Malnutrition nearly separated them for good. Now twins Princess and Precious are looking forward to a healthy future.

Children suffering from malnutrition - Action Against Hunger

Princess and Precious with their grandmother, Sabina. Photo: Joan Nduta for Action Against Hunger, Tanzania.

Although twin sisters Princess and Precious Ferdinand were born only hours apart, their health was vastly different. Princess, the older twin, was born healthy and strong, whereas Precious was small and weak.

The girls live in the village of Chisayu, Tanzania, with their grandparents. When they were born, their mother experienced a long and difficult labour and was not able to breastfeed. Their grandmother, Sabina, would boil water with sugar and salt to feed the babies. Sometimes she added honey. “We paid more attention to Precious because she was weaker than Princess,” she says. The hospital staff advised Sabina to buy milk formula. Although the formula helped Precious gain strength, it was unaffordable for the family in the long term.

In Tanzania, where Action Against Hunger has been operating since 2015, undernutrition is a major public health issue. Eighty percent of the rural population relies on subsistence farming. However, sporadic rainfall, poor soil and inadequate farming equipment often mean meagre harvests and food shortages. As a result, many children suffer from malnutrition, which can lead to stunted growth, poor cognitive development and lower school achievement.

The twins’ mother began experiencing chest pains shortly after they were born, and her health never recovered. She died before her daughters reached their second birthday. Princess and Precious were left in Sabina’s care. “I have a big challenge,” says Sabina, who at 67 is a farmer who also looks after two of her other grandchildren. Between farming, childcare, and preparing daily meals of ugali (maize porridge) and vegetables, her time is stretched thin, and with little support, she must carry the twins with her when she goes to the farm or shops.

“This is a community that depends on women to do much,” says District Nutrition Officer Asiatu Mbwambo, who has observed a high number of grandmothers taking on the role of primary caregiver for their grandchildren in the villages. “They often don’t have time to prepare food for the children because of so many tasks.”

Despite Sabina’s efforts, Precious grew weaker and began losing weight. A community health worker visited Sabina’s home and advised her to take the little girl to the hospital. Following the community health worker’s advice, Sabina caught the first bus to Mpwapwa with the twins. “I also had to carry Princess with me as leaving her behind wasn’t an option. You see, they are twins, and they love each other so much that I couldn’t separate them.”

After four days in hospital, Precious’s appetite returned and she was strong enough to be released. Sabina received guidance from the hospital staff on how to keep her healthy. “I noticed there is an order of how things are done,” she says. “We were shown how to ensure cleanliness of feeding utensils, washing hands before feeding the children as well as information on foods that will make the children strong.”

Now that Sabina knows that Precious is out of danger and is equipped with the knowledge to keep her healthy, her vision has shifted toward the future. “My biggest desire for my grandchildren is education, All other matters will follow, but this is the most important. May God give me strength to support them till they reach their dreams,” she says.

In Tanzania, Action Against Hunger has supported and expanded malnutrition treatment services at nearly 60 health centres. In 2019, our teams trained 200 community health workers and nearly 1700 parents and caregivers to identify malnutrition at home. Action Against Hunger also works with communities to improve nutrition and health outcomes through gardening and cooking demonstrations and hygiene awareness.


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