A year since the Nutrition Rehabilitation Centre (NRC) was set up as an initiative of the paediatric department of B J Medical College and Sassoon General hospital,a total of 112 severely acute malnourished (SAM) children have recovered. Such has been the impact of the simple but effective treatment that the public health department has been sending more than 300 officers and staff for training before strengthening the NRCs in the state.
Be it a simple feed by mixing coconut or groundnut oil and sugar with milk to be given every two hours to stabilise the SAM child or preparing special protein and calorie rich feeds,the NRC at Sassoon general hospital ensures that children recover within the scheduled 14-day stay.
Dr Aarti Kinikar,in charge of the NRC at Sassoon General hospital,said the centre was set up purely as a voluntary effort and is not part of the National Rural Health Missions plan to set up NRCs in the state. This is the only NRC set up at a government medical college in the state and 10-15 dedicated volunteers have been contributing generously, she said.
The paediatric OPD where doctors examine at least 100 children every day ,also tries to identify those who have severe acute malnutrition. At least 3-4 are identified as SAM children and at the NRC,we take special efforts to help the mothers prepare the WHO-recommended diet,Kinikar said.
WHO guidelines say the childs height in centimetres is compared to the weight and if the standard deviation is under 3 then he or she is categorised as malnourished. We also check if the childs mid-arm circumference is less than 11.5 cm or if the boy or girl fails the appetite test where the child is unable to digest a measured quantity of specially prepared feed, Kinikar said. These children cannot eat a lot. So feeds like F-75 (75 kilo calories of milk with oil/ghee and sugar added to it) is given for stabilisation. F-100 is another feed where the amount of water is reduced and a cereal-based milk paste is given. The special feed has roasted groundnut powder mixed with oil and sugar. For mothers who are unable to lactate,a special tube is attached to the breast so that the child gets the feed and continues to suckle, Kinikar said.
To ensure that malnourished children are given the feeds during the night,a medical intern is deputed to the NRC,Kinikar said. She however admitted that with paucity of funds from the state there was no follow-up on the children. We need a dedicated dietician,special nurse and social worker to strengthen the work,Kinikar said.
Rs 84 lakh for NRCs in 15 tribal districts
The public health department has allocated Rs 84 lakh for Nutrition Rehabilitation Centres at 15 tribal districts,Dr S G Kulkarni,Assistant Director of Health,State Family Welfare Bureau said.
Severely Acute Malnourished (SAM) children with medical complications will be admitted to primary health centres (PHCs),rural hospitals and sub district hospitals for 21 days and Rs 2.1 crore has been allocated for the child treatment centres,he said.