Thanva recovers from malnutrition in Laos

It’s a hot morning towards the end of the dry season in Nan District, Laos, when Bouanang brings her son Thanva to Thongkang Health Centre for a check-up. Small trucks called tok-toks drive past, with people or farm produce in the back. The sound of cockerels crowing is interspersed with the noise of chainsaws and there is a faint tang of smoke in the air. Further down the road, a farmer is burning a field in preparation for planting casava, ahead of the expected rainy season. There should be an impressive view across the valley to the hills opposite, but the mountains are wreathed in smog due to slash-and-burn agriculture, and the far ridge is a faintly sketched outline against an unnaturally grey sky.

Carrying her two-year-old son on her back in a sling, Bouanang walks down the hillside to the small, green clinic building. She takes a seat in the waiting area, where Thanva plays happily with a yellow plastic fan. When their turn comes, health worker Ounhearn Phanthachack weighs and measures Thanva. Another child who arrived at the same time cries and holds out her arms to her mother while this is done, but Thanva submits to the process without complaint. The results are good: after two months of treatment, he is almost fully recovered.

“Thanva got sick while my husband and I were away working in Thailand,” Bouanang, 30, explains. “He was living with his grandparents. We came back because we were worried about his health. When we got home, he was crying all the time. He wouldn’t eat anything and couldn’t breathe properly. He was too young to explain what was hurting him. So we borrowed money to take him to the district hospital.”

Like many people in Nan District, Bouanang is a casava and rice farmer. Her family owns a field, which used to provide enough to make ends meet. But recent years have seen increasingly severe droughts and floods due to climate change, and crop yields are down. “In a good year, we can earn up to 20 million kip (US $934),” Bounanang continues. “But last year our casava died because there was no rain and we earned only a quarter of that. That’s why we left to work in Thailand. We sent money home to Thanva’s grandparents, but it wasn’t enough.”

At the hospital, Bouanang discovered that her son had severe acute malnutrition. If left untreated, this can be fatal. Malnutrition weakens children’s immune systems, leaving them vulnerable to diseases like malaria and pneumonia. “The doctor said Thanva was not eating enough food,” Bouanang adds. “But we are a poor family and have a lot of debts. I do everything I can but it’s hard to feed three children.”

Getting back on track

Thanva is now in a nutrition programme, run by UNICEF Laos with support from the Government of China. This provides ready-to-use therapeutic food (RUTF) to treat children with malnutrition; community outreach to find malnourished children in nearby villages; nutrition education for parents; and training for health workers. Thanks to the UNICEF programme, Thanva now has regular check-ups at his local health centre and a supply of therapeutic food until his weight returns to normal. All of this is free of charge.

“We’re managing three cases of malnutrition in the nearby villages at the moment,” Head of Thongkang Health Centre Chanseng Kosisaboun comments. “Sometimes parents bring their children to the health centre, other times we go out and find them in the community. The support from UNICEF has really helped us with equipment, supplies like RUTF and training for health staff and volunteers. I’m really happy to have the support from UNICEF. It is helping us reduce child deaths from malnutrition.”

UNICEF relies on the support of donors to reach all children at risk of malnutrition. In Nan District, the programme is funded by the Government of China, through the Ministry of Commerce. Recently, the China International Development Cooperation Agency (CIDCA) donated a further $1.5 million to improve the health, nutrition and protection of over 220,000 children in Laos.

"On behalf of UNICEF, I would like to thank the Government of China for supporting our nutrition programme in Laos. This has helped us reach more women and children, including here in Nan District, saving many children’s lives," Khamseng Philavong, nutrition specialist at UNICEF Laos, says.

“Even though Laos has made significant progress in the reduction of malnutrition, the prevalence of acute malnutrition here is still high compared with other countries,” Ms Wang Haipei, Third Secretary at the Chinese Embassy in Lao PDR comments. “I’m very glad that our project, funded by China, has come into reality and is making a difference in Laos. UNICEF plays a key role in addressing the needs of children and it has very rich experience. I’m more than confident that through our joint efforts, we can truly help the children in Laos.”

Hope for the future

It’s late afternoon back at Bouanang’s village and the heat is starting to ease off. She sits with Thanva in the doorway of the family’s small wood-and-bamboo hut, which is raised on stilts to provide room for chickens underneath. Bouanang mixes some of the RUTF she was given at the clinic with clean water and feeds it to Thanva with a small plastic spoon. He is clearly enjoying the high-energy, peanut-based paste and quickly finishes the whole bowl.

Now that Thanva is recovering, Bouanang is feeling more positive about the future. She hopes that the coming rainy season will turn the family’s fortunes around and that Thanva will eventually be able to join his siblings – two older girls – at school.

“I don’t have the words to say how happy I am to get my son back and see him getting well again,” she says. “He can eat, he can sleep. In the night-time, he doesn’t cry anymore. When I see him smile, that makes me smile too. When he cries, I also cry with him. I’m so grateful to the doctors at the health centre – they have looked after my son very well.”

Asked about her hopes for her son’s future, Bouanang takes a moment to gather her thoughts. “I want Thanva to study, to be a good person, and to have a better life than his parents,” she decides. “When he grows up, I would like him to be a doctor, so that he can look after other children the way these doctors have taken care of him.”