Outpatient Malnutrition Treatment

   

Outpatient Malnutrition Program

   

Children’s Health Ministries has treated over 2,000 malnourished children using Medika Mamba! Read below to learn more!

   

What is Medika Mamba?

Medika Mamba (MM) is a ready-to-use theraputic food (RUTF) made from peanut butter, powerdered milk, oil, sugar, vitamins, and minerals. “Medika mamba” literally means “peanut butter medicine” in Haitian Creole, and it is an entirely Haitian product. Meds and Food for Kids, the company that produces MM, buys peanuts grown in Haiti by trained Haitian peanut farmers and employs Haitian workers in the production and packaging of the mamba in their factory in Cap Haitian. This product stimulates the Haitian economy while saving the lives of its children at the same time.

For more information on Medika Mamba and Meds and Foods for Kids, please visit MFK’s website.

What is malnutrition and how is it affecting Haiti?

It is estimated that over 19% of children under 5 years are under-weight in Haiti and that over 4% are acutely malnourished (UNICEF). Fifty-three of the child deaths in Haiti are the result of malnutrition. This is a huge – and largely unaddressed – problem. Malnutrition can present in a variety of different ways and can range from moderate cases to severe. Outcomes also vary, ranging from physical and intellectual stunting to death.

Example of kwashiorkor and edema in the face

Example of kwashiorkor and edema in the face

Kwashiorkor is a poorly understood form of malnutrition that is believed to be a combination of factors including severe protein deficiency, malabsorption, and intestinal infection. Kwashiorkor is typically characterized by edema (swelling of the feet, legs, hands, arms and/or face), irritability, anorexia, and skin breakdown.   Kwashiorkor is the more acute form of nutrition. It is harder to treat and more dangerous for the child. Approximately 10% of the children admitted to CHM’s Medika Mamba Program have kwashiorkor.

Example of marasmus

Example of marasmus

 

Marasmus is a form of severe malnutrition characterized by energy deficiency. A child with marasmus looks emaciated. Body weight can be reduced to less than 60% of the normal body weight for the age. Marasmus can be an acute condition, but it can also present in children who have been chronically malnourished.

How is Medika Mamba used in treatment?

On a patient intake day, a child is weighed and measured for length. We then consult a weight-for-height chart that shows whether a child is “red” (severely malnourished: -3 standard deviations from average), “yellow” (moderately malnourished: -2 SD), or “green” (mildly malnourished: -1 SD). Red and yellow children can be admitted to the program. Edema (swelling) as a result of malnutrition is also a factor in admitting a child to the MM program. Any child with edema is automatically qualified for the program, regardless of weight.

 

We then instruct the child’s caregiver on the specifics of the program. Depending on the weight of the child, the caregiver is instructed to feed the malnourished child (and ONLY that child) a certain number of sachets of mamba each day. Each sachet contains 500 calories. A child, for example, that weighs 15 pounds will eat 3 sachets per day and thus be taking in 1500 calories. Nutritionally the mamba is all the child needs and if the child eats all the prescribed mamba each day he or she will gain weight. The MM protocol directs that each child be given amoxicillin and de-wormer at the beginning of treatment. A checkup is also given to each child and other medications are given based on need. Occasionally we send children on the program to other facilities for more specific, intensive care. Lastly, each family is given a supply of clorox for water treatment purposes.

 

After the initial intake of a patient, we ask the caregiver to return with the child once a week depending on the severity of the child’s condition. At each subsequent visit, the child is weighed, checked over, given any medications necessary, and given the appropriate amount of mamba to carry them to their next appointment. The caretaker also receives weekly training on issues such as proper nutrition, hygiene, clean water, and the causes of malnutrition.   After 4-12 weeks on the program, if a child has reached their goal weight they are discharged from the program. Each family is always given an open invitation to return to the clinic if they have health or nutritional concerns for their child.

How can I help?

Mamba is expensive! One box of mamba, which treats an average of  one child, costs $70. With transportation, staff, and medication costs, we estimate that treatment of each child costs an average of $125.   If you would like to help cover these costs, please join our monthly giving team! You will be greatly blessed as you bless these children with life-saving treatment.

 

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