Audio Blog: Interview with Dr. Kapere, Malnutrition Expert

Malnutrition expert Dr. Yona Kapere has met mothers in Uganda who have lost multiple children to starvation. As a senior manager for Compassion International’s Health Advisory team, Yona sees both the data and the devastating human stories of loss caused by the global food crisis—but he also sees hope.

26 Apr, 2023

The world is facing its worst hunger crisis in 70 years and children’s lives hang in the balance. From Yona’s professional perspective, it is mothers and young children who are most in need of help.

You can listen to the full interview with Yona below.

Could you introduce yourself and tell us about your role?

I'm Dr. Yona Kapere. I lead Compassion’s Health Advisory team as a senior manager. I’m located in Uganda, but I provide support for Compassion’s work in Africa, Asia and Latin America.

How is the global food crisis affecting Uganda?

Currently, even among the children who Compassion serves, foot shortages are increasing. There is an increase in the number of malnourished children, especially children under age 5. There's an increase in instances of disease resulting from malnutrition. And we've also witnessed an increase in the number of deaths from starvation, especially in the region of Karamoja.

Why are current food insecurity and hunger levels different to a year or two ago?

The global food crisis has happened at a time when Uganda is recovering from a two-year period of lockdown during COVID-19. People's wellbeing and income sources were affected because they couldn’t feed their families.

Secondly, we've experienced prolonged drought. We've experienced drought before, but it hasn’t been this severe and long. Because of the drought, there has been an increase in food prices. There's also an increase in inflation in our country, which has led to rises in the cost of living. This has mainly impacted the vulnerable and the poor who Compassion supports.

How does drought relate to the global food crisis?

In Uganda, for the second subsequent year, we've not had the usual amount of rain. So the yields for last year were poor. The yields for this year have been worse because of insufficient rain. We are actually expecting the situation to worsen because there is no increase in the production of food. And this has happened because of changes in climatic conditions that are beyond the control of the local farmer who depends on rain for their harvest.

Most people in Uganda depend on subsistence farming and the majority depend on rain. There is no irrigation. If there is irrigation, it's at a very, very small scale and cannot be afforded.

Can you give some examples of inflation and how food prices have changed in recent years?

Currently, inflation is at 10 per cent in Uganda. Matooke is a local food here and the price of a bunch of matooke used to sell for about 7,000 Ugandan shillings (A$2) a year ago. Now it goes for 30,000 shillings (A$12) and not many people can afford that. One kilogram of corn, another common food, used to be about 1,000 shillings (A$0.39) a year ago. It now costs about 4,000 shillings (A$1.6). This is the food that families living in poverty rely on to survive.

When you talk about a region like Karamoja in Uganda, can you describe what people do to survive during this food crisis?

I visited Karamoja about a month ago. In the community we visited, we saw evidence of fresh graves. They told us these people had died from starvation. We saw malnourished children in the community all around us.

We found some children just eating leaves and surviving on those. The situation was dire and they really need relief to survive. It was very difficult to talk about anything else without first providing food.

At one household we visited, a caregiver told us they'd lost three children in three months. The children were not registered in Compassion’s program. They had lost their children because of the lack of food and when there's a lack of food, there is increased illness. So these children fell sick and died. There was a lot of despair in that community—everyone was visibly hungry.

What is Compassion doing to address these needs?

The Disaster Relief fund helps to provide funding for food relief to those we serve. But we’re now looking at how we can extend this help to other families within the community beyond the children who are registered with Compassion.

When we give food relief only to Compassion assisted children, we actually endanger them. They become a target because they're the ones with food in a community where no-one has food. So Compassion has started using Disaster Relief funds to support other families.

And through our church partners, Compassion has also provided more sustainable measures to help prepare for the next rainy season to purchase seeds, farm equipment and fertilisers, enabling these families to start again. There are also discussions about networking with other organisations because we know that Compassion cannot handle it alone.

Why is it necessary to focus on disaster relief right now even though Compassion is a long-term development organisation?

