In August 2012, RMF CNE Santosh Pall found Pooja, a 9 month old girl, in Devigarh village, with a MUAC of 7.9. Picture the circumference of your thumb: that was the size of her upper arm.
Pooja was immediately rushed to the closest Nutritional Rehabilitation Centre (NRC) in the Thandla Hospital. There, she received the care that was required, and slowly began gaining weight. After 16 days in the NRC, she was released for home feeding.
Over the course of the past three years, RMF’s Community Nutrition Educators (CNEs) have helped thousands of children recover from malnutrition. Some times these cases are easy to handle: the CNE diagnoses a child, refers them to treatment, and the family agrees to do everything they can to help their child. Often, however, there are too many challenges for these families to overcome to give their child the treatment they require.
Right now in Madhya Pradesh, the only treatment option for children suffering from Severe Acute Malnutrition (SAM) is a 14 to 21 day stay in a Nutrition Rehabilitation Centre (NRC), located at central facilities outside of villages. In addition to the child, a primary caretaker, such as the mother, has to also stay with the child for the duration of their treatment. With responsibilities at home, work required in the fields for agricultural livelihoods, the care of other children, and a high level of migration for work during the dry season, it is extremely difficult to convince parents to take their children to the NRCs for this care.
In March 2010, Caitlin and I were driving around Khandwa district on a motorcycle desperately searching for staff to begin operations of our ambitious “Eradicate Malnutrition” program. In our heads, we had a checklist of criteria for potential new staff, mostly focusing on education levels and any experience in the health, nutrition, or NGO sector. As we drove from hamlet to hamlet, over dried streambeds and through fallow, dusty farmland, the checklist was whittled down to one item: literate.
In July of 2011, 5 of our amazing CNEs from Khandwa are now on the cutting edge of technology, helping Microsoft design their Digital Slate technology for data collection in the field. At the same time, the rest of our Khandwa team is collecting information with an application on their phones specifically designed from RMF called Commcare. After a 3 month study, Microsoft Research will publish a paper based on the inputs of our team comparing these solutions to data collection problems. It seems that my initial pessimism, as it so often is, may have been a bit misguided.