Convalescing from SAM: The pitfalls and possibilities of caring for vulnerable children in Harare's high-density neighbourhoods

Abstract

It is widely recognised that children recovering from Severe Acute Malnutrition (SAM), remain vulnerable to risk of death following hospital discharge due to a wide range of biological and social factors. In light of this heightened risk, we report here on a qualitative study which aimed to better understand the caring contexts that children recovering from SAM were recuperating in within the high density urban and suburban districts of Harare, Zimbabwe. Undertaken with the mothers and other primary caregivers of 10 children enrolled on a large observational cohort study (HOPE-SAM), this paper identifies several dimensions of the women's lives that impede their caring capabilities. Given the country's status as a global ‘hunger hotspot’ (FAO/WFP, 2022), it should not be surprising that food insecurity featured prominently amongst these. Beyond this, the paper highlights the women's uneven access to informal social protection, experiences that are reflective of what recent scholarship refers to as examples of ‘uncaring’ or ‘noncaring,’ as well as their responses to discourses of shame and stigma within the community and hospital settings. The paper concludes by considering what this means for understanding of, and responses to, the bodies encountered in the place of global health research and interventions.