Malnutrition Claims the Life of Another Baby in Sierra Leone


In Dec. 2006 – Jan. 2007, I was able to be part of a short-term mission team to Sierra Leone, West Africa. While there we spent time at our ministry site in the rural chiefdom of Banta Mokelleh (an eight-hour drive up-country from the capital city of Freetown). Banta Mokelleh is the poorest chiefdom in all of Sierra Leone (which is the poorest country in the world). In Banta, we truly minister to the poorest of the poor. Sierra Leone also holds the #1 ranking in the world for infant mortality (babies that die before reaching age 5) and also the #1 ranking of maternal mortality (mothers that die during labor, due to the young age of mothers and a lack of prenatal care). Malnutrition is a huge problem in Sierra Leone, due in part to a lack of food, but also a lack of education as to proper nutrition requirements.

Our ministry site in Banta currently includes staff/short-term team housing, a school, a farm, and a malnourishment clinic. Construction continues on our children’s homes (to which we’ll relocate the children currently in our care in our Freetown Children’s Home) and an additional school, which will be completed in Summer 2007.

Our Banta ministry site also serves as the base for our Village Assistance program to the nearby village of Nguala, a predominantly Muslim African village about a ten-minute walk into the jungle. Our Village Assistance program provides a coming-alongside kind of assistance to the children and the community by providing schools, medical services, a feeding program, etc. Many of Nguala’s children (325+) are enrolled in our program; however, roughly two-thirds of these children are still in need of individual sponsorship.

My experience in Banta was life-changing. I’d like to share a couple of excerpts from my journal…

Tuesday, January 2, 2007 – Upon our team’s arrival, we were introduced to Nurse Jennifer, a COTN staff member that provides medical care to our children in the Village Assistance program, the village of Nguala, and other nearby villages. Nurse Jennifer is African, in her 40s. She’s educated and trained as a nurse and speaks very good English. She started our clinic here in Banta two years ago, and is just now beginning to be trusted by the locals. Word has spread and people walk for hours, in some cases, to be treated by her. All day long, patients (usually mothers with sick babies) fill the “waiting room” (an open-air, thatched-roof, lean-to structure) while they wait their turn. Jennifer works until she’s seen them all. Many walk home to their villages in the dark.

Along with treating patients, Jennifer seeks to combat malnutrition by educating mothers as to proper nutrition, the importance of exclusive breastfeeding, and also trains them in the preparation of nutritious baby food/formulas (using local, readily-accessed ingredients).

Nurse Jennifer’s medical clinic consists of an “admitting area” (her desk, a round table, and a chair for the patient or mother) and the “infirmary” (two twin beds behind a single curtain). The night we arrived, a 7-month-old baby boy was staying overnight in the clinic. He only weighed about 10 lbs.—severely malnourished. Nurse Jennifer said his teen mother brought him, gasping and vomiting. She said he was not responding well to medical treatment. Cindy (another team member) and I went in briefly. The baby looked so sick—so tiny and so sick. Nurse Jennifer had him under a blanket and said she’d be watching him throughout the night.

Wednesday, January 3, 2007 – I saw Nurse Jennifer and heard that the baby we had seen last night in the malnourished clinic had died about 3 a.m. It was very sad. So tiny. Nurse Jennifer said his mother waited too long to bring him in.

Thursday, January 4, 2007 – Cindy came by and told me there was another baby in the malnourished clinic that probably wasn’t going to make it. I went over to see Nurse Jennifer and the baby. Nurse Jennifer said she had just sent the mother out to get something to eat in the “waiting room.” The mother hadn’t eaten, she was so upset. Pastor Sorie was in with the baby and I went in and joined him. The baby was 15 months old but so tiny (maybe 12 lbs.?). His head was large for his body, but shrunken-looking due to the malnutrition. Plus he had several teeth, which was odd-looking since he was only about the size of a newborn. Nurse Jennifer had him wrapped up and propped on his side. His eyes were about at quarter-mast and his breathing was slow and labored—kind of a gasp every five seconds or so. Nurse Jennifer said he suffered from much—malnutrition, a respiratory infection, dehydration, etc.

