1,000 DAYS OF HUNGER

Child malnutrition is a silent tragedy jeopardising the future of more than one million children across Ghana.


Many Ghanaian children under the age of five suffer the irreversible effects of malnutrition in their critical first 1,000 days of life. This is the time in children's lives that determines their health as adults, their ability to learn in school and to perform at a future job.

Over a quarter of children under the age of five in Ghana suffer chronic malnutrition. These children will never reach their full potential in physical or intellectual milestones. This is not a new pattern. Nearly 40 percent of Ghanaian adults grappled with stunted growth as children.

Government statistics about child malnutrition and stunting, data by UNICEF, WHO, the World Food Programme, and the Global Nutrition Report, have compelled little action to improve the situation. This crisis remains an abstract issue of statistical figures to which most of the world turns a blind eye.


But malnutrition is a burden for society as a whole and the effects of childhood malnutrition ripple through the social layers of the affected country.

Journalist Roger Thurow has discussed how child malnutrition in the first 1,000 days of life is driving up healthcare costs and creating chaos in the healthcare system, hindering workforce productivity, and straining education institutions.

A recent report calculated that in 2012 the Ghanaian economy lost over two billion dollars as a result of the impact of malnutrition on Ghanaian children. This loss amounted to 6.4 percent of the country's GDP.


Child malnutrition in Ghana also disempowers women and destroys the social fabric of communities. Child malnutrition is perceived as a stigma in small communities - mothers hide their malnourished children from the community; there is a sense of embarrassment. Mothers are also alone in caring for children, which disempowers them economically and socially.

As a result, there are high levels of social conflict among women in these communities - "Your child is fed and goes to school, but mine is malnourished and we cannot afford school," the mothers debate. The social fabric of these small communities break down, and there is a lack of organised women's support networks to help each other.


School meal programmes help lessen the burden for the few who can afford to go to school. [UBELONG/Adam Walker]


"The thunder killed my baby."

Credit: UBELONG/Nick Parisse

Kate Afful, 40 is at home with her mother telling the story of how one of her daughters died at age two. Another one of her six children died at birth. She worked as a fishmonger for her husband until his death about 10 years ago. Ever since, she struggles to find work and take care of her remaining four children. Her children are malnourished and often get sick. They only eat ‘banku’, a fermented corn and cassava dough. ‘God took my two-year-old daughter,’ Afful says. ‘She was not feeling well so I put her to bed. Later that evening, there was a bad storm. The sky was loud and angry. I heard an explosion in the clouds. When I went to check on my baby, she was dead. I believe the thunder killed my baby.’


"A lot of children die in this village."

Credit: UBELONG/Rosanne Furniss

Ama is in her 20s. She lives with her two children and her husband in the fishing village of Nyanyano. Her husband is a fisherman, and she works selling fried food on the street. Her two children are both malnourished, and her oldest child has suffered from an eye infection for two years without medical treatment. ‘A lot of children die in this village,’ Ama says. ‘People talk about my children being sick and malnourished, but I don't care what they say. There is nothing I can do because I can't afford to take my children to the hospital or to give them the food supplements the nurses recommend.’


"My kitchen is empty."

Credit: UBELONG/Adam Walker

Hannah Abekah, 23 sits at her home, surrounded by the yellow buckets of rainwater she collected the night before. Hannah never attended school and started working at a very early age as a fishmonger. She is married to a fisherman, and they have two young children who suffer from malnutrition. Her husband is often away for weeks. ‘My kitchen is empty. I have no food,’ Abekah says. ‘My children don't even eat the little food I give them. I don't know about malnutrition. I just pray my children become great people.’


The world of malnutrition is a world for mothers - they struggle alone for their children. Most fathers are not involved in childcare. [UBELONG/Raul Roman]


"Women don't support each other here."

Credit: UBELONG/Raul Roman

Rebecca is 17, and her two children are malnourished and fall ill frequently. Her children receive over-the-counter medical remedies from the local store instead of professional healthcare at the hospital. Like many women in the village, Rebecca doesn't receive much support from the father of her children. ‘He doesn't take care of us as he should,’ says Rebecca. ‘He says he doesn't have money, but I know he is not honest.’ Rebecca feels she has nowhere to turn. ‘Women don't support each other here, it's not something we do.’


"Whatever you do for food, is on you."

