Combating Protein-Energy-Malnutrition in a Rural/ Peri-Urban Southern African Black Population

ROTEIN-ENERGY-malnutrition (PEM) is a major cause of morbidity and mortality in young children in Africa. In South Africa, in 1987, to help combating and preventing PEM in the rural black population, the Gold Fields Nutrition Unit was inaugu rated at the Medical University of Southern Africa. In 1987-9, 442 patients (rural/peri-urban) plus their mothers or child carers were admitted, and 406 attended as outpatients. Average age was 15.4 ± 7.6 months, weight 7.0 ± 1.6kg, stay in hospital, 12 ± 10.8 days, and daily weight gain during treatment was 31 ± 48g. Mothers mainly were young and unmarried. Primary causative factors were infections, ignorance, and insufficiency of food. Since results from rehabili tation are usually poor, mothers and carers were taught how best to prepare meals using local foodstuffs. The interventions included teaching and demonstrations of how to grow vegetables, maintain an orchard, a fowl-run, and improve kitchen and laundry facilities. In 1990, in a follow-up of 73 patients, no deaths had occurred within a 12 month period. This far better than usual outcome is being furthered by setting up satellite nutrition clinics.