Thursday 17 September 2020

What's the difference: Francis Hannaway’s Centre for Malnutrition, Mary’s Meals and Aid Organisations?

Some people say, “Francis, why don’t you contact Mary’s Meals? They’re probably in Congo by now and they do the same as you.”

Francis Hannaway at his Malnutrition Centre
in Basankusu, Congo

Six years ago, when I was about to set off for my old stomping ground of the Congo, one of my past students, Jean René Lingofe, told me about his life as a teenager at secondary school. He lived in a village 80 km from Basankusu, with his younger brothers, so they stayed with an uncle near the school, returning on foot to their village at the weekend. His uncle often had little to give them and so they often went hungry. Studying was difficult on an empty stomach.

The logo for Mary's Meals - they give


One of the staple foods in the Congo is called fufu. It’s basically, flour of some sort, usually cassava flour mixed with cornflour, boiled up like ground rice, or semolina, without the milk and sugar. It accompanies whatever else you have and is usually dipped into sauce, or gravy, for flavour.

“If you want to help the local population, Francis,” Jean René implored, “please, just set up a kitchen to give school kids some fufu every day. We suffered so much, trying to study and then having to walk home hungry each weekend.”

Fufu - a filling and starchy favourite
in the Congo


I seriously considered it. There would be a huge group of hungry teenagers. Then there would be the people who cooked the food – perhaps they would take some home. People who already sold doughnut balls, peanuts, fried sweet potato and so on would see their businesses go down. The people cooking it would take half of it to send to their families at home – I would be feeding half of Basankusu.

Mary’s Meals is a fantastic organisation. They aim to give children one substantial meal a day at their school. They train local people to cook the meals, and build, or adapt an existing building, to serve as a kitchen. Children learn better when they’ve been fed. Simple.

Are they in the Congo? No.

Will they be in the future? They tend to be in English speaking countries, Congo prefers French. Perhaps I should talk to them.

However – that’s not what my centre for malnutrition does. 

Up to 75 children are treated at
Francis Hannaway's Centre
at any one time


The children we help are severely malnourished, and many in danger of death. Indeed, since we began, around 100 children have come to us too late, or had serious underlying conditions, and died. There is a difference with the children benefiting from Mary’s Meals. Our children are not hungry schoolchildren needing to eat before studying. They are usually from families who don’t have the means to send their children even for free primary education. Other children with moderate malnutrition are already on the slippery slope to severe disability and possible death – our job is to prevent further decline and to educate their parents to vary their diet and to make feeding their children a priority. Malnutrition can be seen in several ways; it isn’t just about not having enough to eat. Children can eat until they are full and still be malnourished. Malnutrition happens when they eat energy-poor and protein-poor foods. The child doesn’t thrive without protein, vitamins, minerals and energy giving foods like fats and carbohydrates. 

Some children have suffered neglect in some form or another. Family breakup is common. A child is left in the care of others – others who actually don’t care. Sadly, some very small children are left at home, without a thing to eat, from early morning until the evening while their parents go to their forest garden, or go hunting. That’s neglect.

Little Mboyo was so thin,
we named him "Skeleton" 


However, the classic case of malnutrition, in our experience, is of a child who has lived a fairly poor existence and then become ill. Perhaps his mother has become pregnant again, or given birth to a second child. Whatever the situation, the child loses weight drastically and struggles to put it back on with the poor diet that is available. Often the supplement of breast milk is no longer available.

Illnesses can include, malaria, intestinal parasites (worms), low blood iron due to poor diet, childhood immunisable illnesses such as measles, mumps, rubella, TB and general infections. Measles for example begins with a fever, small sores appear in the mouth, the child feels lousy and to top it all gets chronic diarrhoea. All these things prevent the child from eating.

A child with severe acute malnutrition (SAM) will start to use the protein of his muscles for energy. Fluids will build up because of the imbalance of proteins and salts. The classic big belly, thin arms and legs image is created. Feet swell until they are so painful they look like they could burst. Damaged skin is stretched and starts to peel – it looks like the child’s been scalded. Even though this is not a burn, the effects are the same – blood fluid (plasma) is lost through the damaged skin and pressure sore develop easily because of tissue damage. Internal organs, such as kidneys, can be damaged. 

