Nutrition challenges in Mwembezhi

Lutheran Mission Rural Health Centre stands as a beacon of hope for communities that face limited access to healthcare and resources. For many families, it is the first and sometimes only line of defense against malnutrition and its far-reaching consequences. At the heart of these efforts lies the Nutrition Department, a dedicated team working tirelessly to ensure that no child or mother is left behind in the fight against hunger and poor nutrition.

Mwembezhi Lutheran’s catchment area is predominantly rural, with most households relying on subsistence farming for both food and income. Seasonal food shortages, poor diets, and widespread poverty often make it difficult for families to provide consistent balanced meals. Limited awareness about proper nutrition further contributes to high rates of undernutrition, stunting, and micronutrient deficiencies among children under 5. Nutrition is not just a health issue; it’s a barrier to education and overall community development. Recognizing these challenges, Mwembezhi Lutheran Mission Rural Health Centre has a nutrition segment to help in early detection and treatment of malnourished children. We do clinical care, education, and community engagement to create lasting change.

Nutrition services at Mwembezhi
1. Growth monitoring and promotion (GMP)
We provide regular weighing and height checks for children who are under 5. Growth monitoring helps us detect early signs of malnutrition and intervene before problems escalate. Caregivers receive personalized counseling on age-appropriate feeding, hygiene practices, and how to make the most of locally available foods. Early childhood development (ECD) services are integrated into GMP, allowing us to assess developmental milestones and ensure that children are not only well fed but also mentally stimulated through play, laying the groundwork for a healthier future.

2. Management of acute malnutrition
Children presenting with moderate or severe acute malnutrition are given life-saving care. This includes Ready-to-Use Therapeutic Foods (RUTF), High Energy Protein Supplements (HEPS), and close follow-ups to monitor recovery. Children with medical complications are referred for inpatient treatment to ensure that no case falls through the cracks.

3. Maternal and child education and counseling
Expectant and breastfeeding mothers receive essential information on maintaining a balanced diet during pregnancy and lactation. Health talks emphasize exclusive breastfeeding for the first six months, timely introduction of complementary foods, and continued breastfeeding up to two years and beyond. Mothers are also encouraged to incorporate nutrient-rich locally available foods into their family meals.

4. Community outreach and awareness campaigns
Beyond the clinic walls, the staff and community health volunteers work hand-in-hand with villages. They conduct home visits, follow up with at-risk families, and lead cooking demonstrations that teach caregivers how to prepare balanced meals using locally available foods. These outreach activities not only extend the reach but also foster trust and awareness in the community.

5. Integration with other health services
We work together with Maternal and Child Health, HIV care, diabetes and hypertension clinics, and immunization programs. Late last year, one notable success story was of a diabetic patient who was on the verge of giving up life due to his condition. Through consistent counseling, dietary monitoring, and regular blood sugar checks, his glucose levels were brought under control solely through proper nutrition. Remarkably, he has maintained normal blood sugar levels for more than eight months without the need for medication. This integrated approach demonstrates that nutrition is not treated in isolation but as part of a broader continuum of care, addressing both the immediate and underlying causes of poor health.

The human impact
Beyond every statistic lies a story. Mothers who once feared losing their children to malnutrition now return to the center with healthy, thriving toddlers. Caregivers often share testimonials about how simple lessons on meal preparation and hygiene have transformed their family’s health. In October of last year, 1,700 children under 5 were screened for malnutrition, and 12.6 percent (214) were found to be moderately malnourished and 1.8 percent (31) were severely malnourished. This represented an overall malnutrition rate of 14.4 percent. Following close follow-ups and interventions, moderate cases reduced from 214 to 17 (92.1 percent reduction), severe cases from 31 to 6 (80.6 percent reduction), and the overall caseload from 245 to 23, marking a 90.6 percent overall improvement.

All the achievements in nutrition programs are a result of your support, help from CAMM, and the efforts of our dedicated staff.

