What does the treatment process look like?

Bwindi Community Hospital has a robust program for the treatment and prevention of malnutrition. Combining multifaceted community education, the assessment of nutritional status of children, and treatment of acute malnutrition, its goal is to prevent all forms of malnutrition. Hospital in-patient treatment, supported by Watsi, is reserved for the most acute cases. Every three months, the hospital’s Community Health Nursing Team (CHT) works with Village Health Teams (VHTs) to assess the nutritional status of all of the approximate 10,000 under-five children in its catchment area. Milder cases of malnutrition, which are the majority, are referred to district health centers for management. Early case-finding and treatment prevents progression to life-threatening, expensive, and complicated malnutrition. In addition, the CHT and VHTs conduct health education classes for the community. Subjects covered include family planning, sanitation and hygiene, maternal health, and prevention of illness. All of these issues are related to malnutrition. Once admitted to the hospital, a child is given a series of milk formulas. These formulas are calibrated to carefully increase nutrient and protein intake. After the formula phase, the child transitions to “Ready to Use Therapeutic Food” (RUTF). At Bwindi Community Hospital, the RUTF is a peanut butter-based food called plumpyNut™. It is nutrient-rich and packed with a high concentration of protein and energy. Supplements, such as Vitamin A and folic acid, are given. Antibiotics are given, if needed, to treat concurrent infections. After transitioning to the RUTF, the child is given an appetite test. If he or she eats well, the child is discharged and returns home with a supply of plumpyNut™ to supplement local foods. While the child is in the hospital, his or her caregiver receives health and nutritional education, including cooking classes, to help prevent recurrence of malnutrition. Food from a demonstration nutritional garden is used in the cooking classes and provided free to patients. When discharged, the child is referred to a local health facility and community nurse for follow-up. The child continues receiving treatment and supplemental food until his or her goal weight is reached.

What is the impact of this treatment on the patient’s life?

If the correct treatment is started promptly, a patient’s life can be saved. Any long-term impacts, such as stunting or cognitive development issues, can be mitigated or prevented. The child’s development is put back on track.

What potential side effects or risks come with this treatment?

There are no side effects or risks with this treatment.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Care for malnutrition without severe complications is available in district health centers, which is where most children are treated. When complications arise, adequate treatment is only available in hospitals. Patients are usually referred to the hospital by a community health team. They generally travel from 20 to 50 kilometers away and arrive by either walking or traveling on a hired motorcycle.

What are the alternatives to this treatment?

There are no alternative medications to treat acute, complicated malnutrition. Alternative hospitals are more than two-hour drive away.