Janet’s mission to fight malnutrition in her community

Janet Mwendo, 60, a community health worker living in Tanzania’s Singida region, has been nicknamed “the street doctor” because of her commitment to her community. For four years, she has gone from home to home in her village and neigboring ones, checking on children’s health and nutrition and teaching caregivers how to keep their children healthy.

In Tanzania, 14% of children under five are underweight and 34% are chronically malnourished. As more mothers and other caregivers learn about health and nutrition for themselves and their children, hunger decreases – and that’s where Janet comes in.

Janet is one of 290 community health workers trained by Action Against Hunger in Singida. Two days a week, she visits homes and meets with different people in her community, including children suffering from malnutrition, pregnant women, and breastfeeding mothers. She works across 14 wards, each with about five villages in them. She spends the rest of the week at Kiomboi Hospital, where Action Against Hunger supports a Therapeutic Feeding Unit (TFU), helping patients she identified and referred for care.

For her home visit days, Janet pairs her Action Against Hunger t-shirt with a bright and colorful maxi skirt, a sweater, and her handbag. Inside her handbag – and her well-trained mind – is everything she needs to share what she knows. She carries a MUAC (mid-upper arm circumference) band that is used to detect malnutrition in children and pregnant women, pen, registration book, health manual, and education guide.

Janet’s goal is to raise awareness about nutrition and healthy feeding practices and to explain the health consequences that can result from poor diets. With her training, she can offer education and solutions for the challenges her neighbors face.

Changing Her Community

Years ago, Janet wasn’t certain if she was doing great work in her community. Then, she started working as a community HIV champion and her contributions were recognized. When Action Against Hunger began training health workers, Joyce, a nurse at Kiomboi Hospital, remembered Janet’s work and put her name forward as a candidate. Janet credits Joyce as ‘that one person who mentioned her name in a room of opportunity’ and has been working as a Community Health Worker ever since.

“Nothing feels as good and satisfying as seeing the children who were once very weak due to malnutrition now playing outside their houses, full of smiles.

It makes me happy to see them with smiles again as some of them ran in my direction and hugged me whenever I come on follow-up visits.” – Janet

During her visits, Janet shares knowledge on health-related matters with the goal of improving eating habits for children, pregnant women, and breastfeeding mothers. She teaches parents about healthy food and the diverse diets needed to support the growth of their children and to prevent malnutrition. Janet also provides advice to pregnant women, telling them to go to maternal health clinics as soon as they know they are with child and offering guidance on the best foods for pregnant women and breastfeeding mothers to eat.

In the beginning, it was not easy for Janet to convince parents that malnutrition is treatable. Some parents denied her access to their children because they didn’t believe in her approach or her teachings. Things are changing now: very few people deny Janet’s mission and dedication to her community.

“Educating my community through house-to-house visits came along with lots of people coming to the hospital for proper medical treatment, unlike how it was earlier. The majority took their children to traditional healers, thinking they were bewitched,” says Janet.

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Toby Madden

Action Against Hunger, Tanzania

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Rehema Hamis is one of the minds Janet helped to change. When her granddaughter, Eliciana, fell ill, she thought she was bewitched. Janet visited and insisted that it was not magic, but malnutrition.

“I was not aware that it was malnutrition. I was among those who believed that witchcraft was connected to Eliciana’s disease. Janet educated me, and I followed hospital instructions on how to feed her. I looked up to Jesus Christ. A few weeks later, Eliciana was back to normal,” Rehema says.

Rehema now champions Janet’s work among her doubters by telling them that malnutrition is curable. At age seven, Eliciana weighed just over 6.5 pounds before she started treatment. In the United States, according to the CDC, the average seven-year-old girl weighs between 40-65 pounds. Now, months of treatment and healthy eating later, Eliciana weighs five times more, about 33 pounds.

A Day in Janet’s Life

To strike a balance between her community work and other work to earn income, Janet’s day starts at 5:30 am. Apart from being a community health worker, she is also an entrepreneur who sells household items like charcoal, salt, and soap.

Before Janet leaves her house for her daily activities, she walks to her small kiosk and packs charcoal and soap into small packages for people to buy at $0.35 per package. She cleans the kiosk, then goes back home to prepare her breakfast and clean her house.

Some mornings, her daughters do the work at home, which makes Janet’s life easier. On those days, she just has to bathe, pack her books, and set off to the communities for her visits. Her grandchild helps her with sales at her kiosk.

Since Janet does home visits twice a week, she is very familiar with which houses have children, pregnant women, and breastfeeding mothers. She is always walking to the villages, and the farthest village she cares for, Luluma, is about an hour and a half walk. She is well known, and it is easy for her to access many families.

On this day, she begins at Elilumba Albert’s house, which is just down the street from Janet’s home. Janet started visiting Elilumba in 2019 when she was pregnant for the first time. Now 20 years old, Janet has just given birth to her second child, a baby boy.

Elilumba credits Janet with teaching her the proper foods to eat during pregnancy and when breastfeeding, as well as the importance of visiting a health clinic as soon as she knows she’s pregnant.

“She is now like my own mother. She taught me the proper clothes for the infant while they sleep, depending on the weather. She told me to exclusively breastfeed my child until he reaches six months. She insisted on no other food until the baby turns six months,” says Elilumba.

Elilumba focuses on gaining knowledge about healthy hygiene practices – such as washing her hands before breastfeeding – and eats a balanced diet to ensure a healthy life for herself and her children. She calls for more awareness among other women in her community.

Helping Families Find Hope Again

Katarina Mkumbo, who lives in a village about 30 minutes from Janet’s, also knows Janet well. Her grandson Michael was born healthy, but then his mother died, and his health declined. When Janet visited Katarina and Michael, she found that he was malnourished. She advised Katarine to take Michael to Kiomboi Hospital, where Action Against Hunger runs a nutrition treatment center, instead of the village hospital.

“Despite it being on Sunday, she came with us. We spent almost the entire day at the hospital. We waited for the doctor, and we were admitted on the same day,” says Katarina.
Michael was severely malnourished. At first, he was treated intravenously in a special room where he received more attention and care.

“We stayed there for more than two months, and apart from medicine, we were also given special food for malnourished people,” says Katarina.  After two months of treatment, Michael recovered and was discharged from the hospital. The doctor insisted that Michael visit the hospital every week for more treatment to ensure that he fully recovered.

“Janet is a good person. May God give her more energy to continue with her community work. I had lost hope with Michael. Without Janet’s support, I doubt we would be able to have Michael today.”

– Katarina

“We call her our street doctor,” says Mwajuma Kilunga, who has known Janet for years. They became friends when Janet started visiting her to check on her grandchild, who was malnourished and HIV positive. Through Janet’s teachings, her grandchild is in treatment and doing well.

Walking miles a day is a challenge for Janet, but she is happy to do it because it is worth it. And there is still work to be done: some families are still going to traditional healers, and children are dying. Janet wants more training for Community Health Workers to learn new skills to convince community members who are still hesitant to receive professional medical care.

Janet has seen over the years how being kind and loving is the best way to deal with patients and her neighbors. With love comes trust, and when people trust Janet and her teachings, everyone sees the benefits. Someday, Janet dreams of a future where her whole community is free from malnutrition.