Looking ahead
Despite successes, challenges remain. Persistent poverty, cultural feeding practices, and seasonal hunger continue to put families at risk. We will continue to encourage parents to bring their children for growth monitoring and promotion, ensuring that no child misses essential health services.

Written by Jackson Kalewka, clinical officer in charge

Last month, my husband Gary and I visited Malawi and Zambia over 11 days, meeting with our leaders and staff and visiting clinics. This was my third trip to Africa in the three years since Gary and I returned to the United States. Gary had also been to Kenya to start preparations for our 2026 medical camp, and then joined me in Malawi. We stayed in the apartment adjoining the house in Lilongwe and were able to see just how our Clinic Administrator, Lusungu Mwambeye, is capably handling the challenges of running the Lutheran Mobile Clinic. One example is how she arranged for surveys to be done of all four of the clinic properties to obtain government leases and prevent people from encroaching on the properties. We were there for the monthly staff meeting, and saw everyone diligently working together on monthly inventory and statistics, so that Violet Chikwatu, Nurse in in Charge, could complete the government reports for May. Violet and Lusungu continue to work well together and keep things running smoothly.

Going out to the village clinics is always my favorite part of these visits. It was obvious that the many outpatients seen in a day reflected the recent higher numbers in our monthly reports. I noticed that some patients had been seen at local government clinics and prescribed medicine that they were told to obtain at our clinics, because those clinics didn’t have any. I observed the nurses at the pharmacy station calmly giving numerous injections and intravenous medications for children and adults who were seriously sick with pneumonia, asthma, and infections. There were several referrals to the hospital in Lilongwe. I saw in Violet’s record where in one day, eight patients were referred, mainly with severe pneumonia which is common in the cold season. These people depend on the preventative care and lifesaving treatment which the Lutheran Mobile Clinic provides. We are thankful that the Central Africa Medical Mission (CAMM) is able to afford the essential medications, and that Violet works hard to find them in pharmacies around Lilongwe. Most importantly, we know that our patients also hear the soul-saving message of the gospel.

Moms waiting for the under-fives clinic

I was still impressed with how—despite seeing 150-200 patients along with the under-fives, antenatal, family planning, nutrition and HIV testing/counseling clients—the clinicians and nurses worked cheerfully and efficiently as a team. The same volunteers which helped us through COVID were still doing blood pressure checks, malaria tests, weights, and directing patients to the proper lines. Violet stepped in to help in whatever station she was needed. The nurse-midwives were happy to receive a new fetal doppler we had brought, to more easily hear the infant heartbeat of our antenatal clients.

One of the highlights at Msambo clinic was being able to see all five of the children with disabilities who still receive regular physical therapy, and their mothers. All are continuing to make progress in mobility or speech. One little girl named Lontira who was born with a very deformed spine and has had difficulty sitting, is waiting for surgery. Her mom told me she will go to a hospital in Blantyre when the specialists come to Malawi to do these complicated procedures. She is a member of the Lutheran church in Msambo. We pray for her brave mom, and for Lontira to have a successful surgery, which will improve her mobility.

After a busy week, we flew to Zambia. We spent time with Alisad Banda, Clinic Administrator, who drove us out to Mwembezhi for a day at the Lutheran Rural Health Center. The staff warmly welcomed us as they prepared for under-fives and diabetic clinic (pictured above). We spoke with Future Beloyi, our nurse who recently completed midwifery training. She was also happy to receive a new fetal doppler for use with antenatals. We also spoke with Muzundwase Chikwekwe, a nurse who would soon start her midwifery training for the next 18 months. The clinic will benefit from having two Lutheran nurse-midwives, with about 150 deliveries at clinic in the past year.

