Sierra Leone

Nourishing newborns in Ebola-stricken Sierra Leone

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Moses had already beaten the odds when he was born, as his mother contracted Ebola infection when he was in the womb. Here, he is 1 month old. © UNICEF Sierra Leone/2015/Francia

By Marge Francia

FREETOWN, Sierra Leone, 7 April 2015 – Moses is a healthy baby who coos and smiles at the sight of his mother.

He has also surmounted incredible odds. This chubby, wide-eyed boy came dangerously close to death five months back when he was still in the womb of his Ebola-stricken mother.

“When they told me I was positive for Ebola, I was not happy, and my whole family was worried. I felt cold and I had pain all over my body. My eyes changed colour,” says Isatu Mansaray, Moses’ mother. “I was worried that my baby would get Ebola from me.”

She had good cause to worry. The prognosis for pregnant Ebola patients and their babies is especially grim. There are only a few known cases wherein both mother and baby have survived and recovered from the disease.

When they do survive, another challenge presents itself: Ebola virus can be present in the breast milk of a survivor for some time. When it is not possible to test breast milk, mothers are advised not to breastfeed for eight weeks. This poses a risk to the infant, who needs proper nutrition to get the best start in life.

Four months ago, Isatu delivered safely, and Moses tested negative for Ebola.

Strong foundation, strong nation

Giving children a good nutritional foundation is critical to ensuring their physical, mental and social development. Children who are well nourished learn better and are better able to fight infection, which is especially important in this health emergency. The effect of good nutrition lasts well into adulthood, and is a key ingredient in nation-building.

“For any nation that is aspiring to develop, nutrition is the most important component of human capital development,” UNICEF Sierra Leone Nutrition Manager Faraja Chiwile says. “Investing in nutrition has high gains in terms of reducing expenditures in health and education, and providing the country with a quality work force. If you want to build a developed and prosperous nation, you have to have a healthy and well-nourished population.”

Nourishment for the vulnerable

In Sierra Leone, nutrition is a challenge; 12.9 per cent of children are malnourished. Traditional beliefs on infant feeding can be harmful to children.

To help children’s nutrition at this especially difficult time, UNICEF provides a host of interventions to benefit mother and baby. UNICEF is a key partner of the Sierra Leone Ministry of Health and Sanitation in providing children with the nutrition they need to be able to survive and thrive. Two key elements of this work are helping guide the strategies and protocols that are responsive to the current emergency and providing health workers with training. Delivering nutrition supplies to health centres, Ebola holding and treatment centres and quarantined households also ensures that the most vulnerable children are reached.

For the Ebola emergency, UNICEF is directly providing 16 Ebola treatment units (ETUs), 47 Ebola holding Centres (EHCs), 7 ETU/EHCs, 12 interim care centres (ICCs) and 14 observational interim care centres (OICCs), as well as 31 community care centres (CCCs), with nutrition supplies.

Nutrition supplies have been pre-positioned at district medical stores for replenishment to all Ebola centres, as well as to support quarantined households and children under 6 months of age who are separated from or have lost one or both parents. Two hundred seventy-eight surviving infants have been receiving supplies of ready-to-use infant formula (RUIF) on a bi-weekly basis since the emergency began.

Coming home

One of these babies is Moses. When the time came for Isatu and Moses to be discharged, they brought two weeks’ supply of RUIF. RUIF is given as a last resort when mothers are not able to breastfeed and there are no other safe options to feed the baby.

Every two weeks, Isatu goes to the health centre to pick up a new ration of RUIF, as well as have Moses’ weight and height monitored. By the time Moses is 6 months old, Isatu will have begun giving him complementary food to support his continued growth and development.

“I feel very happy now because I am feeling well,” reports Isatu. “And my baby, he is healthy, he is growing,” she beams. “I pray to God that he will give Moses long life and good health. Because I am not educated, I also pray that my child will get an education, so he can be somebody in the future.”