Tag Archives: health

Nutrition and gardening

Improve nutritional status by promoting gardening

Although attention is focused on the country’s political and security transitions, malnutrition is a major concern in Afghanistan. Because the lack of adequate nutrition has crucial long-term effects on individuals and on the social and economic development, nutritional status deserves attention and appropriate action.

A national survey, conducted jointly by the Ministry of Public Health, UNICEF and the Aga Khan University [1], provides an overview of the nutritional status of women, children, adolescents and the elderly. In particular, it shows that the country has one of the highest stunting rates in the world, with 41% of children under five affected. Stunting is a sign of chronic undernutrition during the most critical periods of growth. Stunted growth prevents children from reaching their potential; affected children are more likely to develop diseases and have less success in school.

Chronic nutritional deficiency in Afghanistan is largely the result of poor nutrition. Inadequate dietary diversity and insufficient amounts of food, combined with poor hygiene, represent health risks and are a cause of mortality in older children. When mothers have an inadequate diet, a vicious cycle is created; malnourished infants grow up to become stunted mothers, generation after generation.

Nai Qala’s projects as a gateway to other nutrition-related actions

Poor feeding practices are common in Afghanistan and are not only a result of poverty, but also the result of the families’ limited knowledge or the way social norms influence decisions. Staff at the Nawur clinic are trained to help women acquire the knowledge and information they need to adopt healthy eating habits.

Early childhood education classes are also a means of transmitting health-related prevention messages, such as teaching children to wash their hands before eating together.

Several types of actions can be taken to address some of the causes of malnutrition. The community infrastructures built by Nai Qala represent a tremendous platform for communicating positive health prevention messages.

Carrot plantations in the surroundings of the Nawur clinic

The benefits of vitamin A no longer need to be proven; it prevents blindness and strengthens the immune system, especially in children. Carrots, apricots, spinach, or eggs are foods that are a source of vitamin A and are part of a healthy and diversified diet for children in many parts of the world. Unfortunately, even the least varied diets are still out of reach for more than two thirds of infants and young children in low-income countries and remote parts of central Afghanistan are no exception.

To increase children’s chances of survival, improve their development and prevent stunting, nutritional interventions must be implemented during the mother’s pregnancy and the early years of the child’s life. In Afghanistan, it is estimated that more than 80% of children receive vitamin A supplements in their first two years of life [2], and young children around the Nawur clinic benefit from national supplementation campaigns. Young mothers and the population benefiting from the clinic also receive gardening advice and vegetable seeds. This has led to a multiplication of carrot plants in the allotment gardens of the region, an important source of vitamin A for young and old.

School Gardening Competition

The Zeera Gag school, built a few years ago by the Nai Qala Association, is now one of the few green spaces in the region and is a source of inspiration for an entire population. Each class participates in a gardening competition. Children grow vegetables and fruit trees, ensure that they are well irrigated and take care of the land allocated to them. The children are happy that their school has such a green and clean environment, and are also very proud to see the result of their hard work. It is incredible to see how the culture and interest in food has changed. Children encourage their parents to grow vegetables at home too.

“Five of my children go to Zeera Gag school. Since they started school, my life has changed: they come home clean, rarely get sick, and are very motivated to plant vegetables and trees at home. Now we have a lot of vegetables in our garden, our diet has changed and we are used to eating more varied foods, I see my children happy, it makes us happy… ” says Zahra, mother of 7 children.

Gardening as a solution to malnutrition?

The results of a UKAid-funded study [3] show that ownership of irrigated land and garden plots is positively associated with household food diversity.

The FAO and WHO recommendations emphasize the benefits of food diversification in combating many nutrition-related diseases. Food diversity is used to assess food quality and food security. The vegetable garden is a practical addition to improve the nutritional content of the food and, ultimately, to improve the health of local populations. The presence of community infrastructure or the small actions of Nai Qala that encourage community gardening are a concrete contribution to improving the health status of local populations.

[1] National Nutrition Survey Afghanistan (2013): https://reliefweb.int/sites/reliefweb.int/files/resources/Report%20NNS%20Afghanistan%202013%20%28July%2026-14%29.pdf

[2] https://data.unicef.org/topic/nutrition/vitamin-a-deficiency/

[3] Kawsary, R., Zanello, G. and Shankar, B. (2018) The Role of Irrigation in Enabling Dietary Diversity in Afghanistan, LANSA Working Papers Vol 2018 No 26, IDS: Brighton

Children with carrots afghanistan

Nawur health center as a confirmed base for vaccination

Nawur health center is used as a platform for vaccination campaigns in the region

Afghanistan is one of the last three countries in the world where poliomyelitis is still endemic [1]. 14 polio cases were reported in 2017, and by the end of April 2018 there were 7 new cases reported in the country [2]. Polio mainly affects children under 5 years of age and one in 200 infections leads to irreversible paralysis.

Polio is one of only a limited number of diseases that can be eradicated and it can be eradicated because it affects only humans, because a cheap, safe and easy oral vaccine exists and immunity lasts a lifetime.

In March, the Afghanistan polio eradication initiative conducted its first national immunization campaign for eradication of the disease in 2018. In just a week, around 70,000 workers knocked on doors and stopped families in health centers, city streets and border crossings to vaccinate almost ten million children [3]. Monitoring data reflected more than 94% coverage in each vaccination campaign during 2017. The number of children missed due to inaccessibility went down since 2017 but an estimated 138 000 children were still missing in the national vaccination campaign of March 2018.