We met with Jackson Kalekwa, clinical officer in charge, and Anthony Kasonga, laboratory technician, to discuss topics like the need for more space for maternity patients and a separate laboratory area for TB patients. Anthony is the chairman at Martin Luther Church, adjacent to the clinic. We learned that he has been instrumental in growing church attendance to about 100 people each Sunday, including many clinic staff members, despite there being no permanent pastor. Alisad also holds Bible studies for staff on a regular basis. Crispin Chikonka, the clinic’s psychosocial counselor, gives a devotion for clinic attendees each morning. The clinic now has a second clinical officer, Samalani Nyirenda, who works as a clinician alongside Jackson. We were glad to meet him in person and know that he was a welcome addition to the team.

That’s the update from the field! Gary and I joined three other CAMM committee members in attending the Lutheran Women’s Missionary Society (LWMS) Convention in Tulsa, Okalhoma, the last weekend of June. It was a joy to meet fellow CAMM supporters and speak with those who might be new to the medical mission. They have good questions and ideas for how to communicate about the mission and support our staff and patients. Thank you all so much for continuing to show your love for the work of CAMM and being faithful in prayer!

Written by Beth Evans, former nurse in charge for CAMM

Last December the clinic lost one of our members of staff, a nurse/midwife by the name of Mayase Banda. Mrs. Banda had worked at the clinic for 13 years. On Sundays, she would attend Martin Luther Church, which is on the grounds of the clinic. Pastor Titus Mbele conducted her funeral service. Is there anything one can talk about that happens without God being involved? I am not sure of anything, but one thing is that God exists everywhere and, at the end of the day, there is nothing that happens for no reason. She was one of the senior nurses, and we appreciate her work and time spent at the clinic.

Working as a member of the administrative staff at the Lutheran Mission Rural Health Centre, I am grateful for God’s grace. The facility has seen people come to the health center from as far as 15 kilometers to seek medical services, and we have heard people say, “We came this far because the medicines in this facility are prayed for and we trust that we shall find the help.” Others still say because of the name of God they trust they will be healed.

Appreciating God is acknowledging that while we were lost in sin, God did everything according to his plan to save us from the powers of Satan and power of death and indeed purchased us with his blood. Jesus Christ suffered death for the whole world to be saved. It’s a gift worth appreciating. Maybe a question would be this: How do we show appreciation for what God has done in our lives? How do we as individuals, parents, children, families show this appreciation? When you are alone and look around at how far God has brought you, do you pause for a moment and appreciate him?

Appreciating God comes in many ways. I would rather raise a generation that will have fear for the Lord at all times. There are times when I see children who do not always live as God and their parents have taught them to live.

Finally, it would be a great thing if children would be encouraged to maintain the legacy of a Christian family, so that even when the parents are gone the faith will remain. As people, we discuss how well-mannered the children are, but sometimes I find it difficult to help families realize that they could do more to help their children to be faithful, truthful, honest.

I ask that you continue to pray for families and children and encourage them to grow strong in their faith.

Written by Alisad Banda, clinic administrator in Zambia

HYPERTENSION AT LUTHERAN MISSION RURAL HEALTH CENTER (MWEMBEZHI)
The hypertension program started when the clinic saw the need. Patients were traveling to hospitals in Lusaka (the capital of Zambia) for drugs refills. This is about 50 miles from the Mwembezhi area. Due to lack of funds, most of the patients were unable to travel to Lusaka. In 2004, we had seven patients who suffered strokes in our catchment area; of those, three of them died the same month because of hypertension. Seeing the need, we began the program for those who were not able to go to Lusaka for treatment and medications.

The program began with only ten patients. The number has kept on increasing so much that now we have 561 hypertensive patients. To make sure we attend to patients in line with the Ministry of Health policy, members of staff sat and started a special blood pressure clinic one Saturday per month. Since Saturday is not a working day, it helped members of staff to decongest patients on treatment days. On Blood Pressure day, all members of staff report for work at 8:00 a.m. Blood pressure check-ups are done. We have essential hypertension (the diastolic blood pressure between 90 to 99mmHg) and crisis hypertension (the diastolic blood pressure above 100mmHg). All patients with essential hypertension are given their monthly drugs refill. Patients with crisis hypertension are admitted for observations. They can only be discharged when their blood pressure stabilizes. If it fails to stabilize, we refer to the hospital for investigations and further management.

