Asurut Eperit smiles wryly as we enter her hut where she is resting with one of her young children. She points to a mat and tells us to feel at home. Despite the heat outside, the mother of four tells us in broken Kiswahili that the last meal they had was the previous day.
When I enquire what that meal comprised, she flashes that same smile and says that she boiled plain maize which she shared with her famished children. Her smile leaves us in awe. Again, I ask how she still manages to be cheerful under such depressing circumstances. She says her malnourished son is much better now.
A severe drought and depleted water reserves have led to biting food insecurity in this small community in Ngameriyek, which has a population of about 2,000 people.
This state of affair is what Eperit blames for her two-year-old son’s deteriorating health. The child was diagnosed with acute malnutrition in January during a mass screening exercise supported by Save the Children.
The child was later admitted to the outpatient therapeutic programme with a Mid Upper Arm Circumference (MUAC) of 11.3 centimetres. Last week, for his follow-up visit, he had improved with his MUAC of 113.2 centimetres.
“The outreach has really been of great help. They have been giving us sachets of the Ready to Use Therapeutic Food (RUTF) every two weeks for almost three months now and that is what is steadily restoring my child’s health,” Eperit says.
She is certainly among the lucky ones.
Some households in Turkana North have been forced to spend their days desperately searching for water. Each day, the distance they have to cover in their quest to quench their thirst keeps increasing.
The daily treks in search of water on some days totals more than 10 kilometres. And when they do eventually strike gold, they still have to expend their remaining energy reserves on hauling the precious untreated water from deep under the belly of the scorched and barren earth.
Two kilometres from Eperit’s homestead, we find Ngichwae Akalale, who says through an interpreter that she doesn’t know her age. She is a second wife with three children and seven months pregnant with her fourth.
She recently stopped breastfeeding her 16-month-old baby. She is malnourished to the point you can barely tell she is pregnant. Our visit falls on the day that an outreach is being carried out for children and mothers.
We find her sheltering under an acacia tree, away from the blazing sun. They have just been attended to at the emergency integrated health outreach in Kaakim, Turkana County.
In her arms is her 16-month-old son who is sound asleep. The child’s head is slumped over, chin touching the chest, quite an unusual posture for a baby that should be enjoying the warmth and love of her mother’s breast.
For mothers of malnutritioned children, the situation often gets so bad that they have to share the food supplements meant to treat their malnourished children with those who are healthy.
Save the Children International Project Management Officer, Patrick Kalale, who is in a team that has been detecting and treating malnutrition, says that such desperate actions by mothers only aggravates the situation for their malnutritioned children.
“As you can see, we have given her corn soya blend which has added vitamins and minerals. She is supposed to take a cup every day for two weeks when she will come back for replenishment. We make it clear that while this is food, it is also treatment and usually it’s not advisable to share treatment. But these mothers usually ignore the advice, understandably so, because in such a situation, what do you do if you are the mother in that household?” Mr Kalale asks rhetorically.
Mr Kalale explains the relationship between malnutrition and other ailments.
“Malnutrition takes away the body’s capacity to fight off infections. This means if you are malnourished, you are more vulnerable to illnesses. If you are sick, you are more likely to become malnourished and it kills,” he says.
“If children with acute malnutrition are not identified and treated in good time, their condition may deteriorate to marasmus or kwashiorkor, whose management is more complex, and which puts children at increased risk of death.”
In Turkana, as is the case with many other northern Kenya counties, experts say, malnutrition is a social, cultural and economic issue.
“It is a culmination of so many factors that failed to happen in the first place. If you don’t solve the food security issue, poverty and literacy problem, then you are not dealing with the root cause of the problem,” he says.
As Turkana faces what experts say might be its worst drought in a decade, children are bearing the brunt. Parents are struggling to feed them, with nearly half of the children, pregnant mothers, and lactating mothers in the county likely to suffer from acute malnutrition.
This, even as aid workers say there has been an increase in admissions of severely malnourished people to stabilisation centres, with children younger than five years the most affected.
“We have seen higher cases of severely wasted children aged under the age of five,” says Joseph Bii, a nurse at Atapar outreach site.
On the day of our visit, the site had screened 21 children, five of whom were malnourished and one acutely malnutrition.
A similar scenario played out at Nakapelewoi, where from the 20 children who were screened, five of them and two lactating mothers were found to be malnourished.
As we speak, Mr Kalale draws our attention to a young woman who is resting her head on a stone as her young daughter sits next to her. He says that she is in her teens and six months pregnant with her second child. As you would expect, she is also malnourished.
“During the mass screening two weeks ago, she was very weak but her health has since improved significantly,” he says.
According to Mr Kalale, most women and children here usually wake up very early to do domestic chores before embarking on their daily search for water. As if finding water is already not hard enough, they still have to find wild fruits for the family dinner.
“It takes them close to four hours to walk to and from the nearest water point.”
Usually, water is drawn in turns as per an agreement reached between the local communities.
One mother tells us that she has eight children and that they often spent their nights on empty stomachs because they can’t find anything to eat.
“Even the wild fruits are becoming scarce as days go by. The drought has worsened everything,” she says.
Unlike other villages, Nakapelewoi has no markets or shops, making it hard for the villagers to buy foodstuff and non-food items. The nearest market is 27 kilometres away. The villagers have to walk the distance whenever they are in need of staple foods such as maize and beans.
But it’s not just scarcity of food and water that these communities are grappling with. Insecurity has been escalating in many of these regions. Drought and insecurity have forced the community members to prioritise their needs in a rather lopsided way. Most of them would rather look for food and water than seek medical attention.
According to Mr Kiko Gilberto, who is the Operation Lead for emergency health, East and Southern Africa, as of March 25, 2022, Save the Children had 887 children from Turkana North in the health outreach programme and 220 women.
“Two hundred and sixteen were new admission compared to 21 discharges, and this was only in the last two weeks. We are getting more and more admissions while very few are being discharged,” said Mr Koki.
He attributes the high malnutrition caseloads in Turkana North to the ongoing drought.
Being pastoralists, community members entirely rely on their livestock for survival. But even the livestock have not been spared by the drought. The number of animals dying for lack of pastures and water keeps rising by the day and as you would expect, the market value of the animals that have survived the drought has gone down considerably. To make matters worse, there’s no milk for the children, hence the spike in malnutrition cases, he says.
In Turkana County, Save the Children, in partnership with the Ministry of Health, is supporting emergency integrated health outreaches in Turkana Central and Turkana North Sub Counties, which have been severely affected by drought. The intervention in the two areas focuses on hard to reach areas where children do not have access to regular healthcare services.
Services offered in the outreach include nutrition screening and treatment, immunization, treatment of minor illnesses such as fever and diarrhoea, as well as health education promotion.
According to the drought early warning bulletin released by the National Drought Management Authority (NDMA) last week, for the last six months, dry and hot weather conditions dominated across all parts of the county during the period under review.
Drought conditions being experienced in Turkana County will continue, with vegetation and livestock conditions deteriorating.
The county is at an alarm stage with the pastoral areas being classified as being at an emergency stage with worsening trends.
Livestock migration was also observed towards the peripheries with livestock deaths attributed to starvation or dehydration being reported across most areas.
According the Turkana County Chief Officer for Economic Planning, Jeremiah Apalia, the drought has affected more than 640,000 people in the county.
A food and nutrition security assessment conducted in January by NDMA also found that more than 600,000 children are acutely malnourished.
The World Food Programme has reported that at least 2.4 million people in Kenya risk going hungry as the drought hits the north and east of the country, a nearly threefold increase from last year.