‘Hunger kills softly’

Hunger is a silent killer which drastically weakens the body’s defence and opens the way for big killers such as malaria, tuberculosis and Aids.

This untold story contradicts President Peter Mutharika’s promise that “no one will die of hunger in the country.”

Melia Chipoya from Matchado Village, Traditional Authority (T/A) Mlumbe in Zomba wants honest conversations about how hunger is slowly killing Malawians, especially malnourished children and people with HIV.

The 38-year-old and her seven children are hit hard by  the crisis which has left almost 1.9 million Malawians in need of food aid.

She often suffers the pain of facing her frail children empty-handed when she is also famished.

Sitanisitani (L) with her kinsfolk in Dedza

“When there is nothing to eat, I just doze off inside the house—waiting for a miracle—to avoid seeing my children suffering the pangs of hunger or running to me for help I cannot provide,” Chipoya says.

Last year, her last-born aged four—the worst hit so far—was treated for acute malnutrition at Namadzi Health Centre.

The boy came back better after receiving food supplements, including fortified peanut butter and nutritious  porridge, but could be destined for another term in the nutritional rehabilitation  programme.

The United Nations Children’s Fund (Unicef) reports that 23 percent of all deaths of children aged under five are related to under-nutrition. According to the 2015 Malawi Demographic and Health Survey, 37 percent of the survivors are stunted or too short for their age—a sign of chronic under-nutrition.

While adults are more resilient to hunger, Chipoya feels for all children aged below five.

“Most children do not understand hunger. They expect to eat three times a day. If not, they cry, lose weight  and  get sick,” she adds.

Also hit hard by hunger are patients, including people on HIV treatment  and tuberculosis drugs.

Nutritionist Dr Mary Shawa says the drugs work effectively when one takes meals comprising all the six food groups.

“When properly nourished, the body of an infected person takes time to start showing symptoms and it is not susceptible to opportunistic diseases,” she explains.

The former secretary for the Department of Nutrition, HIV and Aids in the Office of the President and Cabinet  explains: “When someone is infected with HIV, the virus attaches itself to a cell membrane made of the nutrients that a person eats every day.

“When the nutrients are not there, the virus eats the membrane until it is finished and then enters the nucleus where it takes full control and multiplies in millions, thereby making the body weak.”

Ireen Sitanisitani opened up on the impact of hunger on people living with HIV. Her husband died five years ago, leaving her to look after five children. A balanced diet is but a wish for the widow  from Nkoloko Village in Dedza, where about 40 300 people require food aid.

Despite being on drugs which require her to take nutritious meals, Sitanisitani mostly survives on porridge prepared from banana suckers.

“What we harvested last crop season ran out three month ago. Since we depend on piecework, which is scarce but little-paying, I often cannot afford decent meals. As I wake up every morning, I think about what to feed my children,” she narrates.

Shawa says there is nothing nutritious in banana suckers pounded to pulp

“A person who cannot afford a balanced diet requires nutrition supplements such as Likuni Phala and fortified maize flour. Those who cannot afford this can use beans known as kholophethe, which are rich in proteins,” she advises.

Shawa says taking HIV drugs on an empty stomach causes side-effects which forces some to quit treatment. She states that antiretroviral drugs [ARVs] deplete nutrients, making the situation trickier.

“One is supposed to have an adequate, nutritious diet for the drugs to work. Banana suckers or any other food that does not have the required nutrients does not help at all,” she explains.

She urges government to support HIV-positive people with highly nutritious food and supplements to beat the raging spate of hunger.

“Don’t forget there are over one million people who are HIV-positive in the country. We cannot kill them. We have to live with them and they require special attention.  They need nutrition support,” she says.

Shawa urges people with HIV not to stop treatment, which has reduced the annual count of Aids-related deaths from 64 000 to 13 000 since the start of free access to ARVs in 2005.

According to Principal Secretary for Health Dan Namarika, about 92 in every 100 HIV-positive people know their status, 84 percent of them are on treatment and 91 percent are taking the drugs so consistently that they viral load is neither detectable nor transmittable.

“The change is dramatic; it’s so tangible every household feels it. Once the BBC aired a documentary showing how coffin workshops in Mchesi Township [near Kamuzu Central Hospital]

in Lilongwe are no longer cashing in on Aids-related deaths, but furniture,” he says.

As food scarcity threatens the gains the country has made to ensure people with HIV live longer and enjoy healthy lives, Shawa has a word for those hit hard: “Whatever the case, do not stop taking treatment.

“If you stop, when the opportunistic infections come back and you go back on ARVs, they do not work. You will die faster when you should have lived longer. Just make sure you take the drugs with something in the stomach.”

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