However, hypertension has no signs and is not painful. As a result, it is very difficult to convince patients to take drugs for life. Some older people still believe in witchcraft. In 2019, we lost one Village Headman who came to clinic because of an abscess. He was also found to have hypertension. He was given drugs for the abscess and hypertension, but when the abscess healed, he refused to take the hypertension drugs. He said he cannot continue taking drugs. After four months, he was brought to the clinic with a stroke. We referred him to the hospital, but the hospital could not help. After his death and burial, Mr. Kalekwa called for a meeting with the Village headmen to explain his death. Headmen who believed in witchcraft saw the need for taking hypertensive drugs. The senior headman told other headmen to stop believing in old beliefs. He said they should always work hand in hand with health personnel to avoid disease complications. All the headmen promised to educate their citizens.

Drugs for hypertension are purchased by our clinic administrator, Mr. Banda, through the help we get from CAMM. The clinic staff work hard to provide good quality health services to all hypertensive patients. We start every morning with devotion and a prayer, followed by health education. All hypertensive patients are happy with and appreciate the services we provide.

May the almighty God bless you all in helping the poor in Zambia.

Written by Jackson Kalekwa, clinical officer in charge

HYPERTENSION AT LUTHERAN MISSION RURAL HEALTH CENTER (MWEMBEZHI)
The hypertension program started when the clinic saw the need. Patients were traveling to hospitals in Lusaka (the capital of Zambia) for drugs refills. This is about 50 miles from the Mwembezhi area. Due to lack of funds, most of the patients were unable to travel to Lusaka. In 2004, we had seven patients who suffered strokes in our catchment area; of those, three of them died the same month because of hypertension. Seeing the need, we began the program for those who were not able to go to Lusaka for treatment and medications.

The program began with only ten patients. The number has kept on increasing so much that now we have 561 hypertensive patients. To make sure we attend to patients in line with the Ministry of Health policy, members of staff sat and started a special blood pressure clinic one Saturday per month. Since Saturday is not a working day, it helped members of staff to decongest patients on treatment days. On Blood Pressure day, all members of staff report for work at 8:00 a.m. Blood pressure check-ups are done. We have essential hypertension (the diastolic blood pressure between 90 to 99mmHg) and crisis hypertension (the diastolic blood pressure above 100mmHg). All patients with essential hypertension are given their monthly drugs refill. Patients with crisis hypertension are admitted for observations. They can only be discharged when their blood pressure stabilizes. If it fails to stabilize, we refer to the hospital for investigations and further management.

However, hypertension has no signs and is not painful. As a result, it is very difficult to convince patients to take drugs for life. Some older people still believe in witchcraft. In 2019, we lost one Village Headman who came to clinic because of an abscess. He was also found to have hypertension. He was given drugs for the abscess and hypertension, but when the abscess healed, he refused to take the hypertension drugs. He said he cannot continue taking drugs. After four months, he was brought to the clinic with a stroke. We referred him to the hospital, but the hospital could not help. After his death and burial, Mr. Kalekwa called for a meeting with the Village headmen to explain his death. Headmen who believed in witchcraft saw the need for taking hypertensive drugs. The senior headman told other headmen to stop believing in old beliefs. He said they should always work hand in hand with health personnel to avoid disease complications. All the headmen promised to educate their citizens.

Drugs for hypertension are purchased by our clinic administrator, Mr. Banda, through the help we get from CAMM. The clinic staff work hard to provide good quality health services to all hypertensive patients. We start every morning with devotion and a prayer, followed by health education. All hypertensive patients are happy with and appreciate the services we provide.

May the almighty God bless you all in helping the poor in Zambia.

Written by Jackson Kalekwa, clinical officer in charge