Without a clinic, a region like Nawur would have remained unknown to the health authorities; at its opening, the ministry of public health informed organizations such as UNICEF which registered the clinic as a vaccination center. The ministry and its partners have long been trying to reach isolated areas with vaccination campaigns and the health clinic gives them a base for this in the region. Before the establishment of Sar Assya clinic in the district of Nawur in 2011 [4], various illnesses remained untreated, the mortality rate among mothers and children was high, and children did not receive the requisite vaccinations. The Nawur clinic’s services have brought about significant improvements in the health situation of the population.

Since it registration in the national health care system, the Nawur clinic’s staff vaccinated thousands of children not only for polio, but other infectious diseases such as tuberculosis, diphtheria, tetanus, pertussis, etc. In 2017, 1,022 children and several hundreds of women were vaccinated in Nawur. During the March 2018 vaccination campaign, 142 young children received the polio vaccine.

Through its implementation in a remote region of central Afghanistan Nawur health center contributes to the reduction of mortality and serves as a base for vaccination and other prevention campaigns.

[1] http://moph.gov.af/en/page/polio-eradication/polio-situation-updates

[2] Note: No cases have been reported since 2016 in the central region of Afghanistan where Nai Qala operates.

[3] http://www.emro.who.int/afg/photo-essays/ten-million-children-70000-workers-five-days.html; http://www.emro.who.int/afg/programmes/polio-eradication-initiative.html

2011 – Sar Assya

A clinic focusing on women

In the Nawur clinic project, mothers and babies are the primary focus of Nai Qala.

Men with a health concern can travel to town to get treatment in a hospital, but the situation for women is more challenging. A woman who is ill must be accompanied to hospital by at least one other female family member and by a male family member. If the woman has children, she must leave them behind if she goes for treatment. Some health problems require a longer stay in hospital and some need medical follow-up over months. Furthermore, families are often reluctant to pay the costs of prolonged hospitalization. Consequently, women simply do not travel to clinics or hospitals that are far away. This is one reason for high female and child mortality rates and it is also why the Nai Qala Association built the Nawur clinic.

Inaugurated in November 2011, the clinic now has 11 staff providing health services for a population of 20,000 in the surrounding region. Since its opening, there have been more than 60,000 consultations, of which over 11,000 concerned children. Some 750 babies had been born in the clinic as of December 2017.

Nai Qala Association is proud to have been in direct contact with the Ministry of Public Health since the beginning of the project. Our original partnership with the ministry was from 2012 to 2016 and we were offered an extension to 2020. The administration of the Nawur clinic was transferred to the ministry in June 2015. In many official meetings the example of the Nawur health centre has been cited to show that it is possible to provide health services to one of the most isolated regions of Afghanistan.

Women in Nawur typically have large families. It is unusual to see a couple with fewer than five children. Most families have more, and it is not outside the norm to have 12 children. Observers may question why parents have such large families, especially given the economic limitations. However, where the survival rate of children is low, it is understandable that parents have more to increase the chance that some will survive. Limitations in care both during pregnancy and in the postpartum period leave mothers and babies at risk.

Reducing or eliminating these risks will reduce parents’ anxiety about their children’s survival and will foster a subsequent reduction in supernumerary pregnancies. The clinic is vital to reducing these pervasive risks.

As of the end of December 2017, 3156 women and 1022 children had been vaccinated in the clinic. Some 13,000 outpatient visits took place for a range of conditions that, without the clinic, would have gone untreated until they became far more serious, and the records show 125 cases of severe malnutrition receiving medical care. Some 175 Nawur patients were referred to other health facilities for more specialized treatment.

The local people have realized the clinic’s value – more women and babies are surviving – and they are determined not to give it up.

News from the clinic

The Nai Qala Association built the clinic at Nawur in 2011 and supported and ran it until 2015 when it was officially handed over to the state. Today the clinic is supported by the Organization for Research and Community Development (ORCD) in partnership with the Ministry of Public Health.

We visited the clinic in 2016 and were impressed to see how well the it is functioning; it has become part of Nawur’s identity and life. It is well-maintained and has become a normal part of the community’s life.

According to a report by the ORCD and the Ministry, the clinic with its 7 staff (2 women and 5 men) continues to provide a good service for the Nawur community. In 2016 alone, a total of 8’377 women, men and children were treated in this center. Over 100 babies were born in the clinic and vaccination is continuing for women and children.

ECD simple hygiene measures

Early Childhood Education program includes basic hygiene measures

During the early childhood education class, children learn how to wash their hands before going to class or before eating. Children are effective communicators and agents of change: they learn the habits of good hygiene at school and pass them on home and in the community. For children, this direct involvement in the promotion of hygiene inculcates a sense of personal capacity building.

According to Unicef, every day about 4,000 children under five die of diarrheal diseases worldwide. Washing hands with soap and water is one of the most effective and cheapest ways to prevent these deaths. Washing hands reduces the number of deaths associated with diarrhea by more than 40% and acute respiratory illness by around 25%.

Promoting good hygiene and health habits early in life can lead to lifelong hygiene behaviors.

Health

 

We improve the health conditions of thousands of people by providing access to health services and increasing hygiene and health awareness.

  • We provide access to health services:
  • We increase health awareness and improve hygiene practices:
    • by training thousands of schoolchildren who attend the schools we built or participate in our early childhood education programs on basic hygiene measures;
    • by promoting gardening initiatives to enhance the nutritional  status of the entire family.