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Who's Who
Nutrition and Food
During Annie's two week stay in Chimteka, she found all in good order in Katakumba except that food had run out due to rains coming late. She paid for food to be bought and delivered for the children, to last for the first quarter (they plant again in November) and we see it being unloaded here and the volunteers making porridge. The children are very interested.

The rains were very late this year and the food crop proportionately low. The food was running out and people hungry. CCS sent €5,000 of its funds to Irene to purchase maize while there was some left. It was held in the volunteer house and given out periodically, giving priority to those running the kitchens to provide porridge for the young children.
The people of Katakumba were most anxious to apply methods to fight against climate change and Martin has been instructing them on how and what to plant for winter crops. This message has been relayed to the other villages also.


The village of Katakumba, which is one of the poorest and furthest out, also has a thriving pre-school. The mothers make a porridge from maize to feed the children after school. On Irene's recommendation funds were sent to build a kitchen for this purpose. The pictures show the work in progress and the finished kitchen, with Irene in attendance.
At the same time the roof of the pre-school building was repaired where strong winds had blown it off.

This was the Global week of Action 2014 - Nutrition for Health. Francis was asked to lead the whole district of Mchinji in activites for this day, which involved receiving all the delegates from the Office of the President and cabinet and driving them to the venues.

Daniel Neilon began a 6-month Programme in Chimteka, sponsored by VMM. He has undertaken to accompany the HSAs on their visits to our villages to report on paediatric malnutrition in the area. He succeeded in getting some Healthcare Statistics

Chipondi is being collected each week from Mchinji District Hospital for CTC(Community Therapeutic Care.
CTC program is growing every week with more infants attending suffering from malnutrition to get the Chipondi. It is a good sign that people are attending the weekly sessions but worrying that more children have poor nutrition status.

Christi reports that some of the children are in very bad condition, but hopefully when they become part of the program things will improve. She has spent a large amount of time moving with the Health Surveillance Assistants and undertaking growth monitoring of children and vaccinations in villages. The HSA’s collect vast amounts of data and she is very keen to see how this data is applied to develop interventions.

A root cause of much of the problems that she is seeing at the Health Centre can be attributed to bad nutrition and this can be linked to lack of agricultural development.
The new Feed the Children Country Director (Ken Patterson) resolves the issue of allocation of vitameal for CBCC and disabled children.
Rooms in the Chiosya clinic have been refurbished by CCS to provide storage places for the food necessary for the CTC program for malnourished children. The first consignment of Chipondi/RTF (20 boxes) to begin the static Community Therapeutic Care, CTC, program began this month. This is a very exciting development with all the records for malnourished children/infants kept at Chioshya rather than Kochelera and the end of collecting the outreach team twice per month! A Peace Corp Health volunteer will shortly (in the next 3 months) be posted at Chioshya Health Centre for 2 years. An office has also been prepared.

The CTC (Community Therapeutic Care) program has gained permission from the District Health Dept to go ahead and begin work at Chiosya clinic. CCS proposes to make changes to existing rooms to facilitate this process. Annie, representing Dineen Chimteka Trust, is completing her very successful working visit and suggests Trust funding could be potentially used for this development
We receive news from Feed the Children that our application to begin supplementary feeding for malnourished disabled children has been approved.
Also, the headmaster agrees that a a school feeding program could be implemented on one/two days per week, using the maize from the school garden and 50kg of sugar from CCS, that would probably last at least 1 or 2 months leading to increased school attendance and improved child nutrition.
Feed the Children accepted our application to include Katakungwa CBCC(newly formed pre-school) into the Vitameal program and will soon give us an allocation of 400kg of vitameal per month.

The collection of the Vitameal allocation from the Office of the President for People living with Hiv and Aids Program (PLWH
Work on Disertification of Food products has been successful with good harvests of vegetables, soya and beans etc from the community and school gardens (see Farming and Gardens). Also crops are plentiful in these Spring months so that malnutrition has decreased and CTC is not finding so many cases.

Screening has been on-going in some of the twenty-one Chimteka villages, from April ‘09 to July ’09. Statistics are available showing the prevalence of malnutrition, both moderate and severe forms of acute malnutrition, as well as the percentage of underweight children. Children of normal/standard weight/height,are indicated.

