How Acholi locals are tackling malnutrition with food banks

By Rosemary Anena

Gulu | The high rate of malnutrition in Northern Uganda’s Acholi sub-region continues to be a silent dream killer for many young mothers.

The health condition that results from a lack of nutrients in the body continues to claim the lives of children under the age of twelve (12), affecting hundreds of them.

In 2024, Kitgum and Nwoya districts had the highest death rates among children admitted and treated for malnutrition, at 16.1 and 10.2 percent, respectively. In the same year, 3,279 children were discharged from various health facilities across the nine districts that comprise the Acholi sub-region.

According to the Uganda Nutrition Action Plan II, the Acholi sub-region has a 30.6 percent stunting rate among children under the age of five. The plan classifies the region’s stunting prevalence as serious, with rates ranging from 30 to 40 percent.

Love One International, a non-governmental organization operating in the sub-region, reported last year that the prevalence of malnutrition among children and pregnant women was 25% in Agago district, followed by 18% in Amuru district and 16% in Gulu district.

Bishop Janani Loum, Senior Nutritionist at Gulu Regional Referral Hospital and Focal Person for Nutrition in the Acholi sub-region, says the burden of malnutrition rises with the start of the rainy season because many parents leave their children at home without food to tend to their gardens.

“Boys under the age of five are at most risk of malnutrition, especially undernutrition. Communities should pay much attention to prevention of malnutrition by reducing the rate of alcoholism, minimizing gender-based violence and engaging in food production,” Loum told tndNews during an interview.

In March, Noel Akumu (not real name) resident of Alero sub-county, buried her four year old son who had succumbed to chronic malnutrition. The child was admitted and discharged six times at St. Mary’s Hospital, Lacor, in Gulu City.

“Several medical tests did not find evidence of sickle cell disease. He later lost appetite for food, preferring to eat silverfish and greens a few times,” Akumu narrated.

Akumu is a peasant farmer whose livelihood depends on tilling her smallholding. She had spent most of her planting season in the hospital trying to treat her first child who succumbed to the health condition while weighing just five kilograms.

Malnutrition, according to medical experts, is caused by food insecurity, which has severe and negative consequences for children such as stunting, being underweight, and becoming malnourished as they face the challenges of inadequate dietary diversity.

The United Nations Children’s Agency, UNICEF, has identified malnutrition, malaria, pneumonia, and HIV/AIDS as the leading causes of child mortality in Northern Uganda in 2023. It says the condition presents as stunting and wasting, thereby weakening the children’s immune systems. This makes them more vulnerable to infections by increasing their risk of death.

Mary Isaac Lakica, 35, resides in Lanyal village, Cuku A parish, Alero sub-county, Nwoya district. Her child, born in December 2021, was diagnosed with severe acute malnutrition in May 2023 when his body suddenly swelled.

Food Banks

Locals in the sub-region have devised local mechanisms for responding to malnutrition cases, which include food banks.

Under the initiative, every household is encouraged to store food at home or in their garden. Cassava, sweet potatoes, pumpkins, and yams are among the foods they keep fresh in their fields.

Lakica says she learned about the food banks from Love One International after her son was diagnosed with severe acute malnutrition.

“We were introduced to the concept of keeping beans, peas and cereals in our food stores for the worst of times. Previously, we would sell all our food to raise school fees for our children,” she narrated.

At community level, Love One International has re-introduced the Acholi granaries in Odek sub-county in Omoro district as well as in Agago district. The concept had died out during the Lord’s Resistance Army insurgency.

Officials of Love One say the initiative is blended with backyard farming where greens and vegetables are grown. Hundreds of vulnerable families affected by malnutrition and nodding syndrome in Omoro district have benefitted from the initiative.

Last year, the Omoro district local government backed up the intervention with approval of a District Nutrition Action Plan (DNAP), aimed at addressing food shortages among some families.

Richard Luganya Bongowat, the speaker of Omoro district council, states: “We approved the action plan after a report from the department of Health indicated that up to 747 cases of malnutrition were registered between August 2021 and July 2022 in the District.”

Home-based care

Love One International deploys two sets of models in the management of malnutrition in Acholi – the Home-Based Nutrition Rehabilitation and the Center-Based Nutrition Rehabilitation designed for children with severe acute malnutrition.

Those still breastfeeding are cared for from home under the Home-Based Nutrition Rehabilitation for children with moderate to acute malnutrition.

By mid-March this year, the organization was rehabilitating 90 children with malnutrition under the Centre-based nutrition rehabilitation while 525 children are being rehabilitated under the Home-Based Nutrition Response Program across all the Districts in Acholi.

Dan Derricks Oling, Coordinator Social Workers at Love One International told tndNews, “We prevent malnutrition through water, sanitation and hygiene education in communities alongside nutrition awareness we conduct in community outreaches involving some healthcare facilities.

“The children reach us through different pathways for example Police, Community Development Officers, and Probation Officers.”

Several Village Health Team members have been trained to identify affected children as well.

Malnutrition in Uganda is primarily caused by inadequate dietary intake, a high disease burden, food insecurity, and limited access to healthcare and sanitation.

Even though food is always readily available in some families, their children still suffer from malnutrition due to other ailments like Sickle Cell Disease (SDC) as Delfina Akello, 56, a grandmother and resident of Kicuka village, Paicho sub-county, Gulu district experienced.

From April 2021 to December 2024, 571 children with severe acute malnutrition were rehabilitated at Love One International Centers, and 3,979 malnourished children were rehabilitated in their homes.

Love One International assisted 5,401 children with acute malnutrition, and 31,012 caregivers were trained in Health and Nutrition Education and Counselling, with a focus on improved feeding practices.

There are basically two forms of malnutrition, namely: chronic and acute malnutrition. When a child has chronic malnutrition, his age doesn’t tally with his height, a condition known as stunting.

For example, if a child is 5 years, he/she looks like a child of 2 years, and the stunting rate remains high.

While acute malnutrition has also been categorized into two: Severe Acute Malnutrition (SAM) which is characterized by life-threatening medical complication and the mortality rate is high and a Moderately Acute Malnourished patient which has no medical complication.

According to the Uganda Nutrition Action Plan II, Uganda spends USD$ 718M about 5.6% of the country’s GDP on combating malnutrition annually.

The plan acknowledges that the total losses in productivity attributed to childhood malnutrition were estimated at approximately shs1.9 trillion (US$899 million), which represented 5.7 per cent of the nation’s gross domestic product (GDP).

In terms of education, the report found that stunted children have a higher incidence of grade repetitions (7%) than other students.

The adoption of local food banks is expected to reverse and eradicate this negative trend in Acholi and allow children to achieve their full growth potential.

This story was produced with grant support from the Northern Uganda Media Club (NUMEC).