Credit: UBELONG/Nick Parisse

Nana Agya Kwao, 76, the Chief of the farming community of Bentum, has been the chief of Bentum for 35 years. He has spent most of these years battling claims over lands that have been assigned to him by tradition in his role as a local leader. He is proud of his palace and throne. Two years ago, he sold most of the farming land in the Bentum area to a developer. As a result, the majority of local villagers lost their livelihoods and now struggle to feed their families. ‘I am very proud to be the chief. It's not easy. No one will take my land. I know my people in Bentum cannot farm anymore. But whatever you do for food is on you,’ says the chief.


"I struggle to earn a quarter of what I made before."

Credit: UBELONG/Nick Parisse

Christy Ansah, 32, walks with her youngest daughter besides the farm where she used to work in Bentum, a community plagued by poverty and child malnutrition. Two years ago, the village chief sold all the farming land in the community to a local company. ‘No one here can access their farms,’ she says. ‘I was able to feed my four children before, but there is no food anymore and no jobs in this village. I struggle to earn a quarter of what I made before.’


"I have no freedom and no future."

Credit: UBELONG/Jonathan Pemberthy

Dorothy, 17, stands at the counter of a grocery store with her youngest child, in Nyanyano. Dorothy was orphaned at age 14 and is now mother to two malnourished children from separate fathers. Though she rarely sees either man, Dorothy has been taken in by the family of her second child's father. Fathers in the fishing village of Nyanyano do not accept pregnancy without marriage and they abandon the mothers. Many unwed mothers face discrimination and are perceived by the community as prostitutes. Dorothy says she is trapped in a situation much like domestic slavery. She is unable to leave the household without permission and has no decision-making power over any aspect of her life. When she is outside, she fears physical abuse from men and verbal harassment from women. ‘I have no freedom and no future. I only get to meet people when I am sent on errands,’ she says. ‘My sister-in-law controls the food and money so I can only feed my children whenever she wants.’


"I have no power."

Credit: UBELONG/Joey Rosa

Nana Obeng Wiavo V, the chief of Nyanyano is a traditional leader. He is responsible for overseeing political and ethical issues revolving around the Nyanyano fishing community - a coastal area with multiple challenges, from child malnutrition to human trafficking. ‘Fishermen leave women pregnant and then they run away. Mothers are left to fend for themselves and support their children alone. My people are starving,’ says the chief. ‘Mothers are desperate - many sell their children to fishermen to get some cash and food. The government does nothing about it. So many people look to me for answers, but I am only one man. I wish I could help them, but I have no power.’


Health services lack the resources to tackle widespread malnutrition. The majority of malnourished children in Ghana never receive treatment. [UBELONG/Nick Parisse]


"Our effort is just a drop in the ocean."

Credit: UBELONG/Joey Rosa

Beatrice Amponfi, right, and Joy Glii, left, are in charge of the childcare and malnutrition unit at the Kasoa Clinic, the most important centre assisting malnourished children in the area. However, according to Beatrice's estimate, only 20 percent of malnourished children are taken to this clinic - mostly extreme malnutrition cases. A few community nurses cover a population of more than 30,000 people. ‘Women with malnourished children have problems that they cannot openly discuss with friends or family. There is a stigma associated with having a malnourished child. So we mostly identify malnutrition cases by talking to neighbours,’ they say. ‘Besides, mothers of malnourished children are lonely and they don't feel supported by their husbands. Our most important job is to provide a safe environment to counsel them about their children, so that they don't feel embarrassed about bringing them here. But our effort is just a drop in the ocean.’


"My baby went to sleep and did not wake up."

Credit: UBELONG/Nick Parisse"

Mary Essil, 27 sits at her home in the farming community of Bentum, holding a bottle of glucose that a nurse gave her at the clinic to combat the malnutrition symptoms of her newborn baby. She could not breastfeed her son, who was very small at birth. Following advice from the nearby clinic, she gave glucose to her baby. But he died six weeks later, at just two months old. ‘My baby went to sleep and did not wake up,’ she says. Local tradition mandates that when a baby dies of malnutrition, the baby is taken away. Mary and her husband were not allowed to attend their son's funeral.


"I am not happy."

Credit: UBELONG/Nick Parisse

Rachel Edifile, 18 works as a fishmonger. She struggles to provide food for her children. Her youngest child is underweight and malnourished, and she relies on help from her grandmother to pay for medical costs. Like many mothers in the area, she cannot send her older child to school. ‘I am not happy,’ she says. ‘I want to take better care of my children, send them to school and buy good food.’


Malnutrition impairs cognitive development in childhood and productivity in adult life. [UBELONG/David Taylor]


This project was organized and produced by UBELONG - a Washington, DC-based social venture - and sponsored by Newton Europe - a leading UK-based consulting company. It is an independent effort, self-funded, non-partisan and non-ideological, in the tradition of journalism in the public service.