The baby’s mother came in as we were standing there. She was only seventeen and already pregnant again. Nurse Jennifer told me she was the last wife (youngest) of her “father-husband.” (A “father-husband” is old enough to be a girl’s father; a “grandfather-husband” is old enough to be her grandfather.) According to Nurse Jennifer, the first wife rules the roost and decides on the care of the children—which in this case is the same as the first wife did it thirty years ago when she had her own children. Nurse Jennifer said there is much antagonism and jealousy between the wives. They don’t help each other. And the “pecking order” often determines the distribution of resources (i.e. food), and when there is not enough to go around, many are left without.

I put my arm around the young mother’s shoulder and hugged her tight to my side. I kept it there as we were standing over the baby. One lone tear ran down her cheek. When I let go of her about five minutes later, tears were streaming down her face and dripping off her jaw line, but she didn’t make a peep or attempt to wipe them away. Nurse Jennifer sent her back outside to rest. I remained and sat in a chair by the baby boy. I didn’t understand why the mother was ushered out. I think it’s their custom to leave the dying unattended. Nurse Jennifer came back in and propped him upright, maybe he’d be able to breathe better? She said to me, “The mother waited too long. This baby is already halfway to God.” Then she left the room.

I sat there looking at this precious little baby thinking, “This is so preventable! How can they not feed their own children?” I unwrapped the blanket and pulled out his tiny hand. I wrapped his fingers around my finger. His hand and arms were so cold. Margaret, the nurse on our team came in and sat too. She told me that when the body is dying it shuts down circulation to all but the vital organs, which is why he was so cold. We sat there, the two of us, her rubbing his head and me stroking his hand and arm. We watched his beleaguered breathing. And then another didn’t come. It reminded me of losing my mom last year—how we just sat there staring, thinking, “Wait, another breath will come.” But it didn’t. He had died. There was so little life left in his tiny hand, I didn’t even notice a difference in his passing. I started to cry. Pastor Sorie and Nurse Jennifer came in. Pastor Sorie put his hand on the baby’s head and said a prayer and then put his hand on my shoulder to comfort me. “It is alright, Pam,” he said, very softly. I felt kind of silly that I was the only one who got emotional. I thought to myself, “How horribly sad it is that the death of a baby becomes so common that it barely creates a disturbance.”

I went back to my room and Sarah, one of our associate teachers, was working on decorations for the staff tea that we were to host later that night. I sat and helped her. It was the weirdest feeling to be switching gears so quickly—from spending time with a dying baby to something as seemingly trivial as preparing party favors. I tried not to think about it. Our team leader poked her head in and said they were heading to the village if we wanted to go. I welcomed the diversion.

Later that night…After a couple of hours in the village, we headed back to prepare for the tea. We passed many workers on the trail who were heading home from a long day of work at COTN (farm staff, the cooks, construction workers, etc.). As we crossed the road, we passed the young mother of the baby who had just died hours earlier. She was walking alone, heading back to the village with a basket of laundry on her head—not a moment to grieve before getting back to work. It made me sad. I’ve come to realize they hold onto life very loosely here in Africa. Malnutrition claims the lives of far too many babies—it has become such a common occurrence that it is nothing out of the ordinary. African parents grieve for a child as Americans might grieve the loss of a pet. They grieve and they move on quickly. I suppose they must. For me, that is hard to reconcile.

God is truly doing a wonderful work through Children of the Nations in Sierra Leone. COTN is making an incredible impact on the people and communities there. It is through the efforts of COTN staff and short-term teams, working in-country with the nationals, that this work is accomplished—and there is so much yet to do. Thanks to a recent partnership with UNICEF, funding is being provided to expand our malnourishment program in Banta Mokelleh. However, we still need funding to provide for the staff to carry out the work this funding will pay for. If you would like to join us in our effort to abolish malnutrition in countries like Sierra Leone, you can Sponsor A Child or Make A Donation to the Malnourishment Clinic.