Ladda is a survivor. She didn’t experience war or natural disasters. She was not forced to move from her hometown. She was not infected with COVID-19. Yet she survived another scourge. A more silent, unfortunately more ordinary killer operating all over the world. Aged fourteen months, Ladda was 61cm tall and weighed just 3.8kg. This made her significantly thinner than other children with the right height for age.
If we didn’t do anything at that time, she would have died.
says Lammone, a health professional at the Atsaphone district health office, in Savannakhet province, Lao PDR.
Despite all the progress witnessed over the past decade, Laos still sees a high number of its children malnourished. In 2017, at least 10% of children under five years old were suffering from acute malnutrition in the three southern provinces of Attapeu, Saravane, and Savannakhet. During the same year, World Vision was granted the Accelerating Healthy Agriculture and Nutrition (AHAN) Project by the European Union, to improve the nutrition of vulnerable communities in those three provinces.
In August 2020 during their quarterly visit supported by the AHAN project, the health professional of the outreach clinic found Ladda exhausted, feverish, and irritable. Her mid-upper arm circumference (MUAC) measurement indicated a severe case of malnutrition. The little girl never had the chance to know her biological parents, who divorced before she was born. After delivery, her mother left the newborn with her sister - Ladda’s aunt - Khampheng. Aunt Khampheng and her husband became Ladda’s foster parents and have been a loving and caring family who consider the baby as their own child.
However, the absence of her mother’s breastmilk added to common poor feeding practices and insufficient access to diversified food in rural communities of Atsaphone district, resulted in Ladda becoming severely acutely malnourished with complications. A situation requiring immediate hospital management and treatment.
The AHAN Project directly supported Ladda’s journey to recovery. The project staff drove her to the district hospital and monitored her status with health workers. After two days with slow improvement, Ladda was referred to Savannakhet Provincial hospital - a bigger health facility with specialist care. Being put on therapeutic nutrition foods and having her medical complications treated, Ladda steadily recovered as her weight increased by 2kg.
While Ladda was recovering at the hospital, health workers of her community attended the Integrated Management of Acute Malnutrition (IMAM) training organised by the AHAN Project as part of its health system strengthening component. She then became a case study for Lammone, the health professional who first identified her condition. The new graduate from the IMAM training saw much more than a case study in Ladda: she viewed her as a symbol of hope and resistance against malnutrition for her community. To support the infant’s long-term recovery, AHAN invited Khampheng (Ladda’s aunt) to participate in the Mothers’ Nutrition group activity.
Alongside pregnant women and young mothers of the village, the 41-year-old woman discovered what good nutrition means for the health of Ladda and how to cook nutritious food that will support her growth. Khampheng is thankful for the support of the project to help Ladda to be healthier:
I will raise her to become a strong child and have a good future ahead, and use the knowledge I learnt from the activities.
The brave little girl already loves the rich rice porridge with ivy gourd and water spinach that her adoptive mother cooks. In addition to the 1,000L water tank, water kettle and energy-saving cook stove provided by World Vision, Khampheng and her husband will soon receive training and materials to practice home gardening, allowing the rice cultivators to diversify their access to nutritious food.
Since the IMAM training, Lammone feels less and less anxious monitoring the growth of Ladda. The MUAC measurement tool only shows green value every time she visits the little girl’s village. It’s already been few months since Ladda didn’t need the peanut flavored ready-to-use therapeutic food (RUTF) to treat severe malnutrition. Now 27 months old, she is 74.2cm tall and weighs 7.9kg. Ladda thrives and shows signs of normal growth: now able to walk, she likes to play with her neighbors. The little girl can now start enjoying a new life, with loving and supportive parents.
Like Ladda, over 6,300 Lao children under five years old and their family are benefitting from the AHAN Project’s intervention, and can dream about a brighter future, free from malnutrition.
 Approximately 3.1 million children die from undernutrition each year (UNICEF, 2018)
 According to the Lao Social Indicator Survey II 2017 – % of CU5 suffering from acute malnutrition (wasting):
Savannakhet: 10%, Saravane: 13%, Attapeu: 15%