Two-and-a-half-year-old Uwimanaimpaye mostly goes by this, her second name, which means ‘the one God has given me’. But family and friends in her Oruchinga neighbourhood, in southwestern Uganda, like to cut it short to just Wima.
Her grandmother keeps an exercise book with the toddler’s medical records. The pages show when she was born — 12 August 2016 — and when she was immunized for polio and tuberculosis. Then, when Wima was four-and-a-half months old, health workers at Oruchinga refugee settlement in southern Uganda wrote: ‘This child was abandoned on Christmas Day, 25 December 2016, by her mother. Came (to the health centre) with the (village) chairman. She looks weak with a fever. Body weight: 3.8 kilogrammes…’
Wima’s case is not unusual. Across southern Uganda, poor child care and even abandonment, count among the factors behind stunted growth and life-threatening malnutrition. The phenomenon not only affects the country’s sizeable refugee population, but also local Ugandan families.
A 2018 food and nutrition security survey carried out by WFP and its partners found that nearly one in three children is stunted in southern Uganda’s Isingiro district where Oruchinga settlement is located. The average rate of life-threatening (acute) child malnutrition was also above the alert threshold.
“Too often, women expect other people — their mothers, usually — to raise their children,” says nutritionist Maureen Tusiime with WFP’s nutrition partner Medical Teams International (MTI), who works with refugees and nationals around Oruchinga. “But the grandmothers or caretakers are often poor, with insufficient resources to care for these children.”
A 2018 nutrient gap analysis carried out by WFP and the Ugandan government found that a nutritious diet among refugees costs the equivalent of US$4 per day. US$ a day is hugely expensive for many who depend on support from humanitarian groups such as WFP to get by.
Reasons vary for why women — and men — can neglect their parental duties. But around Oruchinga, many of their children are nonetheless off to a good start. WFP and MTI help boost children’s health and reduce the food burden on caretakers.
The two organizations also sponsor a women’s group of refugees and nationals who help their counterparts at Oruchinga manage malnutrition and practice safe motherhood.
The child given by God
Wima’s mother did not eat healthily during her pregnancy, partly because she did not register with the Ugandan government as a refugee, making her eligible to receive WFP food. She did not know then that she had tuberculosis. She grew extremely weak giving birth. Consequently, Wima came out weighing not more than 3 kilogrammes.
That Christmas day in 2016, Wima’s mother still struggled with hunger. It was a year in which a drought caused severe food shortages in Uganda’s cattle corridor, which stretches from the northern Karamoja region southward to Isingiro district.
Wima’s mother walked away for unknown reasons, leaving her child alone at home. Her paternal grandmother, 70-year-old Perepetua Minirakiza, found the infant crying, hungry and bitten by mosquitoes.
“I thought she would die,” Perepetua recalls. “I did not know what to do, so I called health worker (Virginia) Kamagaju because I knew she belonged to the village health team.”
The two women took Wima to the local village chairman to report the abandonment and the child’s condition. She was taken to the local government health centre and put on a regimen to treat malaria and malnutrition.
A few weeks later, when Wima’s condition improved, she was enrolled in WFP’s mother-and-child health and nutrition programme, which targets pregnant and nursing women and children under two. The programme provides fortified food which protects children from stunting.
“The locals in Isingiro grow lots of healthy foods,” Maureen of MTI says. “But they sell off a lot of it, which is another reason for poor child growth in the area.”
She speaks as she mounts a steep hill covered with banana plants, heading to check on another formerly abandoned child.
Twenty-month-old Ronas Kyokusiima was neglected by her mother over a long period. Her mother, who was on strong medication for an illness, often went away for entire days and nights, leaving her alone at home. Ronas was often heard crying as she crawled out of the house into the banana plantation where it sometimes rained on her.
When the child’s maternal grandmother, Lookardia Tugumisirize, learnt of it, the neighbours said it was too late. They advised her to keep the child in the house, expecting her to die in a matter of days.
“Two days later, she was still breathing,” says Lookardia. “I felt obliged to take her to the health centre. I did not want to regret later that I did not try to save her.”
Lookardia picked up the child and descended the hill to find a means of transport to the nearest government clinic, 11 km away.
Ronas was found to be alarmingly underweight, and diagnosed with malnutrition, severe pneumonia and acute diarrhoea. She too recovered, thanks to local care and special formula milk and today is part of WFP’s mother-and-child health and nutrition programme.
“The neighbours now respect me when they see her,” says Lookardia. “They say I did a great thing.”
Wima’s mother has since returned, after time spent in Tanzania and her native Rwanda. She lives in Oruchinga and often visits the child, who opted to live with her grandmother. Wima’s father, too, comes by often.
Now registered on her grandmother’s refugee card, Wima continues to receive WFP assistance in the form of monthly rations.
“I am very happy that she is well,” grandmother Perepetua says, smiling as she caresses Wima’s head. “I want her to be a nurse when she grows up.”
WFP is grateful to the following donors for supporting nutrition programmes in its refugee operation under the Country Strategic Plan (2018–2022): Canada, Germany, Japan, multi-lateral donors, Norway, the United Nations Central Emergency Fund (CERF) and the United Kingdom.