Marotholi Outreach

We believe that through education and community screening, we can prevent childhood malnutrition in South Africa. Given our limited resources and that we currently do not have a consistent donor/partner, we have been able to see remarkable improvement in some of the children we have been following up and rehabilitating. With more resources and partnerships, we aim to become a fully mobile service which will allow us to access even more at-risk children from vulnerable communities. With the financial support and exposure, we will be able to procure ready-to-use-therapeutic-foods (RTUTF) to rehabilitate all of our at-risk children, as recommended by the WHO for the management of acute malnutrition. We will also be able to get a vehicle which will enable us to reach more vulnerable communities, and serve as a storage facility as we currently have none. We will also be able to procure more scales and measuring equipment which will allow us to screen more children at a time. We may be able to employ a small team to run some operations full time as we are currently running the organisation while having professional careers. This funding and exposure will really help our organisation grow 

I am a paediatrician working in the public sector in South Africa. I am currently completing a fellowship in paediatric gastroenterology, which I hope to use to advance my knowledge and research in nutritional disorders affecting children. I founded Marotholi Outreach with my dear friend-turned-colleague Dr Keketso Mopeli-Tshehla, who is also a paediatrician in the public sector. Together we hope access as many nutritionally at-risk children in vulnerable communities and help rehabilitate them timeously. Our dream is to be mobile, which will allow us to access the most vulnerable communities and find children throughout the country. We believe we can end childhood malnutrition through early screening and rehabilitation, as well as disseminating important information about infant feeding, and dispelling common myths and misconceptions. 

Our vision for the organisation is to reach as many children in as many vulnerable communities. This way, we can identify as many children with growth faltering and/or danger signs for malnutrition to rehabilitate these children and prevent them from developing malnutrition. We believe we can reduce the number of children suffering from this terrible illness, which will improve all children's long term outcomes (nutritional, cognitive, health).

We are an organisation aimed at addressing the high rates of childhood malnutrition in South Africa. The current malnutrition data show that of children under 5, 5.9% are underweight-for-age, 2.5% are wasted, and 27% are stunted. On analysis of our data over the first 3 years of operations in the Motsoaledi informal settlement, we found a 22% prevalence of malnutrition and 24.7% of stunting, which is a cause for concern. 

Childhood malnutrition is driven by poverty, gender inequality, poor education, food insecurity, and poor access to good healthcare. We aim to empower caregivers (who are typically women) through education on appropriate infant feeding and on understanding the growth targets of their children. We provide food parcels and RTUTF where available to try address food insecurity in the at-risk children. 

We have designed a nutritional screening program where we weigh and measure children, and identify children with growth faltering and/or signs of malnutrition. These children's caregivers receive one-on-one nutritional counselling and growth monitoring to help them receive catch-up growth. These children are followed up 6 weekly at our nutritional screening outreaches. The aim is to identify these children early and initiate early nutritional rehabilitation to prevent the development of malnutrition. 

We have been going to children in their communities to screen them for malnutrition. Typically, the national department of health recommends all children presenting to health care facilities get weighed and measured to screen for severe acute malnutrition. Children identified as such are referred to hospitals for nutritional rehabilitation and medical therapy. At the Marotholi Outreach, we aim to prevent these children from developing malnutrition altogether. We aim to identify these children within their communities (so typically before they present to a clinic/health care facility), and we aim to identify early signs of growth faltering before these children develop malnutrition. Through this program, we aim to help rehabilitate these children early and help them achieve catch-up growth early and prior to the development of malnutrition. Considering that all our children come from poverty, we come to them in their communities to make nutritional support and rehabilitation accessible to them.

To date, we have screened over 200 children in the Motsoaledi informal settlement in Soweto, and we have seen remarkable improvement and catch-up growth in children we have been following up over the past coupe of years. The cognitive effects of malnutrition are mostly irreversible, and the first 1000 days of a child's life are crucial from a nutrition point of view, and we have been very aggressive in rehabilitating children under 2 years old to help achieve catch-up growth and prevent stunting (which is irreversible after 2 years of age). Our organisation follows up all at-risk children closely and they are assessed by paediatric doctors and dieticians. 

We have also empowered the caregivers of the children in our service through nutritional education and by dismantling common myths within the community. This education and empowerment will have longterm positive effects within the community and will render our work more sustainable. 

We are currently working towards being mobile as we have had an influx of requests to assist other vulnerable communities. This will enable us to help all children catch up their growth