By Avinaash Mohan Kastura
CHIKKABALAPUR, India, 09 September 2019 - Devamma has a reason to smile. Her seven-month-old son, Nandeep, has been discharged from the Nutrition Rehabilitation Centre (NRC) in Chikkabalapur, located some 60 kilometers away from Bangalore city, after spending two weeks. Nandeep was admitted as a Severely Acute Malnutrition (SAM) case needing critical attention, failing which his very chance of survival was low.
“I am grateful to this NRC, it has given my son a second life,” said Devamma, hugging her baby.
Navdeep was a preterm baby with a low birth weight. After spending over a month in a Special Newborn Care Unit (SNCU), he was admitted into the NRC. Initially, Devamma was skeptical but the doctors and staff of the NRC made her realize the grave danger Nandeep was in and motivated her to admit him. Gradually, Nandeep’s health improved and his weight increased to 1.9 kilograms in few days. By the time of his discharge from the NRC, he was declared ‘healthy’ and weighed almost 3 kilograms.
Hundreds of women like Devamma have stayed in this NRC to avail special care for their sick and malnourished children. With the cure rate of over 95 percent, the NRC functions as per international set standards and is ranked among the best in the state and country. The Chikkabalarpur NRC is unique as it also admits children below six months of age, a first for any NRC.
“I feel at home here. They take good care of me and my son,” says another mother, Sultana who has been in the NRC for four days. By following the doctor’s advice diligently, she has seen the health of her child improve and is now confident that he will make 100 percent recovery
NRCs are facility-based care centers where Severely Acute Malnourished (SAM) children are admitted with their mothers for treatment, stabilization and rehabilitation. They are a bridge between hospitals and home care wherein children between the ages of six months and five years can be treated to gain weight proportionate to their age and height.
Situated in the district hospital of Chikkabalapur, the NRC started functioning with just two admissions in 2012 and, with the resolute efforts of the doctors and dedicated staff, it has attracted more and more cases every year.
Children who visit the hospital are checked and SAM cases with complications are admitted into the NRC. References by mothers who were previously discharged from the NRC, Anganwadi and ASHA workers has led to a spike in the admissions, making it one of the busiest NRCs in the state.
The children and mothers stay at the NRC for a period of two weeks or till the child gains 15 percent weight. The focus is on increasing the weight of SAM children, hence nutrient-rich food for the child is prepared and served every day to accelerate the weight gain of these children. Mothers are also encouraged to breastfeed so that vital nutrients help the kids recover faster.
Counseling of mothers is also done on the importance of hygiene and how to cook nutritious food so that their children maintain good health after discharge. This knowledge supports mothers in providing adequate nutrition to children back at home and prevent relapse.
The cognitive and socio-emotional development of each child is also given importance. Structured play therapy and loving care are also promoted at this NRC, to promote essential motor skills and cognitive growth of the children. A special play area with toys helps them to stimulate their senses and keep them active.
Festivals, birthday celebrations and gifts to mothers have encouraged and motivated them to stay until their children have gained the required weight.
As a pilot initiative, pre-term babies from the SNCUs have also been admitted in the NRC. Such babies have shown tremendous improvement in their health condition. So far, 11 infants have been discharged with zero relapse.
Citing wage loss and unfinished household duties, many mothers in the past have left the NRC before their children gained the required weight and became healthy. To arrest this, a cash grant of Rupees 259 per day is given to the mothers as wage loss compensation. This has been one of the added motivations for mothers to bring their children to the NRC and keep them for the needed period.
Apart from money, imparting skills to earn, like jewelry making and basic tailoring is also taught to mothers so that once they go home, they can use these skills to earn a living. Nirmala is one such mother who has learnt how to stitch borders for sarees and says, “The skills I received here have empowered me. I now earn around 150 rupees per day.”
A Collective Effort
The doctors and support staff at NRC initially faced many setbacks, but their commitment to reduce SAM cases and positive attitude have made them saviors for the people of Chikkabalapur and beyond.
“Without a sincere and dedicated team, we could have not achieved this milestone,” says Dr Prakash P, Senior Pediatrician, District Hospital.
This NRC in Chikkabalarpur is helping Karnataka win the war against malnutrition, one step at a time.