Little Mboyo - before and after


Treatment is a delicate process. It’s a combination of medical intervention and an easily absorbable diet, high in energy and high in protein. Education of the caregivers comes later – the first thing is to save the child’s life. That’s what we do.

“But, Francis,” you might ask, “isn’t that what Doctors Without Borders, the Red Cross, Cafod, Save the Children, Unicef and all the rest do?”

Yes, they do. The difference is that they respond to a specific crisis, spend several weeks and then move on to somewhere else. Our work is long-term. 

Doctors Without Borders recently came to Basankusu in response to the measles epidemic, which killed about 7,000 nationally. The materials that were left behind were never used after the aid organisation left. Instead, it was sold by local health professionals to the only organisation in Basankusu that treats malnourished children – and I know this, because it was my organisation that bought the special milk powder which had been denied to us earlier.

Children become irritable and often bad-tempered when they're severely malnourished. When the start to laugh and play, we know they're on the mend 


“But, Francis,” others might say, “surely you would make a change in society by holding training sessions for the general population. They would pass on the knowledge and malnutrition would come to an end.”

If only this were true.

My experience is that the people who would attend training sessions are the people who already know how to look after children’s wellbeing. It would be like preaching to the converted. I set up a community vegetable garden in a village upriver from Basankusu, with the help of the Catholic Mothers League. They did a great job planting beans to help poor families. Unfortunately, most of the money I sent for the project was spent on so called training – in which each attendee receives transport costs (it’s a village, they all walked), and their dinner. The danger is that people attend for the free meal and then don’t do anything with the training. It’s a national problem. The people who would benefit from any training don’t ever turn up.

Similarly, I’m often criticised for feeding the children with food that they wouldn’t normally eat. “They’ll go back to their villages and won’t be able to find these things,” they say. We use milk with sugar and vegetable oil in the initial stages of treatment. However, our porridge made from soya, peanuts and maize would be easy to make in the village. The traditional foods (actually introduced from Central America) are the things that made them malnourished in the first place. In the 28 years I’ve been associated with the Congo, I’ve seen changes in people’s diets. Bread is a much bigger part of the diet than it ever was, and beans are so easy to grow – and extremely nutritious!

Francis Hannaway's group is registered as the Association of Rural Women - Against Malnutrition


So, getting back to the original idea: Mary’s Meals is a fantastic organisation which helps children to stay in school.

Aid organisations do a great job in emergency situations.

Send a donation today to help Francis Hannaway with his work. 
Click/tap the link above


My malnutrition centre does an amazing job, using local volunteers and mostly local produce. We’ve successfully treated over 3,000 children. We save children’s lives and hope that later on they would benefit from a school feeding programme, like Mary’s Meals

In an ideal world, every neighbour would look over their fence and help the family next door. Because of general poverty, this rarely happens, especially if you’re not in the same family. 

Running a supplementary feeding programme is a very expensive enterprise – we can only do it with your help. Yes, your help. If we had more funds we would extend it further. Nobody takes a salary; we don’t even have a car. Send what you can today – save a child’s life. Thank you.


Wednesday 9 September 2020

Congo Kinshasa: Covid-19 restrictions end - allowing a return to Kinshasa

As the leaves turn to reds and gold, and the sun starts to pass lower in the sky over Europe and North America, I find myself in hot and humid Kinshasa, Congo’s capital of 11 million people.

Since I last wrote, a lot of things have happened in Basankusu, where I run a centre for malnutrition. Basankusu is a small town of about 24,000 people, and sits on the Equator, in the rainforest.

Severely malourished children arrived
almost every day 

The Doctors Without Borders (MSF) team did indeed leave, as expected – and children with malnutrition started to return to us. The effect of their work, and perhaps the slightly earlier arrival of edible caterpillars, did seem to reduce the number of children arriving this year. Perhaps – this being the 6th year of my project, it has been the long term effect of my own project on the population generally. Yes, perhaps it’s time to congratulate ourselves for our ongoing successes.

The children that did arrive – mostly from outlying villages – were in a very poor state. They arrived with grandparents, parents and younger brothers and sisters. We accommodated them at my house. We built a single roomed house for them and a thatched shelter next to it as a kitchen. Three died during the first night after their arrival. A month later, 2 more children died – a week apart. They’d all arrived too late to be helped. 

