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It Makes My Heart Sing

A Letter from Larry and Inge Sthreshley, serving in Congo

Spring 2021

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Dear friends,

I am not particularly good at remembering numbers compared to names, but I can remember numbers better when they are graphed out and tell a story – then they “stick.” And, when the numbers quantify and reveal information on something important to me, like children thriving nutritionally, it makes my heart sing. It just makes me smile.

This is the graph I have been looking at of the proxy prevalence rate for malnutrition in the Province of Nord Ubangi in northwest Congo. The proxy prevalence rate is the estimated number of children who are suffering from malnutrition. The information comes from the intensive systematic screening carried out by community health volunteers. Each quarter, the volunteers use mid-upper arm circumference measuring tapes, otherwise known as MUACS, to measure the arm circumference of every child between 6 months to 5 years of age in each village. Children who have a MUAC reading in the red or yellow range (less than 125 millimeters) are malnourished and are referred to the health center for further evaluation and follow-up. This past year the volunteers have done almost 1 million screenings.

We have been tracking screening results in Nord Ubangi province since 2015, when we first trained community health workers. What you see from the data is a decrease over time in the number of children who are malnourished. The proxy prevalence rate has gone from 14.1% down to 4.6% over the past six years.

The first decreases were the easiest to achieve. In the latter years, the rates have moved down more slowly and have been harder to obtain. The good news for me looking over last year’s results and “reading the chapters of this story” is that the trend is still going in the right direction! The story is getting good.

There are many people in this “proxy prevalence story” who should be highlighted. Much of the credit for these results goes to the 2,500 plus community health volunteers and the young mother’s support groups which they have organized. They have been sharing information in their villages and neighborhoods on best practices for infant and young child feeding and have been carrying out the screening. Other important people are Mr. Papy Lengemo, his team of community animators, Mr. Narcisse Kimbondo, IMA’s nutritionist on staff in Nord Ubangi, and the provincial staff of the national nutrition program (PRONANUT) in Nord Ubangi. They trained the community health volunteers in nutrition education, screening, home gardening, and how to carry out home visits to families with malnourished children.

IMA World Health has been partnering with the Evangelical Community of the Ubangi-Mongala (CEUM) to implement this small but impactful nutrition component of the ASSR project. (ASSR stands for Appui au Système de Santé en RDC and provides support to the health system in Congo through funding from the British government.) Papy Lengemo has been overseeing this work for CEUM and has done a great job managing the team. It has been a privilege to work with him over these past six years.

Papy’s team consists of six to twelve community animators who have been working in the eleven health zones of the Nord Ubangi province. Over these past six years, they have been in the health zones almost every month, reinforcing the capacity of the community health volunteers and meeting with community leaders to help them understand why it is important to prevent and treat malnutrition early on and to discuss with them how the community can reduce malnutrition.

I was really pleased a couple of years ago when I learned that the provincial health office in Nord Ubangi had placed a nutritionist in every health zone. Many were young and inexperienced, and the CEUM community animators have been helping them understand how to work with the community health volunteers to draw up micro screening plans, collect and analyze the nutrition data from the screenings and home visits. With the systematic screening results, they can zero in on which areas and villages have the highest malnutrition rates. The CEUM community animators and Narcisse are now helping the nutritionists develop action plans for those areas, and we are seeing improvements in those communities as those action plans are being implemented.

I also believe that part of the success we have seen in the last year has been due, in part, to getting MUACS into the hands of mothers and teaching them how to use the MUACS to screen their own children on a regular basis. The MUAC bands cost only nineteen cents. As they are color-coded, illiterate mothers can “read” the colors even if they cannot read the numbers.

We still have plenty of work to do in Nord Ubangi. Based on the population of Nord Ubangi, a proxy prevalence rate of 4.6% indicates an estimated 13,600 children still suffer from malnutrition. So, we will all continue writing the next chapter – living into this story, bringing the message that malnutrition is preventable, treatable, and beatable.

Thank you for your prayers and your financial support – for your part in this story! I hope it has made you smile to see these results. Larry and I ask for your continued financial and prayer support as we collectively work together to see that all of God’s children thrive as we strive to be a “Mathew 25 church.”


Inge Sthreshley

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