An 18-year-old girl sits on a small bed at the Redemption Hospital in New Kru Town, looking down at her tiny son, Max, who is so skinny that his big eyes pop out of his face and he seems like an elderly man. “He just started getting dry, and dry. I do not know what is happening, that is why I brought him to the hospital,” Max’s mother explains.
The single mother says she feeds him rice, and does not understand how he became severely malnourished, as diagnosed by doctors. “This is my first child, I had him when I was 16 years old. Now I am 18 years old, and I am pregnant again.”
The medical directors at two emergency hospitals in Monrovia, James N. Davis and Redemption Hospital, are raising an alarm over the high rate of malnutrition and preventable injuries, such as burns, among children of teenage mothers.
Dr. Taban J. Dada at Redemption Hospital said most cases of severely malnourished children on his pediatric ward are those of teenage mothers, who do not feed their children enough food, or don’t understand the elements of a balanced diet.
“Many of them are having a lot of children before they’re adequately prepared. At the end of the day, they’re not able to take care of these children properly,” warns Dr. Dada.
A third of Liberian girls give birth to their first child before the age of 19, giving Liberia one of the highest rates of teenage pregnancy in the world, according to Ministry of Health statistics.
The government’s national nutritional policy, released in 2008, also reveals that Liberia has one of the highest malnutrition rates in the world, with chronic malnutrition affecting 39 percent of children under five years. The research shows that the major developmental disruption caused by malnutrition takes place in the womb and in the first two years of life. The resulting damage is irreversible brain damage and stunted growth.
“Their IQ will be reduced. They will not cope well in school. At the end of the day, we will produce a caliber of citizens that are not the top class we would expect in our society,” said Dr. Dada.
But teenage mothers are not villains who intentionally harm their children, explains Geoffrey Oyat, the Child Protection Program Manager for Save the Children.
“They do love their babies. They try to do their best for them. But within the context they’re operating in, they do not have the resources to independently look after their children.”
Oyat said the real problem is that teenage pregnancies are generally a mistake, and therefore the mother is not prepared for parenting.
He points to poverty in the family which prompts children to get into risky situations. “[The girls] are providing for themselves, exposing themselves, trying to sell in the streets and getting boyfriends.”
He also blames the lack of sex education, family planning, and peer pressure.
And while teenage pregnancy has many negative effects on the life of a young woman, the impact on the children that they bear is most visible on the pediatric ward of James N. Davis Memorial Hospital. Here, small children scream in pain at the slightest movement, with their bodies wrapped in bandages to stop infection of their burns.
“Most of the children that are burned are from hot water, fire or coal pots with charcoal in it,” Medical Director Dr. Torsou Y. Jallabah explains.
Jallabah says the hospital treats emergency burns on children who are mostly born by teenagers or adult mothers who leave their small children in the care of other children.
Dr. Jallabah admits that accidents happen, but insists that children are not mature enough to care for other children. He points to adult mothers who leave their homes to sell or attend to other businesses. “They most often leave the children by themselves or with young people…Most of the times when these children are brought here, the actual parents are not around.”
In a small room with rows of hospital beds and mosquito nets, a little four-year-old girl who has burns on almost her entire body, lies on a white sheet with bandages tied around her head, hands, legs and stomach. Her mother explains that she left her daughter, Salome, in the care of her 13-year old son. “They were playing with a rubber band, before I knew it, he pushed her in the pepper soup on the fire…I was inside the house. I just heard it and I came outside and started pouring the rain water on the girl.”
Salome was in unbearable pain. “She was trembling, all her skin starting peeling off her body.” Now, after two weeks of medical treatment, she is gradually recovering and even manages a smile.
The James N. Davis Memorial Hospital treated six serious burn cases in July, and ten in August. The children were between three and ten years of age. “It’s very, very, very painful,” says Dr. Jallabah, shaking his head. The doctor describes how children must be taken into the operating room and given an injection with anesthesia every day when their bandages are changed.
Back at Redemption Hospital, on the pediatric ward, small children with swollen bodies are being fed rice with greens, while some are given a protein-rich milk blend, called F-100. Like Max, the tiny patients have stunted growth, peeling skin, bony hands and feet, gaunt faces, and their ribs are showing.
A physician’s assistant flips through medical charts and explains that malnourished children have weak immune systems that make them vulnerable to malaria and pneumonia.
Max’s mother looks confused by the medical explanation. She dropped out of school in the eighth grade and has not been back. She has no money to go back to school, and can barely support Max. She’s pregnant again, from a different man, and will give birth to her second child in a few months. Before Max is discharged, she will be given a schedule to go to a nearby clinic where she can receive dry rations every week to provide Max the nutrients he needs to grow.
“Most of the mothers need to be taught the act of parenting,” advises Dr. Dada. He wants more community outreach projects that give pre-natal training to young mothers.