Grace A., 1

Grace is the second-born twin and one of the youngest children in a family of seven siblings. She lives with her mother, a known epileptic, and her twin sister in a small one-roomed mud-walled house, while her older siblings stay with different relatives due to the family’s difficult circumstances. Her mother is unemployed and struggles to provide for the children with very limited support. According to her mother, Grace had been healthy until she suddenly developed repeated episodes of diarrhoea and vomiting. Initially, her mother hoped the illness would improve with home care, but by the second day Grace’s condition had worsened significantly. She became extremely weak, lethargic, and unable to feed well. She appeared dehydrated, restless, and exhausted from the continuous vomiting and diarrhoea. Her body became weak, she cried excessively, and looked visibly unwell and distressed, causing great concern to her mother. Fearing for her child’s life and unable to afford transport, Grace’s mother carried her on her back and walked for more than an hour to reach Siaya County Referral Hospital in search of urgent medical attention and treatment.

Grace was brought to the hospital exhibiting symptoms like vomiting,coughing and passing of loose stool. Investigations were done and she was found to be malnourished. These results warranted admission and she was admitted for a number of days for management. In the ward she was given IV X-pen . She was also given ORS to make up for the minerals and fluids lost and fed on nutrious food. Grace responded well to treatment and was discharged on orals and was advised to visit the hospital at a later date for review. The area CHP was also liased with to ensure Grace was brought for review.

One-year-old admitted for severe acute malnutrition (SAM) at Siaya County Referral Hospital has a generally positive, yet guarded, prognosis, with a likely recovery, though they face a high risk of prolonged hospitalization (often 2–3 weeks) or post-discharge mortality, particularly if severe complications. Grace received prompt treatment and is expected to make a full recovery, however follow up will still be done to ensure proper nutrition intake is followed.