GOAL’s C-MAMI Project continues to save lives in Ethiopia

Earlier this year, GOAL secured vital funding to continue their work combating infant malnutrition in Ethiopia through the Community Management of At-Risk Mothers and Infants (C-MAMI) programme. GOAL was the first International NGO to trial the innovative new infant nutrition programme targeting infants from birth to aged 6 months. In addition to existing funding, a four-year research grant with partners has also been secured to support this ground-breaking work to tackle malnutrition amongst vulnerable infants.

The funding will enable GOAL to expand the C-MAMI programme which has been operating in two refugee camps in Gambella, South West Ethiopia since 2016. The programme aims to identify and support infants at risk of acute malnutrition within the first six months of life. Historically it has been assumed that all women would or could breastfeed, taking care of their children’s nutrition needs. However, globally it is estimated that only 36% of mothers exclusively breastfeed, where in low income countries, this can expose millions of vulnerable infants to malnutrition. The innovative approach conceived by the Emergency Nutrition Network and The London School of Hygiene and Tropical Medicine is making tremendous progress towards helping vulnerable mothers provide for their children. Case studies from Ethiopia have proven how effective the programme is and how vital this funding is.
Here are two stories on how the programme is saving lives:
Nyathok and baby Nyamouach – Gambella, Ethiopia

30-year-old Nyathok fled her home in South Sudan in 2014 when conflict erupted in her village, located in the Upper Nile Region. When Nyathok arrived at the Ethiopian border she had been walking for seven days with her three children and was transported to a refugee camp in Gambella. Nyathok gave birth to a fourth child, Nyamouach, earlier in 2019 in the camp, but has no male partner to support her or her children. A number of family members live in the camp nearby, including her sister, but the young woman is the head of her household and all of the household responsibilities fall on her.
Due to a number or physical and mental disabilities, she suffers an average of 5 seizures per day as well as having palsy in her left arm and leg. The young-woman’s ill health has caused her to fall into the open fire on a number of occasions and means she finds it difficult to support her three-month-old baby when breastfeeding.

Nyathok was brought to the GOAL MAMI support program by her sister following concerns over three-month-old Nyamouach. Communication was limited as Nyathok could only partly comprehend what was asked during the assessment but following the initial checks the staff confirmed the baby was as high risk. The mid-upper-arm circumference (MUAC) indicated low muscle mass – a sign of severe wasting and heightened risk of death. Nyathok was advised to attend the MAMI program daily to receive cooked food for herself, have a comfortable environment in which to care for Nyamouach and to be actively supported to care for her baby. She would be safe from the daily risks to which she is exposed to at home as a consequence of her epilepsy. Given her physical limitations, Nyathok finds it hard to carry Nyamouach and is unable to attend any services without the support of someone else. Nyathok’s 11-year-old daughter now assists her mother each day.Nyamouach and her 11-year-old sister attending the MAMI ProgrammeNyamouach is assessed by GOAL staff using the MUAC bandNyamouach is assessed by GOAL staff Nyathok is assissted by GOAL staff at the clinic
Mary and baby Kuthekur – Gambella, Ethiopia

Kuthekur Hoth was born in October 2018 to 28-year-old South Sudanese refugee Mary. At just 28 years of age, Mary has already given birth to six children, however she sadly lost four, all in their first year of life, due to various illnesses. Mary gave birth to her first child, a son now aged 14, when she herself was only fourteen. On top of providing for her children alone, Mary suffers from a number of illnesses as a consequence of HIV. Mary fled from the Upper Nile State, South Sudan when her home came under attack in 2014 with soldiers killing and raping women living there. She was so unwell when fleeing from the brutality, a family member had to carry her for eight hours to the Ethiopian border where she was then rushed to hospital for medical attention. Mary remained in hospital for 6 months with her then 9 year old son acting as her primary carer for the entirety of the time. When Mary fell pregnant with Kuthekur she was provided with anti-retroviral drugs to combat the HIV virus. Kuthekeur was born HIV negative but was considerably smaller than the average baby due to his mother’s poor physical condition throughout the pregnancy.

When Kuthekur first came to the C-MAMI programme he was identified as a high-risk infant and was referred to GOAL’s inpatient nutrition Stabilisation Centre (SC) for intensive nutritional support. The new-born’s condition was worse than first suspected and he was immediately transferred to Gambella hospital for more intensive treatment for two weeks. At one month old, Kuthekur weighed just 2.6kg – almost half the weight of the average baby his age. When he was deemed stable, aged 2 months, he was discharged from hospital into the care of the Nutrition Stabilisation Centre where his health continued to improve, and he fed well. After some time in the SC, Kuthekur transferred to the C-MAMI programme until he was 6 months old. Now he is older, Kuthekur has transitioned onto the next phase of nutritional support for older children, through an outpatient therapeutic program, but is now a bubbly, smiling little boy.Mary and Kutherkur attending the MAMI programme in GambellaA smiling Kuthekur The MAMI programme in Gambella