Step 1: Active case-finding

Visual aid outlining the program - used for orientation of program staff.

So the first step in the idealized CMAM (community management of acute malnutrition) program is active case finding. We did this with 5.5 (I am the half, because I took pictures half the time) people, covering 4 villages, going door-to-door, in 3 days and MUAC (mid-upper-arm circumference)-screening 613 children under 5 years of age. Of the 613 children we saw, we referred 93 with "dangerous" MUACs to the Masiaka Clinic for screening (weight an length).


Active case-finding: Andrew, James, Isata, Isatu, Amadu, 0.5 (taking the picture)

80 of the 93 we asked to come on Monday, June 22 and 13 of the 93 we asked to come on Tuesday, June 23.

Yesterday, June 22, we screened 85 children, 60 of which were from active case-finding referrals, 25 who came having heard of the program from word-of-mouth (word gets around really, really quickly). We enrolled 35 children (!!) and referred 2 children to the Makeni Therapeutic Feeding Center for inpatient treatment due to the severity of their cases.

Children who were enrolled took home RUTF (ready-to-use therapeutic food, which in our case is locally-produced Plumpy'nut - more about that in another post!) and those who came for screening but were not enrolled, we gave a bar of soap so that their walk to the clinic was not in vain.

Though we've asked only 13 children to come today, the nurses Andrew and James were telling me yesterday that we will probably see as many children today as yesterday because word has gotten out about our program... we'll see - and I'll tell you more about it later!