That's true, we are a development organisation. But in this case, from my experience in Karamoja, it was difficult to talk about anything else to a starving person. The need was overwhelming to first save lives, then we can keep talking about development.

Why is malnutrition detrimental to children? What’s the long-term impact of malnutrition?

Malnutrition affects both physical and mental development. In developing countries, we’re experiencing a cycle of malnutrition, disease and poverty.

Without proper nutrition, a child will never be able to attain their developmental potential.

When a mother is malnourished, as is the case for many of the mothers who participate in Compassion’s program, she's likely to give birth to a low-birth-weight baby unless there is an intervention. And we provide that intervention through our program. Now, when that baby is born, the chances of falling sick are high because of their low birth weight. Their immunity is low and they're likely to get other conditions.

If a child doesn’t receive a supportive response to address the nutritional gap at that age, they'll grow up underweight and we’ll have more instances of children with stunted growth. This makes them more prone to sickness and disease well into their adolescent years. Of course, that affects their productivity in life. And unless that cycle is broken, we face ongoing malnutrition, disease and poverty and the cycle continues.

How is Compassion ensuring this cycle doesn't continue?

Our Mums and Babies program targets vulnerable mothers and their babies early on in life. We intentionally equip those mothers through education. This education includes information on nutrition, how to feed their baby and how to breastfeed their baby. We also provide food packages for mothers during pregnancy so they can be healthy as they carry their babies during pregnancy.

Then as the child grows, there is ongoing growth monitoring, continuous treatment, education and nutrition support provided. We help ensure families are aware of what to eat using locally available foods to prepare a balanced diet for their children. We see many of the children who go through the Child Sponsorship Program living healthy lives and growing up to attain their developmental potential.

Why is the global food crisis so urgent right now?

Well, currently there are some countries where we have an urgent food crisis—especially in the Horn of Africa. Ethiopia is one of them, as is Kenya, Uganda and Burkina Faso. And there are several reasons for that.

Ethiopia, Kenya and part of Uganda, for example, had locust invasions a couple of years ago that destroyed crops. That was followed by drought. In Burkina Faso, the drought was followed by insecurity. In Ethiopia, the drought was followed by war.

So some regions couldn’t plant food and their ongoing need for food relief and support to survive through the season, and plant for the next season, is critical.

What are we facing if the world does not respond to this food crisis?

Of course, the most affected would be the children, as we have seen in places like Karamoja. Without responding, malnutrition among vulnerable groups will increase. We are talking about mothers and children specifically, and that increases the burden of disease. So we shall see an increase in disease and the number of deaths if there is no intervention in these regions.

Where do you see hope during this crisis?

I've seen regions in Uganda where we are supplying seeds for caregivers to start planting food, including in places like Karamoja. When we visited, they were asking us for seeds to plant. They were asking for farm implements so they could plant food for next season. I think that's a sign of hope. They’re willing to do something to ensure that the same situation doesn't happen next season. We see war seizing some countries like Ethiopia where they recently signed a peace agreement. We are praying that works out.

People are starting to grow vegetable gardens around their households so they have vegetables that during the hard times, so they can eat a balanced diet.

We visited a home when I was in Karamoja. They had four children. The two older ones were 13 and 12. They were cared for by their grandmother because their mother had left. The two older children were already in the city working as maids, so they’d actually dropped out of school. The younger ones were living with the grandmother at home.

Thank God Compassion took up those children and registered the ones at home. I was actually attached myself and I sponsored one of the children in that family. So because of Compassion, those who are in the program can go attend school. They don't have to go the city to become maids to support their families because there is support that's coming through the church.

Why is Compassion the right organisation to be addressing the global food crisis?

Compassion works in partnership with local churches to register the most vulnerable in the community. And the food crisis is mainly affecting the most vulnerable in the community.

Compassion is the right ministry to reach out, because we are supporting those who are highly impacted by the food crisis—the children and the mothers.

We have a track record of doing what we promised to do and supporting these communities. Thank you for making a difference. I pray that the Lord will bless you abundantly.

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Words by Yona Kapere and interview by Rachel Lauer.