From the end of May until the end of May, we treated around 30 children at my house (Centre 2). At the main centre food was provided for between 20 and 40 children 3 days each week, by the volunteers. Overall, around 150 children have received treatment since I arrived back in February. Mama Solange arrived with her baby and toddler, herself suffering from severe malnutrition. Everyone at the main centre got better and was eventually able to go home.

We’d applied for special milk (F-75 and F-100) from the Doctors Without Borders group and been refused. After their departure, we found that the health services hadn’t distributed or used the milk, they were waiting for their chance to sell it to the only effective treatment facility for malnutrition for hundreds of miles – namely to my centre. We bought it for the same price we would pay for ordinary milk powder. It has extra vitamins and minerals, and so on, to help children with swollen bellies (oedema). They should have given it to us for free – but they took the opportunity to make a couple of hundred dollars and share it out amongst their colleagues.

F-75 milk

And so our work continued – with the help of the good people of Hull, York, Middlesbrough and the whole diocese.

Because of Covid-19, my return flight of 8 July was cancelled. I’d intended to fly back to Kinshasa at the end of May, but all internal and international flights were forbidden. The government announced that all visas would still be valid, until restrictions were lifted. The local immigration police had other ideas and insisted on hassling me, obliging me to pay them money for a useless document, 2 days after my visa had expired. 

The government lifted general restrictions 3 August – so we were all hopeful that I would get on a flight. Then we heard it was with the exception of churches, as well as domestic and international flights. Flights would start 15 August. The work at both of my centres would continue in the capable hands of our 12 volunteers, led by Judith’s younger sister, Laetitia.

The promise of a commercial flight fell through after I’d bought my ticket (I got a refund!), but eventually I got a seat on the little plane that brings the teachers’ wages each month for the diocesan Caritas association.

It was a circuitous route – dropping bales of cash at several rainforest locations. A flight which would normally take just over 2 hours, lasted 7 hours; nevertheless, I eventually arrived at Kinshasa’s tiny city centre aérogare, of N’dolo.

Francis onboard the small Caritas plane

A plate of chips was the first thing on my mind! In fact, potatoes of any description would be welcome after 7 months without them.

Finally a plate of chips! 

After that, I would have to consider renewing my visa. They’ve made it easy for foreigners to renew their visas for a further 3 months – at a price, of course. Then I should make arrangements for a long-term visa. Should I travel back to England? Lockdown doesn’t seem to be completely over yet – so perhaps I should take a breather in bustling Kinshasa and decide what to do later.

Francis Hannaway in Kinshasa



Sunday Mass at St Pius X Church, Kinshasa. This is the Gloria (Kembo!)

Basankusu: the vanishing cat!

 

So, last night I coaxed my cat, Panda, outside. Too much moving around at night, jumping on the table and knocking things over. A cat should be on the prowl at night, looking for mice - and not peeing where she shouldn't.  

It's not the first time she's been outside for the night - but the frequency of her nights outside has certainly reduced lately.

This morning, no Panda.

We didn't think much about it. She's normally my lunchtime alarm clock - but today she didn't arrive.

Panda - my black and white cat
Panda - my black and white cat


"Why did you put her outside?" asked Judith. "They kill cats at night - and eat them!"

We each went about our business as torrential rain fell.

A bit later, Judith said, "We'll get a new cat when we return from Kinshasa." We were both preoccupied with the situation.

I went through all the scenarios in my head - she's always here at midday, so, it doesn't bode well. Perhaps she's ill, perhaps she's found food elsewhere... she was just next to me yesterday, purring and wrapping her tail around my leg. What a shame if she's dead.

At the house, which is our 2nd centre, we're getting a new fence. Stout posts with thin sticks horizontally packed together will give us more privacy. We've also moved the gate across to the other side. The old fence had verical sticks and the dogs and cat knew where they could get in and out. Perhaps she'd got out through an unfinished bit and, when she'd returned, got confused by the new fence - and so wandered off to meet a stranger's machete. 

At around 3:30 pm, through the clattering noise of the rain on the roof, we heard the noise of cheering - 

"Francis, come quick! Francis come quick! Panda is here!"

They'd found her outside, near the next house. 

She was a bit bedraggled from the rain - but glad to be home. I gave her a small piece of fish, left over from lunch. She seemed suspicious of it and hesitated before taking a nibble. She didn't seem particulary hungry - so perhaps there's more to the story.

In the meantime, we're very glad to have Panda back.