As vehicles start moving past a green traffic light, Rose returns to her seat near the bus stop and starts breastfeeding her lovely son.
“The boy is now ‘eating’ his nutritious food…have you taken yours?’ I joked.
She smiles at me and (defensively) says: “At noon, I ate rice with beans to get energy so that I can continue selling these fruits here.”
Rose, in her early thirties, is among thousands of mothers in the country who are feeding their babies on unbalanced diets due to economic hardships and lack of knowledge on how to prepare nutritious food.
Nutrition contributes a lot in healthy child growth as well in learning, experts say.
Mbeya is among regions in the country with high levels of malnutrition despite being one of the top food producers in the country and home to varieties of fruits, birds and animals.
At least 37.7 per cent of children in Mbeya have been affected by chronic malnutrition, according to the Demographic and Health Survey and Malaria indicator survey conducted in 2015-16.
The situation has also contributed to the region’s poor education performance.
National Examination Council of Tanzania (NECTA) data shows that none of the region’s districts attained at least a 60 per cent pass rate in last year’s Primary School Leaving Examination (PSLE) – notwithstanding the national target of 80 percent.
Reproductive Health Services and Child Care Coordinator for Mbeya region, Prisca Butuyuyu, says that women such as Rose are too busy working in farms and vending food and other products until late hours.
With such busy schedules, she says, they forget to feed their babies properly from an early age. The consequence is seen in rising cases of malnutrition and stunting of children.
“Despite the availability of enough food in this era of climate change, most families in Mbeya don’t have the habit of mixing various food nutrients in their meals. Because of this, when most mothers deliver, they fail to breastfeed their babies properly for six months without mixing with other foods,” Butuyuyu says.
Pregnant women are supposed to start attending clinics within three months of conceiving, accompanied by their partners. Rungwe district nutrition officer Halima Kameta says this is not happening in the district.
“Most of them start to attend clinics in the last three months of their pregnancies, and if there is something wrong with their unborn babies, it becomes difficult to correct it,” Kameta notes. “This is the reason why malnutrition and stunting of children are here to stay,” she adds.
Role of fathers
Husbands who fail to help their wives to attain their nutritional goals have contributed to the challenge.
Kameta says many would-be fathers lag behind in supporting their partners to lift the burden of caring for unborn babies, and also tend to run away from the responsibilities of taking care of a mother and newborn child. This results in many kids growing up without proper nutrition, she asserts.
Selina Mwakyambiki, who vends milk and chapatis at the Tukuyu bus stop in Rungwe district, says when she arrived home with a newly born baby girl 11 years ago from Tukuyu hospital, her husband (whom she declined to name) disappeared leaving her with the burden of caring for the child alone.
According to her, she used the money she had saved from her small business at Tukuyu bus stand. After three months, she returned to her business.
Kameta says Mwakyambiki is just a case in point, and they are many other mothers in a similar predicament.
“When an expectant mother is not eating a balanced diet and not attending clinics, she can fail to breastfeed her baby once born, and this can retard the growth of body and brain,” she points out.
Julius Lwiga, a Tukuyu resident, says many couples in the area have failed to draw a line between their social and economic affairs, and the victims are usually their children.
For example, Lwiga says, a father and mother may both leave home early in the morning to rush off to their income generating activities, with less consideration of what their kids will eat.
Malnutrition and HIV/AIDS
Apart from lifestyle and lack of nutrition awareness, there is a link between malnutrition and places that have recorded high prevalence of HIV/AIDS.
The 2015-16 Tanzania HIV/AIDS and Malaria Indicator Survey (THMIS) published at HuruMap shows that Njombe is the most affected region with 14.8 percent of its population living with HIV/AIDS while the stunting rate stands at 41.4 per cent.
In Iringa region where 9.1 per cent of the population lives with the HIV/AIDS virus, chronic malnutrition has hit 41.6 per cent of the children, followed by Mbeya where 9 percent of the population is affected by HIV/AIDS and 37.7 per cent of under-five children are affected by chronic malnutrition.
Ruvuma is another Southern Highland region where the pandemic disease has affected 7 percent of its population while the stunting is at a critical stage with 44.4 percent of children affected by chronic malnutrition.
Neema Lazaro, a social worker with an international health NGO focusing on eliminating chronic malnutrition in Iringa and Njombe regions, says there is a link between HIV/AIDS victims in the two regions and stunting.
“In Makete district for instance, some children who have lost their parents to HIV/AIDS end up living with their grandparents who are poor. So it is difficult for them to get a balanced diet. Food cooked at night can be three times,” Lazaro says.
She adds that sometimes the children themselves are living with the HIV/AIDS virus, and need balanced diets to survive. “If they miss this kind of care, which many grandparents can’t afford, they are at risk of being affected by chronic malnutrition.”
According to Mbeya regional nutrition officer Lewis Mahembe, if a mother becomes the only family bread winner following the demise of her spouse, her time to take care of the children becomes minimal because she has to concentrate more on business or income generating activities.
“You can see the link in the southern highland regions. The zone is highly affected by both HIV/AIDS and malnutrition,” says Mahembe, who was also one of the coordinators of the 2014 nutrition status survey in the southern highlands regions.
Creating awareness
Mbeya region in collaboration with non-governmental organizations are fighting to eliminate malnutrition. With a 60 million/- support from UNICEF, regional authorities are insisting on clinic attendance by expectant mothers and proper baby development monitoring after delivery.
The region’s chief medical officer, Dr Seif Mhina, names other stakeholders in the campaign to eliminate chronic malnutrition as Africare, Catholic Relief Services (CRS), and Mwanzo Bora.
Efforts to eliminate the problem begun in 2012 after it was established that many children in the country have been affected by chronic malnutrition, whereas in Mbeya alone the problem was above 50 percent.
Nationwide, the government has embarked on a campaign to educate people how to prepare nutritious meals according to their income levels.
Tanzania Food and Nutrition Centre (TFNC) acting director Dr Joyceline Kaganda says the institution is seeking to move people away from the notion that “nutrition is all about ugali and wali”, and instead embark on balanced diets that involve varieties of foods of nutritional value, especially proteins.
According to Kaganda, the government’s five-year plan is to reduce stunting from 34.4 percent to 28 per cent. “If we reach a time when society can demand nutrition as their right, that is when we can say we have managed to reduce chronic malnutrition in the country,” she states.
