“Nutrition is the choice weapon against Covid-19”

These are the words of Nancy Waitherero, Muranga County’s Nutrition Officer. She estimates that nutrition makes up as much 70 per cent of the weaponry against Covid-19, whether for defending the body against it or ridding it of the virus once it is infected. “Nutrition is key in preventative and curative strategies against Covid-19 because it boosts immunity. What do people think happens at our Covid-19 treatment centres? The major activity at the Isolation Centres is nutritional therapy,” she says.

Even in the early stages of the novel Corona virus, the government’s message was moulded around taking a balanced diet. Such a diet must consist of vegetables, fruits and adequate meals throughout the day. Says Nancy:

“The most vulnerable people to Covid-19 are those whose immunities have been compromised by predisposing factors. They include children below age 5, pregnant and lactating mothers, elderly people above 60 years old, and those with chronic illnesses such as diabetes, hypertension, TB and the like.”

Nancy explains that Muranga has the “Triple Burden of Nutrition.” This consists of: i) under-nutrition in children ii) over-nutrition in adults (overweight and obesity) and iii) micro-nutrients deficiency. The Kenya Demographic and Health Survey (2014) indicates that stunting (malnutrition) is found in 2 out of every 10 children, wasting (hunger) in 4.6 per cent and underweight in 6 per cent of all children in Muranga.

These are statuses that would make the children predisposed to getting infected with Covid-19.

Once Coronavirus was confirmed as inevitable in the county, they took steps to build lines of defence. The strategies, according to Nancy, involve:

1. Mapping out the population to identify those in need of nutritional support. Once identified, they were registered. They were identified as those unemployed due to job losses, matatu operators, child-headed households, single-parent households and bartenders.
2. Setting aside money to feed them: They found that out of 30,000 households, 10 per cent are affected. The county response team estimated that sh 10m would be needed to purchase a food basket for every household. A basket contains maize flour, rice, beans, green grams, powdered milk, long-life milk and wheat flour. They also share guidelines and materials that tell people how be safe from malnutrition. This far, they have already spent twice as much as they budgeted for – about sh 20m.
3. The county government also established food security monitoring and mitigation system.
4. Lastly they launched mass media education which remains ongoing.

A challenge exists when it comes to consistently accessing nutritionally-balanced meals. First, because the supply chain has been hugely interrupted by the Corona virus and the steps put in place by the government to combat it. Second, because no single county produces all the food it needs. They have to ‘import’ from across the country.

Nancy acknowledges that Muranga, though enjoying diversity in its food production, still has to depend on trade to access some of the vital nutrition its people need. Nancy explains: “We grow coffee and tea for the most part. Actually these two crops occupy about 90 per cent of everyone’s piece of land. They leave just enough room for a house. Where there are no cash crops, they grow fruits, vegetables and produce milk.”

Though a fertile area with plenty of agricultural activity, the people of Muranga still have to predominantly import a lot of their maize and wheat. Bananas, vegetables and fruits are plentiful, Nancy underlines. “The question is not whether food is available in the market; it is whether they can afford.”

That is the reason why the county government came up with the Food Basket concept. It has, hopefully, helped most families have the quality and quantity of diet they need to keep Covid-19 at bay.

Whether it is because of the nutritional food the county government has tried so hard to have its people access or some other thing, Muranga has experienced few incidents of the Corona virus. “We haven’t had critically ill patients,” says Nancy. “Most are asymptomatic with only one person in the hospital.”

As with most other parts of Kenya, officials like Nancy initially faced a very sceptical public. “There were mixed reactions at first, with some believing Corona was no more than common cold which they would get but be rid of after a while. Perspectives slowly shifted when bodies we began to receive bodies from Nairobi. People took Covid-19 seriously then.”

Then the people began to seek information from government officials about Covid-19. Nancy says they launched house-to-house campaigns to talk to people. “In this way, we covered around 90 per cent of households,” she says. That is an impressive amount of work.

But there was another side which initially presented a challenge: stigma. As with most other Kenyans the people of Muranga interpreted government actions in unintended ways. “A body was brought here from Nairobi. Those who brought it were gowned from head to toe. When they brought it the family refused to receive it. They said they didn’t have gowns with which to protect themselves. As a result, the body lay abandoned on the road for several hours until the government intervened and talked with them.”

The novelty of the Corona virus had other confusions as well. For instance the well-intentioned government move to keep people at home and minimise movement resulted in pregnant and lactating mothers avoiding public health facilities. Nancy concedes that that was actually their intention – to stop people from crowding at the health facilities. And as with a number of government directives and ideas about Covid-19, this had to be reversed. In all that lessons were learnt and Nancy enumerates them as:

1. Team work: “It’s vital to work as a team. We were overwhelmed. We needed support from everyone including the community members.”
2. Small things matter: “There are things we overlook such as hand washing. Just by engaging in it, we have rolled other communicable disease such as diarrhoea and coughs, among many others.
3. Being proactive: “Public health interventions that are preventative rather than curative in nature matter. We don’t have to wait. We need to give information that emphasises prevention.”
4. Impact of unrelated events: “How we handled dead bodies impacted how the communities viewed Covid-19. It affected them and drove stigma. The question we must keep asking is, how does what you do affect everybody else?”

Nancy Waitherero then insists on giving a parting shot and it’s an important one: “Nutrition plays a huge role in prevention of infections and disease, whether they’re chronic or not. People should pay attention to what they eat. ICU equipment cost lots of money. Yet food that would prevent you going there is so much more affordable. Food is the therapy, so important that some people have to get in a capsule form as supplements. Covid-19 patients were not getting anything sophisticated, just food.”

This article is part of a series complementing the DigiRedio Social and Behaviour Change Platform powered by the Centre For Behaviour Change and Communication. The two-way COVID-19 risk communication and community engagement through radio aims to help create and sustain preventive behaviours and complement control measures against COVID-19 in Kenya. This project is implemented in 33 radio stations in 30 Counties through the Ministry of Health with support from the American People through the USAID.