Khumbidze, 6 months old, being breastfed by her mother. Photo: Petrine Elgaard.

Khumbidze Kandwani is whimpering in her mother's arms. Grace Genesis shifts her daughter at her lap, but it doesn't make the child stop crying. It has been like this for almost all Khumbidzes' short life, since she is constantly ill. First she got malaria, then diarrhea, then malaria again and again and again. Now mother and daughter have ended up at Alinafe Hospital by the city Salima, since Khumbidze is so badly undernourished, that it is uncertain whether she will live for much longer. Her cheekbones are protruding through the skin, on the rest of her boney body the skin is saggy and wrinkled due to dehydration and undernourishment. Khumbidze looks like an old woman caught in a tiny body.
Grace doesn't understand what she has done wrong. When she climbed on to the load of the packed truck, that was going to take her and Khumbidze to the hospital two weeks earlier, she could only pray that the drive would pass without any problems, since she wasn't sure her daughter could take more than the three hours drive to the hospital.
When they arrived, Nurse Gertrude Nsowoya stated that Khumbidze's chronic diarrhea came from the murky well water Grace had given her daughter. And that Grace herself is malnourished and almost has no milk left in her breasts. That shortage can have severe consequences in a country like Malawi, where mothers are recommended to breastfeed their children till the age of two, since mother's milk is the best nourishment the children can get.

A long way to go Grace Genesis' husband is working hard to provide his family with food. But his bike repairs can only give them a little maize porridge and vegetables twice a day. Without proper food neither Grace nor Khumbidze are going to get any better. Grace didn't know of this before she came to Alinafe Hospital. As many other Malawian women she has never been to school, and her scarce knowledge of children and nutrition comes from the other women in the village.
"Many people think severely undernourished children such as Khumbidze belong to the past, but the number of them in the villages of Malawi is never-ending", says Bertha Mkandawire, nutrition expert in the organization Cham in Malawi.
"We still have a long, long way to go before it gets better".

Out of touch with reality

DanChurchAid
in Malawi

In cooperation with the partner organization CHAM, DanChurchAid has established common kitchens in several villages, where the local women are taught how to cook healthy and nourishing food for their children. The project villages have been given seed corn to make sure that they can harvest enough to get through the hunger period, which runs from December until February. They have also been given goats and chickens that they can sell if they need money for food. Furthermore the children are being weight and measured by the villagers, who through the scales have learned to see, which children need better and more food.

Read more on our work in Malawi

In the village Sawopa Mpeni, which is situated in the central region of Malawi, the majority of the 400 children are mal- or undernourished. 27 in such severe extent that it is life threatening. This kind of statistic data is normal in the Malawian villages.
In December, when the hunger period starts clawing Malawi, more mothers are arriving at the hospitals with their severely undernourished children. At Alinafe Hospital 30 women with children are hospitalized each month from December till February. Only the worst cases are allowed to enter the hospital rooms. If the children are moderately undernourished they and their mothers are sent back home with advice on nutrition and health.
The first signs of mal- and undernourishment are that the children become weak, tired and passive. Then oedema start to show on the legs, and will later wander up to the face. The children loose their appetite; they stop communicating and they become easy prey for other diseases such as malaria and infections.
At Alinafe Hospital the women are taught how to give their children healthy food and that they can't give the babies well water before they are six months old. But one thing is life at the hospital –another is reality in the villages. The women often return to the clinic three to four times in a row. In spite of their new knowledge and good intentions, they can't give their children the food they need – simply because they are too poor.
Every time the women and their children stay at the hospital for at least one week, to learn more about nutrition and so that the nurses can make sure they see a progress in weight gaining.
Khumbidze Kandwani still hasn't gained weight. But her diarrhea has stopped and Grace thinks that her daughter is doing better. But Grace still has no milk in her breasts and she doesn't know how she and her husband are going to provide the food Grace and her little girl need. By Petrine Elgaard