Playing with his cousins, 2 year old Mehran seems to be just like any other toddler, comfortable with his surroundings at home. He gives a peal of laughter and lunges after a small puppy the children have been chasing around the muddy compound. Mehran’s family shares the house with his paternal grandparents, two uncles and their families.

The children quieten up as they see Shazia, a Lady Health Worker (LHW) enter the house. She is a familiar face here as she visits this family every other week to check on the health of women and children in the family. Mehran along with his two younger cousins Ayan (18 months) and Fizza (16 months), suffered from recurrent diarrhoea throughout the summer months due to unsafe drinking water and inadequate sanitation, along with poor hygiene practices. Families in this area associate such symptoms/illnesses in children with myths and superstitions, preferring to take children to the local cleric for prayer. Mehran was the worst affected among his cousins and was first brought to the Basic Health Unit (BHU) Mahabbat Abad, after Shazia came for a routine visit and noticed the decline in his health.

“The household was consuming unsafe drinking water which caused health and nutrition problems. When I conducted the Mid Upper Arm Circumference with MUAC text, Mehran was under nourished,” Shazia explains how she convinced the child’s parents to visit the health facility. “I asked the mother to accompany me to the BHU for management of diarrhoea and seek advice from the nutrition assistant.” Faryal, the Nutrition Assistant at BHU Mahabbat Abad conducted a thorough check-up and immediately initiated treatment as he was thin and underweight with chances of a stunted growth.

“When Mehran first came to me 3 months ago he was diagnosed with Severe Acute Malnutrition (SAM). He weighed only 6.8 kilograms, which is much less than the average weight for children his age. We initiated treatment by providing Ready to Use Therapeutic Food (RUTF), and other medicines as per standard procedure.” says Faryal. With proper treatment provided at the BHU, Mehran started to show signs of improvement. It contributed to his health and growth and his weight increased to 9.6 kilograms within few months. This convinced the parents of his other cousins to take their children to the BHU as well. These children were also under-nourished, a condition that offsets many health problems in the children due to lack of immunity against disease. “My sisters-in-law noticed how the treatment had aided my child’s growth, so they also took their children to the BHU,” says Asma, Mehran’s mother adding that staff at the BHU are very helpful. “Faryal would always listen to us sincerely and treat our children with utmost care.” Apart from treating the children against malnutrition, the BHU staff also provides counselling to mothers about the importance of having their children immunized against vaccine preventable diseases including Polio. “We were sceptical of having our children vaccinated, as people say they would render them impotent. That is not what parents wants for their children. However, when we saw that treatment at the BHU was making our kids healthier, we decided to have them immunized as well” says Asma.

BUILDING TRUST AND HEALTHIER COMMUNITIES:

Mahabbat Abad is among the 60 Union Councils which are benefitting from UNICEF’s Polio Plus initiative. The project is supported by the Canadian International Development Agency (CIDA) which has provided 20 million Canadian dollars and targets priority high risk polio endemic areas of Khyber Pakhtunkhwa province. It aims to support Pakistan Polio Eradication Initiative by focusing on vaccination through cross-sectoral interventions, including nutrition, maternal, neonatal and child health care; water, sanitation, hygiene, and strengthening routine immunization. Similar cases where nutrition related support has helped in building trust among parents for the health workers, can be observed throughout communities benefitting from the programme. Curbing malnutrition trends among children mean decreased vulnerability to polio due to morbidity and malnutrition. The number of missed children in the targeted areas has reduced and an increased acceptance of polio vaccination is evident among parents.

Ambreen Qazi, Nutrition officer at UNICEF says that the program is contributing positively to Polio eradication efforts through treatment of malnutrition, “Nutrition program in polio high risk districts of KP is not only saving the lives of malnourished children but is also facilitating the path for strengthening routine immunization.” In Mahabbat Abad, the situation has improved to a great extent with increased awareness of issues that directly impact children’s health and nutritional status. The community now has greater acceptance towards water, sanitation and hygiene services, immunization and nutrition which are critical underlying determinants of the continuing circulation of wild polio virus in Pakistan.