Rapid recoveries are becoming common at a new Nutritional Rehabilitation Unit in Malawi.


By Robbie Flick, Health Programs Coordinator, Malawi

Two-year-old Rachel Namazongo has just started to grow her first strands of hair. Giggling, she eagerly munches on a piece of bread with an appetite that didn’t exist just a few weeks ago.

Blessings Banda, the HIV and Nutrition Manager for PIH’s sister organization in Malawi, APZU, recalled Rachel’s condition when she first came to a children’s clinic in the village of Ligowe in the rural southwestern corner of the country. Listless and with sunken eyes, the toddler was dehydrated and severely malnourished. The circumference of her upper arm, a standard method of assessing the nutritional status of children, was less than 9 centimeters — about the circumference of a plastic bottle cap. At this acute stage of malnutrition, she was so sick that she did not want to eat, said Banda. Her mother was frightened.

Clinicians from APZU and the Malawian Ministry of Health saw that Rachel needed immediate medical care, and quickly transported her to Neno District Hospital for admission into the new Nutritional Rehabilitation Unit (NRU).

A complex battery of health issues most likely contributed to the young girl’s malnutrition. She was treated for parasites and given antibiotics to help fight other possible infections. She was also diagnosed with HIV, and quickly began a course of life-saving antiretroviral therapy (ART). The medication soon helped spark a renewed appetite, said Banda. And the NRU staff was well-equipped to provide her with food specially formulated to combat her condition.


Rachel one week after being discharged from the Nutritional Rehabilitation Unit, with Blessings Banda, HIV and Nutrition Manager for APZU.

Every day, she ate packets of a special calorie-rich therapeutic food. Thanks to partnerships with UNICEF and Two Degrees Food, APZU has access to a peanut-based therapeutic formula for treating malnourished patients. The special calorie-rich product quickly helped put weight onto her small frame. After just two weeks of the intensive therapy, which also included drinking a daily concoction of nutrients, Rachel was well enough to return home. As an enrolled patient in APZU’s outpatient nutrition program, she is provided with food packets from our partners and other food supplies to help prevent malnutrition from returning, reported Banda. She will also continue to receive ART for the rest of her life.

Rachel is one of more than 30 children who are enjoying healthy childhoods thanks to the lifesaving care provided by the NRU since it opened in May. The space — with its walls of colorful, hand-painted cartoon animals and hanging dioramas of repurposed plastic — allows clinicians at PIH to provide a full spectrum of care for acutely malnourished children, from treatment of underlying infections like HIV and malaria, to a balanced food regimen that allows rapid recovery. Because of the NRU, a child like Rachel can quickly recover from a critical state, and begin living a healthy childhood in just two weeks.