurse and she is superb at telling the parents that they must keep coming back for the medication every single day.

The children and mothers come back to TFC after they are discharged to be weighed on a weekly basis, and get a new supply of food. The nurses do an educational singing session with the mothers; they are taught about good nutrition and hygiene. It is such a pleasure hearing them sing and it is one of the truly happiest times at the hospital.