Community-Based Therapeutic Care (CTC) and Malnutrition
CCS (Grace) had a meeting with the DHO and key personnel at the local Kochirira Rural Hospital at which. it was sugested by CCS that an outreach clinic to Chimteka might be provided by Kochirira and severe patients be admitted to their Nutrition Rehabilitation Unit, until more HSA’s are trained. The following was agreed subject to approval:
• HSA’s, based at Kochirira, already trained and experienced, will attend, on a fortnightly basis to deliver CTC service.
• The service extends to, under 5’s, pregnant and lactating women and HIV positive patients.
• Likuni phala and Chiponde will be provided. These supplies will be stored at Kochirira and monitored by the stock controller there.
• HSA’s will be responsible for transporting themselves and the food supplements.
• Elias and Grace are to coordinate the programme, ensure an education session is delivered at each clinic, and submit monthly reports.
• Severe cases will be admitted to the NRU. On discharge, these patients will automatically be incorporated into the Supplementary Feeding Programme, hence they will have further monitoring on an outpatient basis.

Mr Elias Kamngola (Supervisor)
Responsible for 17 HSA's

School feeding Programme
Carers receiving Likuni Phala
• The Director of the Feed the Children Programme agreed to supply Vitameal. This is a high protein flour, similar to Likuni Phala, but has a better nutrient profile. Funding is required for transport from the warehouse outside Lilongwe to Chimteka, to be delivered on a 3-monthly basis. However, it is necessary to maintain the search for other donors, to ensure all children are incorporated into the school feeding programme.
• The calorie content of this product may be enhanced by addition of other available, inexpensive ingredients, e.g. vegetable oil. This will maximise the nutritional benefits of vitameal. A shift from school meals only, to meals plus school gardens, was advocated.
• Agreement was reached that Vitamin A be given every 6 months and iron/foliate be given once per week to children under 10 years with promotion of use of iodised salt.

Community-Based Therapeutic Care (CTC) and Malnutrition
Mchinji District has been scaling up CTC services since January 2009,to include rural hospitals and health centres. The nutrition screening programme aimed to identify those children under 5, who are suffering from moderate acute malnutrition and severe acute malnutrition. This data provides a basis for the establishment of a CTC programme, based in the Chioshya Health centre, serving the Chimteka community.

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1. Skin disorder associated with malnutrition
2. Nutrition rehabilitation unit at Mchinji District Hospital
3. 6% of under 5's in the Chimteka catchment area suffer from severe acute malnutrition(SAM).
4. Severely malnourished wasted child (Marasmus) - 25% of under five’s die as a result of lack of food
5. High calorie/protein milk is used as a treatment for SAM

Children with severe acute malnutrition from Chiosya/Chimteka must travel to Mchinji District Hospital for inpatient treatment.
The service depends on availability of Ready to Use Therapeutic Food (RUTF), principally, Chiponde, a peanut-based product,of thick paste consistency. Those who are classified with moderate acute malnutrition are given a 2 week supply of RUTF. To date, Chiponde has been supplied in Mchinji District by the Clinton Foundation. A recent change has occurred, whereby 50 % of the product must now be supplied by the Ministry of Health.
School Feeding
Objective: To discuss potential for school feeding programme with Organisations and Education Dept; assess school gardens and establish a school feeding committee.
Meetings took place at UNICEF, World Food Programme, Ministry of Education and Crossroads Hotel. Outcomes as follows:

  • UNICEF does not support school feeding for children over 5 years.
  • The WFP are unable to accept any other schools onto their programme.
  • The deputy Minister of Education met Francis and I. He maintains that Mchinji schools are to be included in the scaling up of school feeding, but that government funding may well be an issue. The current programme provides Likuni Phala, to pupils, five days per week.
  • ‘Mary’s Meals’, based in Blantyre, currently supplies a few schools in Mchinji. They are stillconsidering our proposal.
  • UNICEF agreed to fund our HSA’s for CTC training.

  • Food Security
    The coupon system commenced; those eligible include vulnerable/poor smallholders of all genders, in particular, orphan-headed households, physically-challenged, and single-parent households, for instance. Coupons are distributed systematically by the DADO, who is responsible for monitoring and evaluating the scheme.

    Coupons cover pesticide, fertiliser, quality protein maize and one protein source to be selected by the farmer. This has been discussed with Isaac. The farmers have agreed that they will share out their protein seeds so that all villages have beans, soya and groundnuts.

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